Women Hold Only 14% of Top Leadership Roles in Medicine

The glass ceiling in medicine persists, with women still vastly under-represented in top leadership positions, such as clinical directors at university hospitals, where they currently account for only 14%. This proportion is significantly lower than that of men and comes from a recent survey conducted by the German Medical Women’s Association (Deutscher Ärztinnenbund e.V. [DÄB]), titled Medical Women On Top (MWoT).

These findings highlight the persistent gender disparity in medical leadership, despite progress in other areas of the profession.

At the same time, the proportion of women in senior physician roles has increased. In some of the 14 clinical specialties analysed, women now make up over 50% of senior physicians, particularly in fields such as paediatrics and pathology, according to DÄB.

Ceiling Clash

Women are denied the most influential positions at the top of the career ladder. Since 2022, the proportion of women university hospital directors has increased by only 1%.

The selected specialties are among the most important clinical fields at the highest salary level, holding significant influence over student training, treatment decisions, and research funding, according to the MWoT author Dr Gabriele Kaczmarczyk. The obvious under-representation of women, who make up nearly 70% of medical students, is alarming: Feminine qualities are thus lacking in the leadership ranks of academic medicine, where they are most needed, she wrote.

Between July and October 2024, the websites of 37 public university hospitals in Germany were analysed, counting 12,590 leadership roles, including hospital directors, senior physicians, and deans, and were listed by gender and role.

The findings revealed that only 206 out of 1149 department head positions, or 15%, were held by women. Among senior physicians with professorships, the ratio was 266 women to 1242 men; that is, only 18% were women.

For senior physician roles without professorships, the ratio was 438 women to 1091 men physicians.

The goal of “parity at all levels” is still a long way off, particularly in hospital director positions. In contrast, women already hold an average of 45% of senior physician positions. In numbers, this equates to 2472 of the 3058 positions.

The specialties with the highest representation of women in senior physician roles were gynaecology (294 women), dermatology (160 women), and paediatrics (457 women).

Fewer Women Apply for Leadership Roles

The study states that few women apply for advertised leadership positions, even though they possess the necessary qualifications. Recruitment efforts by the faculties often do not yield results. Why? Is this due to the challenge of balancing work and family life, inadequate childcare, inflexible working hours, or a lack of support from partners in caregiving responsibilities?

For instance, according to Dr Christiane Gross, president of DÄB, women are approached differently than men when they reduce their working hours for childcare. “A man who reduces his working hours to 70% for family reasons has to ask himself how he will justify this to his career,” said Gross. “In contrast, when a woman reduces her hours by the same amount, the question is: How can you justify working so much to your family?”

While the reasons behind the relatively low number of women applying for leadership roles remain unclear, DÄB suggests measures such as advertising these positions as dual leadership roles, also known as “top sharing.”

DÄB also advocates for the equal representation of men and women on appointment committees. “An interview conducted by a panel of all-male members is hardly welcoming for female applicants,” Kaczmarczyk noted. Last year, only 3 of the 31 committees that responded to a related enquiry adhered to the principle of gender parity.

DÄB recommends that gender equality officers be included in appointment committees and that gender-friendly structures be prioritised and calls for a greater emphasis on soft skills such as communication, teamwork, and conflict management during evaluations.

Gross has been a long-standing supporter of quotas. She believes firmly that “If there are clear guidelines, they will be implemented.”

This story was translated from Medscape’s German edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.