Female medical leadership: cross sectional study.

Abstract

Objective To assess the relation between male and female medical leadership.

Design Cross sectional study on predictive factors for female medical leadership with data on sex, age, specialty, and occupational status of Norwegian physicians.

Setting Oslo, Norway.

Subjects 13 844 non-retired Norwegian physicians.

Main outcome measure Medical leaders, defined as physicians holding a leading position in hospital medicine, public health, academic medicine, or private health care.

Results 14.6% (95% confidence interval 14.0% to 15.4%) of the men were leaders compared with 5.1% (4.4% to 5.9%) of the women. Adjusted for age men had a higher estimated probability of leadership in all categories of age and job, the highest being in academic medicine with 0.57 (0.42 to 0.72) for men aged over 54 years compared with 0.39 (0.21 to 0.63) for women in the same category. Among female hospital physicians there was a positive relation between the proportion of women in their specialty and the probability of leadership.

Conclusion Women do not reach senior positions as easily as men. Medical specialties with high proportions of women have more female leaders.

Introduction

The Norwegian labour market has adjusted to the increased proportion of career women with an equal opportunities policy of positive sex discrimination in favour of women and improved social benefits. Dual career families are now the norm rather than the exception; current employment rates for women and men in Norway are 56% and 70%, respectively. Maternity leave has improved, and working women are entitled to full cash benefits for 42 weeks or 80% benefits for 52 weeks, and men are entitled to 2 weeks' paternity leave. The public day care coverage is 60%, and parents are allowed 10 days' paid leave a year per child for illness in children. Despite this liberal equity policy and an increase in the number of women working, relatively few women hold positions of leadership in industry, business, or the public sector, including health care.[1]

Up to the 1990s, when the proportion of women among medical students reached 50%, women had the advantage of positive sex discrimination in medical schools. Now, though universities use this to increase the proportion of women in academic posts, there is no such policy in the appointment of hospital doctors and public health positions.

Data from Finland suggest that female physicians are largely excluded from decision making in medical research,[2-4] but few studies have explored the relation between specialty and career choices and female leadership in medicine. As the purpose of the Norwegian equal opportunities policy has been to favour women in the workforce and strengthen their participation in all employment positions to obtain equity, it is of interest to study the extent to which female Norwegian doctors have succeeded in reaching senior positions.

With data on specialty and occupational status of Norwegian …