Plenty of moustaches but not enough women: cross sectional study of medical leaders [阳盛阴衰：医学界领袖们的横断面研究]

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BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h6311 (Published 16 December 2015)
Cite this as: BMJ 2015;351:h6311

Authors
Mackenzie R Wehner, resident physician, Kevin T Nead, resident physician, Katerina Linos, professor of law, Eleni Linos, assistant professor

Abstract
Objectives: To draw attention to sex related disparities in academic medical leadership by investigating the representation of female leaders compared with leaders with moustaches.

Design: Cross sectional analysis.

Setting: Academic medical departments in the United States.

Participants: Clinical department leaders (n=1018) at the top 50 US medical schools funded by the National Institutes of Health (NIH).

Main outcome measures: The proportions of female leaders and moustachioed leaders across institutions and specialties (n=20). Additionally, the moustache index: the proportion of women compared with the proportion of moustaches, analyzed with multinomial logistic regression models.

Results: Women accounted for 13% (137/1018) of department leaders at the top 50 NIH funded medical schools in the US. Moustachioed leaders accounted for 19% (190/1018). The proportion of female department leaders ranged from 0% (0/20) to 26% (5/19) across institutions and 0% (0/53) to 36% (19/53) across specialties. Only seven institutions and five specialties had more than 20% of female department leaders. The overall moustache index of all academic medical departments studied was 0.72 (95% confidence interval 0.58 to 0.90; P=0.004). Only six of 20 specialties had more women than moustaches (moustache index >1).

Conclusions: Moustachioed individuals significantly outnumber women as leaders of medical departments in the US. We believe that every department and institution should strive for a moustache index ≥1. Known, effective, and evidence based policies to increase the number of women in leadership positions should be prioritized.