P0588 - Gender Discrepancies in Pediatric Hospital Medicine Leadership

Background: Although women comprise the majority of pediatricians in the United States, they are still not proportionally represented as leaders in the field.


Objectives: The objectives of this study were to 1) determine the gender distribution of university-based divisional pediatric hospital medicine (PHM) leadership positions and 2) compare that to the gender distribution of the broader field of PHM.

Methods: Starting with the 2019 Association of American Medical Colleges list of accredited medical schools, we ascertained the gender of leaders of university-based PHM programs. Program leadership was specified as: division director (or hospital group lead), associate division director, fellowship director, and fellowship assistant director. Data were initially obtained through internet searches and then verified by direct communication with the program. American Board of Pediatrics (ABP) 2019 PHM board certification applications and membership in the American Academy of Pediatrics (AAP) Section on Hospital Medicine (SOHM), the largest PHM-specific organization, were used as proxies for the gender distribution of the broader field of PHM. Descriptive statistics using 95% confidence intervals (CI) were performed. Chi-square testing was used to compare proportional representation of women in the professional population at large to the proportion in leadership positions.

Results: The proportion of women division directors was 54% (95% CI 46% - 63%) in this sample of 136 programs. In the 26 programs with associate division directors, 81% (95% CI 61%- 93%) were women. The proportion of women fellowship directors was 65% (95% CI 50% - 78%) in 49 programs. Assistant fellowship directors were identified in 33 programs, of which 79% (95% CI 61% - 91%) were women. The gender distribution of the PHM field was predominantly women based on both ABP board applications (n=1627) (70% women, 95% CI 68% - 73%) and AAP SOHM membership (n=2299) (71% women, 95% CI 69% - 73%). When compared to the field at large, women appear to be underrepresented as division directors compared to men (54% vs 70%) (p<0.001) but not fellowship directors (65% vs. 70%) (p>0.05). Including assistant/associate directors in the sample did not substantively change the results for either divisional (59% vs. 70%) (p=0.002) or fellowship leadership (71% vs 70%) (p>0.05).

Conclusions: Gender disparities exist in PHM leadership positions at the divisional level for university-based PHM programs. Educational leadership positions appear to have a more representative proportion of women. Further research is needed to create a sample inclusive of community hospital leadership.