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Peek at the glass ceiling: gender distribution of leadership among emergency medicine residency programs
  1. Melissa Parsons1,
  2. Sara Krzyzaniak2,
  3. Alexandra Mannix1,
  4. Nicole Rocca3,
  5. Teresa M Chan4,
  6. Michael Gottlieb5
  1. 1Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA
  2. 2Department of Emergency Medicine, Stanford University, Stanford, California, USA
  3. 3Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
  4. 4Division of Emergency Medicine, Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
  5. 5Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr Melissa Parsons, Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA; melissa.parsons{at}


Background A gender gap in faculty rank at academic institutions exists; however, data among graduate medical education (GME) programmes are limited. There is a need to assess gender disparities in GME leadership, as a lack of female leadership may affect recruitment, role modelling and mentorship of female trainees. This cross-sectional study aimed to describe the current state of gender in programme leadership (department chair, programme director (PD), associate/assistant PD (APD) and clerkship director (CD)) at accredited Emergency Medicine (EM) programmes in the USA to determine whether a gender gap exists.

Methods A survey was distributed to EM residency programmes in the USA assessing demographics and gender distribution among programme leadership. If no response was received, information was collected via the programme’s website. Data were organised by position, region and length of the programme. We obtained data on the number of female EM physicians in practice and in training/fellowship in 2017 from the Association of American Medical Colleges. Data analysis was completed using descriptive statistics and χ2 analysis.

Results Of the 226 programmes contacted, 148 responded to the survey (66.3%). Among US EM residency programmes, 11.2% of chairs, 34.6% of PDs, 40.5% of APDs and 46.5% of CDs are women. The percentage of female chairs is significantly lower than the percentage of women in practice or in training in EM. The percentage of female PDs did not differ from the percentage of women in practice or in training in EM. The percentage of female APDs and CDs was significantly higher than the percentage of women in practice but did not differ from the percentage in training. There was wide variability across regions. Four-year programmes had more women in PD and APD positions compared with 3-year programmes (p=0.01).

Conclusions While the representation of women in educational roles is encouraging, the number of women holding the rank of chairperson remains disproportionately low. Further studies are needed to evaluate reasons for this and strategies to increase gender equality in leadership roles.

  • education
  • teaching
  • management
  • emergency department management

Statistics from


  • Handling editor Simon Carley

  • Twitter @MEParsonsMD, @almannixMD, @TChanMD

  • Contributors All authors jointly conceived the study. AM composed the list of accredited EM residency programs. MG, MP and AM created a data extraction tool to identify and categorise program level data. All authors jointly supervised data collection. TM-YC and MG provided statistical advice on study design and analysed the data. All authors drafted components of the manuscript, and all authors contributed substantially to its revision. MP takes responsibility for the paper as a whole.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was determined to be exempt through the Rush University Medical Center Institution Review Board (ORA number 18121301‐IRB01).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article.

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