Plenty of moustaches but not enough women: cross sectional study of medical leaders

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.