Pay equity is at least 70 years away based on current rates of progress.

A/Prof Linley Lord

Women currently represent more than 50% of medical graduates so why do they remain under-represented in senior medical leadership roles and some specialisations?

Data from the Workplace Gender Equality Agency (WGEA) on Australian hospitals shows that women hold 35% of all CEO positions, but only 10% of CEO positions in hospitals with more than 5000 employees. The gender pay-gap among professionals in Australian hospitals is 25% and increases to 29.7% among key management personnel.

While women’s under-representation in leadership roles is a concern, it isn’t a surprise.

Medicine is not alone in this. Across all the organisations reporting to WGEA, only 6.3% of CEO positions are held by women. And women comprise only 28.5% of key management personnel and it’s these roles that provide a natural pathway to CEO positions.

More worrying is a 2014 Oxfam report suggesting that pay equity is at least 70 years away based on current rates of progress.

What does this mean for women in medicine? Does the glass ceiling still exist?

Prof Siobhan Austen

It would certainly seem so, given the above numbers. Is change likely to occur? No, at least, not without significant resolve and agitation. At the current rate of progress in some specialist areas such as surgery, it has been suggested that gender parity at the academic professorial level won’t be achieved until 2036. Currently, only 12.5% of Australian hospitals have specific pay equity targets in their formal remuneration policies or strategies. Remuneration gap analyses remain rare.

So, what needs to be done? There has been research to identify reasons why women remain under-represented in senior leadership positions in medicine. A number of medical practitioners in formal leadership roles were interviewed and relayed their belief that the absence of women in leadership roles was a result of ‘preventable gender-related barriers’ that impeded women’s progress. Coupled with this were negative perceptions regarding the capability, capacity and credibility of women fulfilling medical leadership roles.

A lack of female role models and a lack of access to mentors and sponsors, combined with the fact that many women encountered bias and discrimination within their career, contributed to their ongoing under-representation at senior levels.

The challenge, therefore, is to implement strategies that will result in systemic and cultural change.

Studies have shown that identical CVs, one showing a male name and another that of a female are evaluated differently. More questions are raised about the woman’s experience and achievements compared with her male counterpart despite there being no appreciable differences between the two. One positive way to address this would be to implement training programs in ‘unconscious and/or implicit bias.’

Perhaps this should be the first step in addressing women’s under-representation in leadership roles within medicine?

References available on request.

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