Article Text

other Versions

Gender and international clinician educators
  1. Dora J Stadler1,
  2. Sophia Archuleta2,3,
  3. Halah Ibrahim4,
  4. Nina G Shah5,
  5. Ahmed Ali Al-Mohammed6,7,
  6. Joseph Cofrancesco Jr8
  1. 1 Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha, Qatar
  2. 2 Division of Infectious Diseases, National University Hospital, National University Health System, Singapore, Singapore
  3. 3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  4. 4 Masters of Education for Health Professionals, Johns Hopkins School of Education, Baltimore, USA
  5. 5 Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, USA
  6. 6 Internal Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar
  7. 7 Medical Education, Weill Cornell Medicine-Qatar, Doha, Qatar
  8. 8 Department of Medicine and Institute for Excellence in Education, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Joseph Cofrancesco Jr, Department of Medicine, Johns Hopkins University School of Medicine, Armstrong Medical Education, Building 1600, McElderry Street, Suite 230, Baltimore, MD 21205, USA; joeco{at}


Objectives To describe gender differences of international clinician educators (CEs) and leaders, and CEs’ perceptions by gender of preparation, roles, rewards and factors affecting job satisfaction and retention in emerging international competency-based residency programmes.

Methods Cross-sectional surveys of CEs and leadership were conductedJune 2013–June 2014 at institutions that had adopted competency-based graduate medical education and were accredited by the Accreditation Council for Graduate Medical Education-International.

Results 274 (76.3%) of 359 eligible participants responded; 69 (25.2%) were female. Two (18%) of 11 chief executive officers and 1 (9%) of 11 chief medical officers were women. Female CEs were younger, more likely to be single and childless. They were less likely to hold academic appointments, despite no gender differences in length of time at current institution or in current position. A greater proportion of female CEs felt they were ‘never’ rewarded by academic promotion. Satisfaction rates were similar between the genders. Single female CEs were five times as likely to report being ‘extremely likely’ to stay in the country. Female CEs with children <21 were less likely to report high likelihood of staying in academia. Marital status and children were not associated with outcomes for male CEs.

Conclusions In the international academic medicine programmes studied, there were fewer female CEs in the pipeline and they perceived a gender gap in appointment and advancement. Stakeholders at international programmes need to develop contextualised strategies to expand entry and decrease attrition of women into CE tracks, and promote gender equity.

  • Clinician-Educator
  • International Medical Education
  • Graduate Medical Education
  • Gender-based Disparities
  • Gender Gap

Statistics from


  • Contributors DJS and JC had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. SA and HI contributed equally to this manuscript. DJS, HI, SA, JC: study concept and design. HI, SA, DJS, AAAM: acquisition of data. DJS, SA, HI, NGS, JC: analysis and interpretation of data. DJS, SA, HI, NGS, JC: drafting of the manuscript. DJS, SA, HI, NGS, AAAM, JC: critical revision of the manuscript for important intellectual content. DJS, NGS, JC: statistical analysis. DJS, SA, HI, AAAM, JC: Study supervision. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Disclaimer DJS affirms that this manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

  • Competing interests All authors have completed the ICMJE uniform disclosure form at and declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethics approval The study received approval from the institutional review boards of Johns Hopkins University School of Medicine in Baltimore, Hamad Medical Corporation and Weill Cornell Medicine in Qatar, National University of Singapore and the Al Ain Research Ethics Committee of the UAE. We also received approval from the GME office of each participating site.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles