Persistent Gaps in Leadership Attainment, Promotion and Salary Among Women Academic Emergency Physicians

Despite consistent increases in women matriculating in medical schools disparities continue to exist in leadership positions and opportunities for advancement for women and for racial and ethnic groups that are underrepresented in medicine (URiM). A new study from BUSM highlights this gap in academic emergency medicine.

“Women are significantly more likely to have no leadership role or an education role. Furthermore, these disparities start within the first 10 years of the career and persist over time,” explains corresponding author Judith Linden, MD, professor of emergency medicine.

Using data from the Academy of Administrators/Association of Academic Chairs of Emergency Medicine- Benchmark Survey, the researchers performed a cross-sectional observational study focused on gender/URiM differences in leadership roles and academic rank. Secondary analysis focused on disparities during the first 10 years of practice. Statistical analysis was then conducted to address the primary aim of assessing differences in gender/URiM representation in EM leadership roles/rank over time (2015 to 2020).

They found women and URiM were less likely to be promoted to professor. Additionally, women (but not URiM) were less likely to be in leadership roles (34.8 percent of women and 43.1 percent of men were in leadership roles in 2020, compared to 44.8 percent of women and 54.3 percent of men in 2015). Women were more likely to hold educational roles than men (residency program director, student clerkship director), compared to operational and administrative roles. Educational roles are less likely to be valued in promotion and leadership opportunities.

According to the researchers, while disparities in leadership in medicine with respect to gender are well documented, two key drivers of persistent inequities for women were identified: 1) gender disparities in leadership attainment among early career faculty (within their first 10 years of practice), and 2) differences in leadership roles held by men and women EM faculty.

The researchers believe that since differences in leadership and promotion opportunities begin in early career, supporting women during this stage (for instance with family friendly policies, increased mentorship/sponsorship), will lead to increase retention and promotion. “Increased diversity in leadership and promotion in academic medicine is good for patient care, bringing different perspectives and strengths,” says Linden, who also is the Executive Vice Chair of Emergency Medicine and an attending emergency physician at Boston Medical Center.

The researchers believe additional research, effort and resources are needed to identify and implement effective strategies early in the careers of underrepresented faculty to mitigate these persistent barriers to the retention and advancement of women and URiMs in academic emergency medicine.

These findings appear online in the American Journal of Emergency Medicine.