Representation and career trajectories of female principal investigators in clinical trials, 2010–2023

Although female PIs remain underrepresented in clinical trial leadership, the gap is narrowing, particularly in terms of early-career progression. Future research should explore the underlying causes of these trends, including bias, career-family trade-offs, and the structural and behavioral mechanisms that shape sorting across medical specialties. Additionally, recent evidence suggests that female PIs may positively influence trial performance-particularly in patient recruitment diversity and safety outcomes, which highlights the broader significance of gender equity in clinical research.