Parity representation in leadership positions in academic medicine: A decade of persistent under-representation of women and Asian faculty

Purpose In academic medicine, faculty from minority groups face discrepancy in career progression and few minorities rise to leadership positions in medical schools. The purpose of this exploratory study is to go beyond aggregate numbers and explore parity representation of different minority groups and women in leadership positions in medical schools. The primary research question of this study is: What is the level of parity representation in leadership positions at academic medical centres, examined by gender and by available race/ethnic categories? Method The Leadership Parity Index (LPI) - adapted from the Executive Parity Index - was used to calculate parity representation using national data obtained from the American Association of Medical College Faculty Roster for 2010-2021. Leadership was represented by department chairs and deans. Comparisons were made by gender and race/ethnicity. Results Within the datasets studied, the LPI for women and Asians was consistently below parity. Faculty who identified as White had LPIs above parity. When parsed by gender and race/ethnicity, Asian women had the lowest LPI of all race/ethnicities. Discussion and conclusion The 'critical mass' argument holds that when a group constitutes 30%-35% of the total, they would form a critical mass that would lead to more representation in leadership. Despite minority groups constituting said percentage, this study confirms that 'critical mass' has failed to lead to diversity in leadership. Furthermore, a focus on 'critical mass' obscures other disparities that exist within the system. The findings of this study show that aggregate data may not provide a true picture of equity and parity in medical schools. The variation in LPI within each race/ethnic group suggests that categories such as under-represented in medicine (URiM) and non-URiM, can mask differences within subgroups and should be applied with caution as they can have unintended consequences.