Women in Leadership: Why So Few and What to Do About It

The numbers of women in medical school and in medical training have increased dramatically and are near 50% overall, but the number of women who advance to senior and leadership positions is not nearly this high. There are many reasons why the number of women in leadership roles in academic medicine has not kept pace with the number of women entering the field of medicine. Two popular themes are the glass ceiling (referring to an invisible barrier to advancement) and the leaky pipeline (the loss of women faculty along the path, or pipeline, to advancement). I believe that both come into play. Glass ceiling issues tend to be of two types: those related to the institutional culture and those related to problems of bias, especially unconscious bias. Leaky pipeline issues include the challenges of work-life integration and the need for leadership development for women. There are solutions to all of these challenges. These include improving institutional culture; making sure women advance as quickly as men and are paid equitably; ensuring that there are resources to help with work-life balance, related not only to family but to all aspects of life; and providing adequate mentoring and leadership training. These measures will help all faculty, as factors that hamper women's advancement may hamper men as well. Although these themes are broadly applicable, there are strategies that can address them all. We just need to be aware, and be proactive, and we will succeed in breaking the glass ceiling and patching the leaky pipeline.