Objectives The aims of the study were (1) to establish potential gender differences in academic physical medicine and rehabilitation faculty across the United States and Canada and (2) to evaluate associations between physician gender, leadership position, and research productivity. Design Physical medicine and rehabilitation programs enlisted in Fellowship and Residency Electronic Interactive Database (n = 72) and Canadian Resident Matching Service (n = 9) were searched for academic faculty with Doctor of Medicine degrees to generate a database of gender and academic profiles. Bibliometric data were collected using Elsevier's Scopus and analyzed by Strata v14.2. Results Of 1045 faculty meeting the inclusion criteria, 653 were men and 392 were women. Men were found in greater numbers across all academic ranks, with professors as most conspicuous (79.14%), and held most (85.54%) leadership positions. The study's prediction model assessed for gender differences in academic rank and leadership roles and found that odds of men having higher h-index as 0.78 (95% confidence interval = 0.24–0.87), indicating that women were not significantly inferior in academic performance. Conclusions A significantly greater number of men make up physical medicine and rehabilitation faculty in all academic ranks and leadership positions. H-index based on gender and adjusted for covariates is comparable between men and women, suggesting that more complex, multifactorial issues are likely influencing the gender differences.