Analysis of dual degree, gender, and specialty on obtaining leadership positions in academic settings: a multi-institutional study

Background: Disparities in advanced degrees, gender, and specialty for medical leadership in academia have not been described. Methods: In this cross-sectional multi-institutional study, the authors used the University of California (UC) employee database and organization charts to compile the physicians and medical leaders at 6 academic centers. Chi-square testing was used to identify factors associated with leadership positions. Results: Among physicians in leadership 34.6% had dual degrees compared to 25.3% without leadership roles (P<0.001). The PhD, MPH, and MBA were the only degrees overrepresented in leadership. Female physicians were underrepresented in general compared to males (42.8% vs. 57.2%; P<0.001), and even more so in leadership roles (28.0% vs. 72.0%; P<0.001). While Internal Medicine (24.6%) was the most common specialty in leadership, the only specialties overrepresented in leadership were Psychiatry (P=0.003) and Neurosurgery (P=0.019). Conclusions: This study uniquely characterizes the distribution of advanced degrees, gender, and specialties in six academic institutions. The MBA, MPH, and PhD degrees, along with Neurosurgery and Psychiatry specialties, were strongly associated with physicians in leadership, while females were largely underrepresented in leadership. Understanding the current state of healthcare management in academic hospitals sheds light upon the disparities in leadership in order to achieve equal representation.