Women make up approximately 66% of active pediatricians, yet they remain glaringly absent from top leadership positions in their disciplines.
Women hold only 34% of division and section chief positions in U.S. medical schools and about 25% of current department chair appointments.
This leadership gap has not changed appreciably in the last two decades despite the increase in women seeking pediatric medical careers. The lack of women in key academic leadership roles only exacerbates challenges children’s hospital face — workforce shortages, providers burnout, worsening disease. And we need women to be an integral part of addressing and solving these issues.
To explore the forces that sustain these gaps and identify potential solutions, we recently gathered a group of distinguished women pediatric clinicians in a conversation led by the Child Health Advisory Council. The panel’s perspectives, taken from years of working in pediatrics and their personal career experiences, provided a series of observations every pediatrics department should consider as they prioritize efforts to address equity in leadership.
Spotting gaps and finding opportunities
Gender inequity in leadership is a failure of the system, not of the individual. Systematic bias isn’t always overt. It can be embedded in referral patterns, speaking opportunities, or stretch‑role offers that men receive more often than women.
Leaders must actively audit promotion pathways, compensation data, publication records, candidate sponsorships, and committee distributions to uncover hidden patterns of bias and opportunities to appoint women to senior positions.
Assessing the organization’s successful advancement of women and failed retention of women leaders often provides insight into issues that should be addressed.
Designing proactive systems
Once inequities are identified, the next step is embedding fixes into the system. High-performing institutions are:
- Building transparent promotion criteria
- Establishing sponsorship initiatives
- Integrating gender equity into leadership succession planning
Rather than waiting for disparities to spark attrition, these changes push equity upstream.
Shifting structures, not behaviors
Women are often told to “lean in” or “be more aggressive,” but the real need is organizational change, not behavioral adjustments. Structures may implicitly penalize part-time roles, nonlinear career paths, and caregiving.
True reform happens when institutions flex, not when women are forced to conform to an outdated leadership standard.
Formalizing sponsorship over mentorship
Mentorship provides guidance; sponsorship fuels opportunity. A sponsor uses influence to elevate women into high-impact roles, nominating them for awards, stretch assignments, and executive pipelines.
Formal sponsorship programs help neutralize access bias by more equitably distributing seat-at-the-table opportunities.
Addressing pay inequities through transparency
Gender compensation disparities are widespread even when there is near-parity in gender headcounts. This persistent earnings disadvantage compounds over a career.
Institutions should implement transparent salary bands and regular salary equity reviews. When pay parity is part of organizational policy, disparities become visible and correctable.
Making equity an organizational responsibility
Leaders at every level, across genders and disciplines, must actively engage in addressing inequities. By reshaping recruitment practices, amplifying women’s voices in meetings, and embedding equity into performance metrics, there’s more visibility across departments that can spark change.
This collective commitment creates a culture in which equity becomes part of daily operations, not an afterthought.
Creating new pathways
Elevating women in pediatrics isn’t a pipeline problem; it’s a leadership design problem. Women have been and continue to be ready to step into elevated roles. With thoughtful programs focused on transparency, mentorship, and sponsorship and gaining the commitment of institutional leaders, we can get there together.
It’s not just our pediatric departments that benefit; it’s imperative for the future of child health that relies on us to deliver better outcomes.
When we elevate women into leadership, we don’t just close equity gaps, we strengthen pediatric medicine itself.
