Female leadership in medicine during the pandemic

This post was written by Melissa Wheeler, Ph.D. and Laksmi Govindasamy, MD

Although female medical graduates now consistently exceed parity, there are persistent inequalities in the participation of women in certain medical specialties and in leadership roles in general. This gap reflects a range of factors, including female physicians’ experiences of bias, discrimination, and harassment within broader organizational structures that perpetuate gender inequalities. An important pathway for medical leadership is within specialty colleges, perhaps most visibly through the role of president. These organizations shape the education and training of the next generation of physicians and play a key role in advocacy within and beyond the health system. By the end of 2021 in Australia and Aotearoa New Zealand, female presidents-elect and presidents led medical schools representing general medicine, physicians, surgeons, emergency medicine, anaesthesia, psychiatry, intensive care, medical administration and dermatology. As we salute and celebrate these individual achievements, it begs the question of whether this is lasting organizational change or simply individual exceptionalism?

The Glass Cliff: A Brief Introduction

Imagine a woman in a leadership position who managed to break through the invisible barrier – commonly known as the “glass ceiling” – only to find herself in a risky position, perched on a precarious ledge, dubbed the “glass cliff”. The glass cliff phenomenon arose from recent research in social psychology which demonstrates that women in leadership positions often experience a second wave of discrimination, in that they are evaluated less favorably and criticized more than their male counterparts. , even when they are at the same level.

In addition to further scrutiny (from colleagues, subordinates, media), another relevant area of ​​research led to the formulation of the concept of the glass cliff. It is the one that highlights the greater tendency for women (and people from minority backgrounds) to be appointed to leadership positions in times of crisis or times of heightened risk. During these periods, people may consciously or unconsciously seek out different types of leadership traits, drawing on different stereotypes of what it means to be a leader, compared to periods of relative stability. A time of crisis indicates the need for change, as well as the desire for certain characteristics in a leader—understanding, empathy, beneficence—that are more stereotypically associated with stereotypical femininity.

Precariousness and failure

Once women assume leadership, having overcome the assumptions of a perceived “lack of fit” and other barriers encompassed in the glass ceiling, the glass cliff adds additional pressures, including perceived expectation of a failure. In a sort of self-fulfilling prophecy, as women are more likely to be promoted in companies and political parties already in downward trajectories, failure is of course more likely than in low-risk appointments. And failure can confirm some negative assumptions and perceptions about women’s leadership competence, fulfilling some people’s expectations that women don’t inherently make good leaders. Interestingly, men are more likely to reject these “golden opportunities” seeing them more for what they really are, “poison gifts” – rejections that carry fewer penalties (e.g., layoffs ) only when women refuse them. This distinction between golden opportunities and poisonous gifts and the consequences of decline point to another layer of precariousness for women aspiring to lead.

COVID-19: Two years of crisis (and counting)

The COVID-19 pandemic years, a period of ongoing global crisis since 2020, could see more women globally in leadership positions, as seen in the increase in the number of women heading medical schools. . This increase may be associated with the glass cliff phenomenon, as there is more demand for stereotypically feminine qualities, such as empathy and concern for others, and in combination with the tendency for women to be named in times crisis, known as ‘think crisis, think feminine trend. It is important to recognize the potential precariousness of these elevations and provide the support needed to see the benefits of these stereotypical feminine traits, giving these women the best chance possible to embrace real change and thrive instead of fail.

Take advantage of the golden opportunity and avoid the poisonous chalice

Organizations can provide support in terms of organizational and structural changes that accelerate and contribute to sustainable and sustainable diversity and inclusion initiatives, such as recruitment, selection, retention procedures and flexible leave policies. Strategies can include bias reduction strategies (such as unconscious bias training), direct affirmative action (such as goals and quotas), or bias mitigation and nudge tactics (such as than CV de-identification or blind auditions).

The benefits of supporting women who have accepted precarious leadership opportunities are many, but we will highlight two as examples. As the saying goes, a rising tide lifts all boats, the benefits extend beyond the individual women who have been lifted up. With the right support, organizations will be able to embrace the diverse perspectives offered by the new leader and give themselves the best chance to change the circumstances and current trajectory that led to the high risk or crisis situation in the first place. location. Another advantage is more forward-looking. The next generation of girls and women will have more visible women in leadership as role models, an important indicator of what can be achieved and what to aspire to. This representation is especially important for women and other minority groups in medicine, as the growing diversity of physicians plays a valuable role in providing quality, culturally appropriate care. There is a continued role for advocacy from leading bodies, including medical schools, due to the need to expand gender equity considerations beyond the gender binary focus and towards a broader inclusion, taking into account the intersectional identities of people and the additional complexities and barriers encountered.

The healthcare sector is not the only industry grappling with the gap between participation and diversity in senior leadership and the challenges imposed by the ongoing COVID-19 pandemic. However, this is a unique moment in that this current cohort of female medical leaders can preside over a generational opportunity to leverage the pandemic crisis to contribute to health system reforms that improve equity, accessibility and quality of care for all. Likewise, the pandemic may create momentum to recognize longstanding physician wellness issues, including addressing systemic bullying and harassment. While celebrating their individual achievements and the symbolism of their portrayal in often male-dominated spaces, we should also help them implement the kinds of organizational changes needed to ensure this is a tidal wave. rising that lifts all boats, not just for other women, but for all marginalized and underrepresented groups in medicine. It would be the most precious inheritance of all.