BACKGROUND: Women are not advancing to leadership positions in academic medicine at rates predicted by their representation in medical school over the past 20 years. The prejudice persists, often as an unconscious mental model, that leaders should be men. We examined whether the presence of the word "leader" in written tenure criteria may have a differential impact on promotion of men and women in elite medical schools. METHODS: We used a retrospective, descriptive design to study 24 academic medical centers top-ranked in both NIH funding and Carnegie classification. The main outcome measure was the slope of regression fit to 7-year annual data on percent faculty who are tenured women (1998-2004) relative to the median slope of all 24 institutions. RESULTS: Medical schools with the word "leader" in tenure criteria were more likely to have slopes below the median slope than schools without the word "leader" (OR = 6.0; CI = 1.02, 35.37; p = 0.04). CONCLUSIONS: Being a leader is associated with stereotypic male-gendered traits. Achieving tenure is a key gatekeeping point in advancement toward leadership in academic medicine. Our findings suggest that including the word "leader" in tenure criteria may promote activation and application of biases that disadvantage women's career advancement.
BACKGROUND:Women are not advancing to leadership positions in academic medicine at rates predicted by their representation in medical school over the past 20 years. The prejudice persists, often as an unconscious mental model, that leaders should be men. We examined whether the presence of the word "leader" in written tenure criteria may have a differential impact on promotion of men and women in elite medical schools. METHODS: We used a retrospective, descriptive design to study 24 academic medical centers top-ranked in both NIH funding and Carnegie classification. The main outcome measure was the slope of regression fit to 7-year annual data on percent faculty who are tenured women (1998-2004) relative to the median slope of all 24 institutions. RESULTS: Medical schools with the word "leader" in tenure criteria were more likely to have slopes below the median slope than schools without the word "leader" (OR = 6.0; CI = 1.02, 35.37; p = 0.04). CONCLUSIONS: Being a leader is associated with stereotypic male-gendered traits. Achieving tenure is a key gatekeeping point in advancement toward leadership in academic medicine. Our findings suggest that including the word "leader" in tenure criteria may promote activation and application of biases that disadvantage women's career advancement.