The discrepancy between the expected and actual numbers of women in leadership positions in business and government is well known. Currently, leadership within obstetrics and gynecology remains dominated by men despite changing demographics within medical school graduate populations. This study was performed to determine whether the proportion of leadership positions in obstetrics and gynecology that are held by women reflects the proportion of women who entered the field at the same time as current leaders.
This study considered as leaders department chairs at academic institutions, editors of 20 obstetrics and gynecology journals with the highest effect factors, and presidents of influential professional societies. The name and sex of the leadership individuals and their year of graduation were obtained from publicly available or medical school databases. The proportion of leadership positions that would be expected to be occupied by women based only on sex distribution was determined from information on graduates entering obstetrics and gynecology residency from 1977 through 1984. Actual proportions of leadership positions held by women were calculated for each leadership category and total leadership positions and compared with expected proportions of leadership positions held by women based on the sex distribution of the mean year of graduation among leaders.
The sex of the current leader was determined for 194 of the total 196 leadership positions. Of these 194 leaders, 12 were Canadian, all chairs at Canadian academic hospitals, and 8 were European or Australian, all journal editors. Eight leaders were nonphysicians, with 7 having doctorates, and 1 was a nonphysician. The mean year of graduation for current leaders in obstetrics and gynecology was 1980, at which time 333 of 904 residents (36.8%) entering obstetrics and gynecology residency were women. Based on this, women should hold 71 of the 194 leadership positions, but they actually hold only 41 (21.1%; P < 0.001). Of the 155 active chair positions, 31 are held by women (compared with an expected 57; P ≤ 0.001). Several journals divide editorial responsibilities, for a total of 25 editors, among whom 3 are women (compared with expected 9; P = 0.01). Of the 14 professional societies evaluated, 7 are led by women (compared with expected 5; P = 0.31). Of 74 leaders (38.1%) who entered residency from 1977 through 1984, women should hold 28 of the 74 leadership positions based on 38.3% of entering residents who were women. Women actually hold 20 of these positions (27.0%; P = 0.05).
These results show that the actual proportion of women holding leadership positions in obstetrics and gynecology is significantly less than what should be expected. The reasons behind this discrepancy are likely multifactorial and could include sex discrimination, research grant funding lacking for women, leading to fewer publications by women, and women removing themselves from consideration for leadership positions because of the personal sacrifices often required. Programs of career development must be designed to rectify this leadership disparity.
Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA