Leadership Gender Disparity Within Research-Intensive Medical Schools: A Transcontinental Thematic Analysis

Background: The underrepresentation of women in senior leadership positions of academic medicine continues to prevail despite the ongoing efforts to advance gender parity. Our aim was to compare the extent of gender imbalance in the leadership of the top 100 medical schools and to critically analyze the contributing factors through a comprehensive theoretical framework. Methods: We adopted the theoretical framework of the Systems and Career Influences Model. The leadership was classified into four tiers of leadership hierarchy. Variables of interest included gender, h-index, number of documents published, total number of citations, and number of years in active research. A total of 2448 (77.59%) men and 707 (22.41%) women met the inclusion criteria. Results: Male majority was found in all regions with a significant difference in all levels of leadership (chi square = 91.66; P value = .001). Women had a lower mean h-index across all positions in all regions, and when we adjusted for number of years invested, M Index for women was still significantly lower than men (T test = 6.52; P value = .02). Discussion: Organizational and individual influences are transcontinental within the top 100 medical school leadership hierarchy. Those factors were critically assessed through in-depth analysis of the Systems and Career Influences Model. Evidence-driven actionable recommendations to remedy those influences were outlined.