Women representation in dermatology residency program leadership: A cross-sectional study : International Journal of Women's Dermatology

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Women representation in dermatology residency program leadership: A cross-sectional study

Abushukur, Yasmine BS; Oska, Sandra MD; Nartker, Nathan MD; Fahs, Fatima MD; Potts, Geoffrey MD

Author Information
International Journal of Women’s Dermatology: October 2022 - Volume 8 - Issue 3 - p e045
doi: 10.1097/JW9.0000000000000045
  • Open

What is known about this subject in regard to women and their families?

Since the mid 1990s, women have made up a majority of dermatology trainees and the dermatology workforce. Despite this, women have been historically underrepresented in academic dermatology as chairmen, dermatology residency program directors, and dermatology fellowship program directors. Several reasons for this inequality have been proposed including child bearing, home/familial responsibilities, lack of proper mentorship, implicit bias, and unequal compensation for a given position. Our study aimed to determine whether this inequality has persisted as of 2021, or if any improvements have been made in the academic dermatology leadership gender gap.

What is new from this article as messages for women and their families?

This article identifies a persistent gender gap academic dermatology leadership, particularly as it pertains to dermatology department chairmen, and dermatologic pathology and surgery program directors. It further highlights a potential form of the glass-ceiling phenomenon in dermatologic leadership attainment. Given that women represent a majority of program directors, assistant program directors, and associate program directors, but a minority of chairmen, our article poses the question of potential disparities in financial compensation or time commitments that may contribute to the persisting gender gap in academic dermatology leadership.

Dear Editors,

Women in dermatology training programs now outnumber men.1 Despite making up the majority of trainees, a gender gap persists within dermatology faculty and leadership positions.1 For instance, in 2016, women were underrepresented as academic dermatology chairs, dermatology program directors (PDs), dermatologic surgery PDs, and dermatopathology PDs.1,2 The goal of our study was to reevaluate the state of the disparity within academic dermatology leadership to determine if any increases have been made given the increased scrutiny to expand gender diversity in medicine and dermatology.

To evaluate representation of women in leadership positions, we conducted a cross-sectional observational study in August 2021 of dermatology departments accredited by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME and official department websites were used to identify accredited dermatology residency programs (n = 142), dermatopathology fellowships (n = 58), and micrographic surgery and dermatologic oncology fellowships (n = 74). Data were obtained from the American Board of Dermatology website to identify pediatric dermatology fellowship leadership (n = 38). The gender expression of dermatologic leaders was obtained through official department websites and department coordinators.

Our results demonstrate that women make up 53.5% (76/142) of dermatology residency PDs, 62.6% (42/67) of associate PDs, and 58.3% (14/24) of assistant PDs. Notably, women are least represented as program chairs, making up 39.0% (48/123) of chairs. Within fellowship program leadership, women make up 41.4% (24/58), 26.0% (19/73), and 76.3% (29/38) of PDs in dermatopathology, micrographic surgery, and pediatric dermatology, respectively (Fig. 1).

F1
Fig. 1.:
ACGME leadership stratified by gender. ACGME, Accreditation Council for Graduate Medical Education.

Previous research shows that in 2016, women made up 48% of PDs, 23% of chairs, 26% of dermatologic surgery PDs, 34% of dermatopathology PDs, and 64% of pediatric dermatology PDs.1,2 Comparatively, our study demonstrates no change in female representation for dermatologic surgery PDs, but showed an increase in all other leadership positions described. Despite this increase, women remain underrepresented, particularly in leadership of dermatopathology and dermatologic surgery fellowships. This disparity is reflective of the general trend in surgery and pathology leadership nationally.3,4 Furthermore, utilizing data from 2012 to 2014, Qiu et al.5 showed that diversity in academic dermatology faculty decreases significantly with increasing faculty rank. Our data mirror this sentiment by demonstrating a majority of women in assistant and associate PD positions, with a minority of women chairs. This may highlight additional mentorship required for women dermatologists early in careers juggling home-life and work-life responsibilities. Further investigation is necessary to determine the implications of this disparity with regards to financial compensation, burnout rates, and time commitments required for differing levels of leadership.

Limitations of this study include its cross-sectional nature and the inability to identify individuals with varying forms of gender expression using department websites. Despite these limitations, our study demonstrates an overall increase in women’s representation within academic dermatology leadership, while identifying a persisting disparity within dermatologic pathology, surgery, and chairman positions. While our study focuses on US residency program leadership, further studies are needed to determine whether this trend mirrors international trends in dermatologic leadership. Overall, this study highlights the advancements made in gender diversity within academic dermatology from 2016 to 2021.

Author contributions

YA: Participated in research design, writing, and data analysis. SO: Participated in research design, writing, and data analysis. NN: Participated in research design, writing, and data analysis. FF: Participated in writing and data analysis. GP: Participated in research design, writing, and data analysis

Conflicts of interest

None.

Funding

None.

Study approval

N/A.

REFERENCES

1. Nambudiri VE, Shi CR, Vleugels RA, et al. Academic dermatology leadership in the United States -- addressing the gender gap. Int J Womens Dermatol 2018;4:236–7.
2. Shi CR, Olbricht S, Vleugels RA, et al. Sex and leadership in academic dermatology: a nationwide survey. J Am Acad Dermatol 2017;77:782–4.
3. Rakestraw SL, Chen H, Corey B, et al. Closing the gap: increasing female representation in surgical leadership. Am J Surg 2022;223:273–5.
4. Lipscomb MF, Bailey DN, Howell LP, et al. Women in academic pathology: pathways to department chair. Acad Pathol 2021;8:23742895211010322.
5. Qiu M, Bae GH, Khosravi H, et al. Changes in sex and racial diversity in academic dermatology faculty over 20 years. J Am Acad Dermatol 2016;75:1252–4.
Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Women’s Dermatologic Society.