Women's Representation in Leadership Positions in Academic Medical Oncology, Radiation Oncology, and Surgical Oncology Programs

Importance Women are underrepresented in medical leadership positions; however, representation of women among academic oncology leadership is unknown. Objectives To evaluate representation of women overall and in leadership positions in academic medical oncology (MO), radiation oncology (RO), and surgical oncology (SO) programs and to examine the association of women leadership with overall faculty representation of women per program. Design, Setting, and Participants In this cross-sectional study, MO, RO, and SO training program websites were queried from October 2018 through June 2019. All faculty from 265 of 273 accredited MO, RO, and SO training programs (97.1%) were included. Exposure Gender. Main Outcomes and Measures Observed proportions of women in leadership positions compared with the expected proportion of overall women faculty in MO, RO, and SO were assessed. Rates of representation of women across each MO, RO, and SO program's faculty based on the presence or absence of a woman in a leadership position were compared. Results Of 6030 total faculty, only 2164 (35.9%) were women. Total representation of women among MO, RO, and SO faculty was 37.1% (1563 of 4215), 30.7% (389 of 1269), and 38.8% (212 of 546), respectively. Women composed only 21.7% (30 of 138), 11.7% (11 of 94), and 3.8% (1 of 26) of MO, RO, and SO chair positions, respectively. The observed proportion of women in chair positions was significantly lower than the expected proportion for MO, RO, and SO. In all, 47.9%, 33%, and 18.5% of MO, RO, and SO programs, respectively, had at least 1 woman in a leadership position (program director or chair). Programs with 1 or more women in a leadership position were associated with a higher mean (SD) percentage of women faculty than those without at least 1 woman leader in MO (40.7% [12.5%] vs 33.1% [11.0%]; P < .001) and RO (36.2% [13.3%] vs 23.4% [12.3%]; P < .001) but not SO (40.2% [15.4%] vs 31.4% [16.9%]; P = .29). Conclusions and Relevance Gender disparity exists in academic MO, RO, and SO faculty, which is magnified at the chair level. Programs in MO and RO with a woman physician in a leadership position were associated with a higher percentage of women faculty, but this was not true for SO. These data will serve as a benchmark to monitor progress toward a more balanced workforce. This cross-sectional study evaluates the representation of women overall and in leadership positions in academic medical oncology, radiation oncology, and surgical oncology programs and assesses the association of women leadership with overall faculty representation of women per program. Question Are women equally represented among academic oncology leadership positions? Findings This cross-sectional study of 6030 faculty from 265 academic medical oncology, radiation oncology, and surgical oncology programs found that women constitute 35.9% of total faculty, a disparity that is further magnified at the leadership level. Medical and radiation oncology programs with a woman in a leadership position were associated with a higher percentage of overall women faculty. Meaning This study suggests that gender diversity in academic oncology is a significant issue.