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Geographic Comparison of Women in Academic Obstetrics and Gynecology Department-Based Leadership Roles

Ricciotti, Hope, A., MD; Dodge, Laura, E., ScD, MPH; Aluko, Ashley, MD; Hofler, Lisa, G., MD, MBA; Hacker, Michele, R., ScD, MSPH

doi: 10.1097/AOG.0000000000002265
Contents: Original Research

OBJECTIVE: To describe and compare geographic representation of women in obstetrics and gynecology department-based leadership roles across American Congress of Obstetricians and Gynecologists (ACOG) districts and U.S. Census Bureau regions while accounting for the proportion of women practicing in each area.

METHODS: We conducted a cross-sectional observational study. To more meaningfully quantify representation of women as leaders in ACOG districts and U.S. Census Bureau regions, we calculated representation ratios—the proportion of department-based leaders who were women divided by the proportion of obstetrician–gynecologists who were women. A ratio of 1.0 indicates proportionate representation and less than 1.0 indicates underrepresentation. We calculated 95% CIs to compare representation of women in leadership roles across geographic areas. The gender of major department-based leaders (chair, vice chair, division director) and educational leaders (fellowship, residency, associate residency, medical student clerkship director) was determined from websites.

RESULTS: The proportion of department chairs who were women was highest in the West and lowest in the South Census Bureau regions. Representation ratios for women in major department-based leadership roles demonstrated underrepresentation relative to the practicing base nationally and in all four regions. Although women were underrepresented in major department-based leadership throughout the country, there was significantly higher women's representation in major department-based leadership roles in the West (ratio 0.82, 95% CI 0.68–0.99) compared with the Northeast (ratio 0.50, 95% CI 0.42–0.59) and the South (ratio 0.45, 95% CI 0.36–0.57). Similarly, in the division director role, the West (ratio 0.85, 95% CI 0.68–1.1) had significantly higher representation of women compared with the Northeast (ratio 0.50, 95% CI 0.40–0.62). Nationally, women were underrepresented as fellowship directors, proportionately represented as residency program directors, and overrepresented as medical student clerkship directors.

CONCLUSION: Representation ratios of women in major department-based leadership roles, which account for the proportion of women practicing in each geographic area, suggest that women were more likely to advance to the department-based leadership roles of chair, vice chair, or division director in the western United States.

Women are more likely to advance to obstetrics and gynecology department-based leadership roles of chair, vice chair, and division director in the West.

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and the Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, New Mexico.

Corresponding author: Hope A. Ricciotti, MD, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Kirstein 3, Department of Obstetrics and Gynecology, Boston, MA 02215; email: hricciot@bidmc.harvard.edu.

This work was conducted with financial support for study design, data analysis, and data interpretation from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award 1UL1 TR001102-01) and financial contributions from Harvard University and its affiliated academic health care centers.

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented as a poster at the American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting, May 2–6, 2015, San Francisco, California.

The authors thank Danielle Duffy from Beth Israel Deaconess Medical Center Media Services and Joseph Connelly from Colby College for their assistance with figure preparation.

Each author has indicated that she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.