No Room to "Lean In": A Qualitative Study on Gendered Barriers to Promotion and Leadership

J Womens Health (Larchmt). 2019 Mar;28(3):393-402. doi: 10.1089/jwh.2018.7252. Epub 2018 Nov 27.


Introduction: The gender gap in professorship and leadership roles persists in academic medicine, whereas reasons for these disparities remain unclear.

Materials and methods: Open-ended text responses to a 2013 faculty engagement survey were analyzed by using the grounded theory and consensual qualitative analysis techniques. The authors grouped 491 faculty's text responses into descriptive codes and three themes: (1) No Obstacles, (2) Barriers to Success, and (3) Concerns Regarding Processes. Demographics of codes were compared by using chi-square analysis.

Results: Male faculty identified barriers that included negative views of leadership or leaders. Female faculty, especially those in clinical roles, expressed barriers related to role overload, including that the demands of their current positions prevented advancement or addition of further roles, no matter how desirable further roles may be. Women also shared that considerable self-promotion was required to receive acknowledgement of their work and support by leadership.

Conclusion: A proposed framework depicts male and female faculty's concerns on a continuum. No Obstacle and Process Concerns were relatively gender neutral, whereas large gender disparities occurred within the Barriers to Success theme. Women's barriers largely revolved around internal obstacles (I can't do any more), and men's barriers largely revolved around external factors (leaders are impeding my progress). Resources are needed to mitigate work overload specifically for female faculty, and to ensure that all faculty are both engaged in advanced career opportunities and encouraged to pursue leadership positions.

Keywords: academic medicine; leadership; mentoring; professorship; women.

MeSH terms

  • Academic Medical Centers / organization & administration
  • Career Mobility*
  • Faculty, Medical / organization & administration*
  • Female
  • Humans
  • Job Satisfaction
  • Leadership*
  • Male
  • Mentoring
  • Physicians, Women / psychology*
  • Qualitative Research
  • Sexism*
  • Surveys and Questionnaires