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Women remain under-represented in leadership positions in both clinical medicine and medical education, despite a rapid increase in the proportion of women in the medical profession. This chapter explores potential reasons for this under-representation and how it can be ameliorated, drawing on a range of international literatures, theories and practices. We consider both the ‘demand’ for and ‘supply’ of women as leaders, by examining: how evolving theories of leadership help to explain women’s’ leadership roles and opportunities, how employment patterns theory and gender schemas help to explain women’s career choices, how women aspiring to leadership can be affected by the ‘glass ceiling’ and the ‘glass cliff’ and the importance of professional development and mentoring initiatives. We conclude that high-level national strategies will need to be reinforced by real shifts in culture and structures before women and men are equally valued for their leadership and followership contributions in medicine and medical education.

The predicted doctors’ shortage in Austria and the increasing feminisation of the medical profession are aspects of a passionate debate on gender inequality in medical careers and particularly on sufficient medical care in Austria. Therefore, this review summarises main findings on gender inequality in medical careers in Austria using an intersectional lens.

The intersections derived from literature elucidate that gender inequality is not predominantly dependent on having a family including children, but that various combinations of these intersections influence women’s careers.

There is a need to further investigate intersections influencing medical careers in women and to relate these to affirmative action measures. Affirmative action measures need quotas and consideration of various areas besides work–family balance. There is a need to evaluate and adapt interventions to promote women in medicine according to the intersections derived from the literature.

Women in medicine face barriers that hinder progress toward top leadership roles, and the industry remains plagued by the grand challenge of gender inequality. The purpose of this study was to explore how subtle and overt gender biases affect women physicians, physician leaders, researchers, and faculty working in academic health sciences environments and to further examine the association of these biases with workplace satisfaction. The study used a convergent mixed methods approach. Sampling from a list of medical schools in the United States, in conjunction with a list of each state's medical society, the authors analyzed the quantitative survey responses of 293 women in medicine. The authors conducted ordinary least squares multiple regression to assess the relationship of gender barriers on workplace satisfaction. Additionally, 132 of the 293 participants provided written open-ended responses that were explored using a qualitative content analysis methodology. The survey results showed that male culture, lack of sponsorship, lack of mentoring, and queen bee syndrome were associated with lower workplace satisfaction. The qualitative results provided illustrations of how participants experienced these biases. These results emphasize the obstacles that women face and highlight the detrimental nature of gender bias in medicine. The authors conclude by presenting concrete recommendations for managers endeavoring to improve the culture of gender equity and inclusivity.

In this introductory chapter, I discuss the rationale for this edited collection and the contribution it can make to advancing knowledge of gender inequalities and promoting social justice in the medical profession and medical education. I provide a short overview of and critique of popular debates in the medical community in the United Kingdom and I also discuss briefly research about women’s careers in the United Kingdom and globally. The introductory chapter provides a description of each chapter and its contribution to scholarship about gender, careers and inequalities in Medicine/Medical Education.

Building leadership skills among faculty in academic medicine is essential, yet professional development programs focused on leadership are not always attentive to the needs of faculty on diverse career pathways or at differing career stages—nor are they often rigorously assessed. Evaluations commonly focus on participant satisfaction and short-term learning but not behavior change and institutional impact, which are difficult to assess but arguably more meaningful. Given the substantial time and money invested in these programs, more rigorous evaluation is critical.

The authors evaluated an intensive, shared leadership-focused training program for early-career and mid-career faculty, offered by the University of Pittsburgh’s School of Medicine over the course of a year. They administered a pre/post-program assessment of confidence in key skill areas, and conducted semi-structured interviews with 21 participants between 1–4 years after program completion.

Participants in both programs showed statistically significant improvement (p < 0.001) on every item measured in the pre/post-test. Analysis of the interviews revealed indications of substantial behavior change as well as institutional impact. The evaluation also suggested particular benefits for female professionals.

The authors conducted a long-term assessment of leadership training focused on career pathway and career stage and found that it (a) prompted both positive behavioral change and institutional impact and (b) suggested benefits for female faculty in particular, which could potentially help to eliminate gender-based disparities in leadership in academic medical centers.

The paper contributes to the discussion on valuation in organization studies and strategic management literature. The nascent literature on valuation practices has examined established markets where producers and consumers are known and rivalry in the market is a given. Furthermore, previous research has operated with a narrow meaning of value as either a financial profit or a subjective consumer preference. Such a narrow view on value is problematic and insufficient for studying the interlacing of innovation and value creation in emerging technoscientific business domains.

The authors present an empirical study about value creation in an emerging technoscience business domain formed around personalized medicine and digital health data.

The results of this analysis show that in a technoscientific domain, valuation of innovations is multiple and malleable, entails pursuing attractiveness in collaboration and partnerships and is performative, and due to emphatic future orientation, values are indefinite and promissory.

As research implications, this study shows that valuation practices in an emerging technoscience business domain focus on defining the potential economic value in the future and attracting partners as probable future beneficiaries. Commercial value upon innovation in an embryonic business milieu is created and situated in valuation practices that constitute the prospective market, the prevalent economic discourse, and rationale. This is in contrast to an established market, where valuation practices are determined at the intersection of customer preferences and competitive arenas where suppliers, producers, service providers and new entrants to the market present value propositions.

The study findings extend discussion on valuation from established business domains to emerging technoscience business domains which are in a “pre-competition” phase where suppliers, customers, producers and their collaborative and competitive relations are not yet established.

As managerial implications, this study provides insights into health innovation stakeholders, including stakeholders in the public, private and academic sectors, about the ecosystem dynamics in a technoscientific innovation. Such insight is useful in strategic decision-making about ecosystem strategy and ecosystem business model for value proposition, value creation and value capture in an emerging innovation domain characterized by collaborative and competitive relations among stakeholders. To business managers, the findings of this study about valuation practices are useful in strategic decision-making about ecosystem strategy and ecosystem business model for value proposition, value creation and value capture in an emerging innovation domain characterized by collaborative and competitive relations among stakeholders. To policy makers, this study provides an in-depth analysis of an overall business ecosystem in an emerging technoscience business that can be propelled to increase the financial investments in the field. As a policy implication, this study provides insights into the various dimensions of valuation in technoscience business to policy makers, who make governance decisions to guide and control the development of medical innovation using digital health data.

This study's results expand previous theorizing on valuation by showing that in technoscientific innovation all types of value created – scientific, clinical, social or economic – are predominantly promissory. This study complements the nascent theorizing on value creation and valuation practices of technoscientific innovation.

Despite the well‐documented resistance to feminism and gender equality within universities, the profound implications for feminist academics have not received sufficient attention. In this paper the author aims to focus on the inauthentication of feminist academic work by powerful actors in higher education and the implications for feminist academic careers. The author illustrates through her professional experience at a UK medical school how the othering and exclusion of feminists, sustained through surveillance and power mechanisms of organisational life, can disrupt and interrupt feminist academic identity.

This is a reflective piece of work that attempts to illustrate the author's experiences of occupational segregation and marginalisation within a patriarchal and an emerging “entrepreneurial” academic department. The author attempts to represent her lived professional experiences as a feminist academic in a medical school, through the use of narrative and metaphors.

Drawing on notions of othering, interrupted and storied subjectivities, the author illustrates how gendered expectations and constructions of academic performance and success within patriarchal organisations can “make up” and “break up” the professional self and affect the nomadic nature of academic careers and identities.

This paper contributes to theory about workplace identities and practice of gender equality in academia.

The author illustrates how the intersections of identities (feminist, social scientist, woman) can shape personal stories, professional experiences and careers within universities. The author demonstrate how personal stories can uncover gender inequalities and challenge dominant paradigms of knowledge and research within a micro‐web of emotionality and power relations.

The purpose of this study was to explore the cultural and structural conditions that influence male and female physicians’ career choices and career expectations. Although women constitute 59 percent of the physicians and 55 percent of the specialists in Finland in 2014, the rate of women in oto-rhino-laryngology (38 percent) was one of the lowest among the specialties. The data consist of semi-structured interviews with young physicians (N = 19), who have entered a career in oto-rhino-laryngology (ORL) in Finland.

The results point to three features which characterize the career pattern in the specialty. First, the specialty is not one that draws students to medicine per se but rather one that is chosen during medical training. The decision to specialize in ORL was by many respondents framed as a “coincidence,” while others were attracted by the diverse character of the specialty. Second, the skills needed for being a “good” practitioner were defined as handiness, courage, and social skills, but these were not defined in a gendered way. Third, the career prospects for women within the specialty were defined by a neutralizing or a gendering framework. The neutralizing framework was represented by the pipeline argument which suggests that there is a temporary time lag in women’s representation in higher positions and that women are advancing steadily in the academic and administrative pipeline. The gendering framework pointed to the male ethos of the surgical tasks in the specialty as a barrier for women’s advancement in those areas. This chapter concludes that the pipeline view belittles existing gender inequalities in men’s and women’s medical careers and views gender differences as temporary maladjustments rather than inherent features of gendered organizations.

The purpose of this study is to demonstrate how action learning can be practically applied to quality and safety challenges at a large academic medical health system and become fundamentally integrated with an institution’s broader approach to quality and safety.

The authors describe how the fundamental principles of action learning have been applied to advancing quality and safety in health care at a large academic medical institution. The authors provide an academic contextualization of action learning in health care and then transition to how this concept can be practically applied to quality and safety by providing detailing examples at the unit, cross-functional and executive levels.

The authors describe three unique approaches to applying action learning in the comprehensive unit-based safety program, clinical communities and the quality management infrastructure. These examples, individually, provide discrete ways to integrate action learning in the advancement of quality and safety. However, more importantly when combined, they represent how action learning can form the basis of a learning health system around quality and safety.

This study represents the broadest description of action learning applied to the quality and safety literature in health care and provides detailed examples of its use in a real-world context.

Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity.

Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included.

In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution.

This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.