Barriers and Facilitators to Women's Advancement and Leadership in Academic Medicine

Academic medicine is currently characterised by the underutilisation of women’s talent and potential, especially, at senior levels and in leadership roles. This presents a serious threat to the quality and international competitiveness of the future health workforce. In order to identify barriers and facilitators to women’s advancement and leadership in academic medicine, we conducted a systematic review of empirical studies published in peer-reviewed journals since 1985. We searched Medline, CINALH, ERIC, and Theses and Dissertations. Two reviewers thematically analysed data from included studies and assessed their methodological limitations.

Most included studies were from North America and frequently had methodological limitations. Eight themes emerged: women may attain lower research productivity than men (as measured by publications and grants); women tend to be more interested in teaching and clinical work than research; women may lack career advancement and leadership skills; there is a lack of adequate mentors and role models for women; women may experience gender bias and discrimination; the culture of academic medicine is less supportive to women; work-life integration is harder for women than men; women are more likely to leave academic medicine than men.

Medical schools and university hospitals should take immediate action to eliminate all forms of gender discrimination and unconscious bias. Strategies and interventions aimed at providing women with the necessary support to increase their research productivity, with adequate mentors and role models, and with opportunities to develop career advancement and leadership skills may encourage more women to stay and seek senior and leadership roles in academic medicine. Institutions can better align research, teaching, and patient care in academic careers and develop more flexible working conditions for both genders. High-quality studies are needed to monitor and evaluate experimentally such strategies and interventions.