Parenthood does not explain the gender difference in clinical position in academic medicine among Swedish, Dutch and Austrian physicians

Abstract

Studies have continuously shown that fewer women than men achieve leadership positions in academic medicine. In the current study we explored gender differences in clinical position among academic physicians at three university hospitals, each in a different European country. These countries, Sweden, the Netherlands and Austria, differ in terms of gender equality. We analyzed whether the number of children, working hours or publications could explain gender differences in physicians’ clinical position. In this cross-sectional questionnaire study 1333 (54% female) physicians participated. Physicians were asked about their gender, age, number of children, working hours and clinical position. We used structural equation models to explore the influence of gender on the physicians’ clinical position in each of the three countries. We explored whether the association between gender and clinical position could be explained by number of children, working hours or publication activity. The analyses revealed that at all three university hospitals gender influenced clinical position. These gender differences in clinical position could be partly explained by gender differences in publication activity. Female physicians as compared to male physicians were likely to publish fewer articles, and in turn these lower publication numbers were associated with lower clinical positions. The number of children or working hours did not explain gender differences in publication activity or clinical position. Therefore, factors other than unequal allocation of household labor, such as the academic working environment, may still disproportionately disadvantage women’s progress, even at universities in countries with high rates of gender equality such as Sweden.

Women’s leadership in academic medicine: a systematic review of extent, condition and interventions

“…No studies beyond those identified were revealed by the 17 contacted scholars. Original data were available for 40 studies, described in 42 articles5 15 52–91 (see online supplementary material 1 for an overview of included studies).…”

“…The majority of studies (n=35) were conducted in the USA, six included Canadian respondents,61 76 information on Canadian programmes,60 77 79 or schools’ leadership,55 one study was conducted across three countries (UAE, Qatar and Singapore),87 one study was conducted across three European countries (Sweden, the Netherlands and Austria),70 one study was conducted across four European countries (Germany, Sweden, Austria and the UK),71 one study in Norway72 and one study in Croatia 80. The earliest study was conducted in 1999,72 and more than 50% of the studies were published in the past 5 years alone.…”

“…The design of nine (26%) studies was retrospective cohort,15 55 56 69 76 80–82 88 one (3%) prospective cohort58 and five (15%) were preintervention/postintervention 62 66 73 75 86. Twelve studies were cross-sectional self-reported questionnaires 5 61 63 64 68 70 83–85 87 89 91. Where questionnaires were used, the response rates ranged from 22% to 100%.…”

“…Only eight studies provided contextual demographic (ethnicity or age) and career (career-stage, other leadership appointments, or leadership training) data on the studied populations 5 55 59 62 66 70 85 86. The MERSQI scores of all studies ranged from 7 to 12.5 (online supplementary materials 1 and 2).…”

“…Twenty-four studies reported the extent of women’s leadership in academic medicine by comparing the number of women attaining leadership positions to the number of men 54–60 63 67 69 70 72 74 77–84 87 90 91. The studies, however, differed in their approaches and which organisational positions they chose to highlight (table 1).…”