The number of women in medical school now equals that of men and women outnumber men in graduate science programs. While our presence in leadership positions is now more visible than in the past three decades, it is still limited, and often accompanied by different rules. According to a 2020 AAMC report:

  • Only 18% of department chairs and medical school deans are women.
  • Underrepresented in Medicine (URiM) women of color comprise just under 3% of department chairs.
  • While women have made gains at the level of assistant, associate, and senior associate/vice dean, they are most likely to serve in roles related to diversity, faculty, and student affairs and are less represented in clinical affairs and research.
  • Just 7% of medical journals are edited by women.
  • Women comprise 18% of hospital CEOs, and just 3% of healthcare CEOs overall—even though 4 out of 5 healthcare workers are women.

At one time, experts expected that if the pipeline of women entering the field grew, the numbers of women leaders would naturally follow. That hasn’t happened.

There are several reasons why:

Sponsors and mentors for women are limited. Whether you’re just starting your career or have, against the odds, gained a leadership role, it’s hard to find someone in your field who can help you navigate challenges unique to women.

Networks exclude women. When opportunities become available, especially nationally, they’re spread via word of mouth. The people at the top are vouching for the individuals they’ve trained and worked most closely with—and those individuals are, most likely, other men.

Institutional policies work against us. Women start families at a time when academics are traditionally expected to be at their most productive. Leave policies, even when they exist, are not taken or often are not conducive to remaining on the career trajectory. On top of this, women who take leave can be penalized during review for tenure owing to unconscious gender bias.

The reward system is not transparent—leading to inequities in pay and advancement opportunities.

Harassment is part of the landscape. Major efforts are addressing gender bias and harassment, significant issues that hamstring our growth. This work is absolutely necessary, and we applaud it, support it, and now add our effort.

But our approach is different:

We are changing the culture that has entrenched this system in the first place. We believe the numbers are critical: When the numbers of women in senior ranks in our academic medical and scientific environments reach a tipping point, the science indicates that the environment that has held women back, or pushed us out of academic science and medicine entirely, will begin to change. And the women who follow us will be part of an academic environment where they can thrive and realize their goals.

Rather than seeking to change any one individual, we connect women to the resources and information they need and are unlikely to find organically so that our faculty, students, and patients of today and tomorrow can benefit from all the talent that is available to tackle the pressing problems of health and science.

Hidden Learning, from the Chrysalis project.

The University of St Andrews’ Chrysalis project brought together women scientists at all stages of their careers to talk about issues and to seek advice and inspiration. Hidden learning explores what women feel they must keep hidden in their work environment.

Original painting by Sophie McKay Knight, with imagery contributed by women scientists from the University of St Andrews.
Courtesy of Wellcome