A Longitudinal Curriculum to Address the Gender Gap in Physician Leadership

Setting and Problem

While women make up more than half of entering medical school classes, the majority of leadership positions in academic medicine are held by men, including 85% of medical school deans and department chairs and 75% of residency program directors. There are many theories to explain the gender gap in leadership, including timeline and pipeline issues, a dearth of female role models and mentors, and women prioritizing family obligations. The authors sought to understand the underlying issues better and address these challenges.

Intervention

The authors' family medicine residency program accepts 12 residents per class, with 5 to 7 women per class over the past 3 years. The Growing and Inspiring Resident Leadership (GIRL) curriculum was created and evaluated as a part of a 2010–2015 US Health Resources and Services Administration (HRSA) training grant. The curriculum promotes development of leadership skills in residents of both genders, but specifically targets female residents. Focal areas included awareness of leadership opportunities, understanding organizational dynamics, conflict resolution, negotiation skills, mentoring, and personal wellness.

The curriculum also includes:

1. A yearly networking event: Female faculty and residents are invited to an annual informal social event at the home of a faculty member. The goals include introducing incoming residents to potential faculty mentors and increasing relationship-building in the nonprofessional setting.

2. Longitudinal leadership workshops: Led by female faculty, these 1-hour workshops include role playing, simulation scenarios, panel discussions with local expertise, and networking opportunities.

3. Faculty mentoring: Faculty members are asked to intentionally seek out residents who share their aspirations and offer career counseling and skill development.

While the curriculum is especially tailored for female residents, male residents are also encouraged to attend the workshops.

Outcomes to Date

Attendance at group events has ranged from 15 to 21 residents (55% to 65% women at the workshops). Women and men have added valuable personal reflections and discussion points at all sessions. Faculty members have estimated their time commitment to be 4 to 6 hours per year, considering preparation, presentation, and mentoring efforts. Although faculty participation is essentially voluntary, the HRSA grant provides some salary support for faculty.

As part of a survey of all graduating residents administered since 2011, residents were asked about the GIRL curriculum. We asked residents about their agreement with 9 questions asked about leadership training and use of leadership skills during residency. Residents indicated strong agreement with statements about the adequacy of leadership training, availability of female leadership models (4.7, Likert 1–5), comparable effectiveness of male and female leaders (4.9), and male and female leaders being equally represented at the institution (4.9). The sole question with which respondents disagreed asked whether they wished they had received more leadership training during their residency (1.4).

We also asked open-ended questions regarding desired leadership skills, whether they received adequate training in these areas, and valuable lessons learned from their role models in residency. Responses were used to refine the curriculum, including content identified by the residents, such as public speaking, listening skills, burnout prevention, and conflict resolution. Feedback from residents has been uniformly positive, and we plan to extend a similar program to junior faculty.

Conclusions

To address the leadership gap in medicine, it is critical that interventions be evaluated to determine their impact. We continue to evaluate this program with various measures and larger samples of graduates, and we will explore whether this training has lasting effects among alumni several years after graduation. We hope to collaborate with other specialties within our institution, where gender gaps are even more pronounced, as well as other departments of family medicine across the country.