Barriers and Facilitators of Women’s Leadership in Academic Medicine in China: A Qualitative Study

Shu Li,1,* Hongling Chu,2,* Jiawei Ribaudo,3 Ning Shen,4 Cheryl A Moyer5 1Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China; 2Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People’s Republic of China; 3Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA; 4Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China; 5Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA*These authors contributed equally to this workCorrespondence: Cheryl A Moyer, Department of Learning Health Sciences, University of Michigan Medical School, 1111 E. Catherine St, Ann Arbor, MI, 48109, USA, Tel +1-734-417-3116, Email [email protected] Ning Shen, Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, No. 49 North Garden Road, Beijing, 100191, People’s Republic of China, Tel +86-82266699, Email [email protected]: Globally, far fewer women than men are in leadership positions in academic medicine. This study aimed to explore the barriers and facilitators of female leadership development in the Chinese medical field, identify significant factors promoting leadership development, and ultimately provide a basis for the formulation of leadership enhancement strategies.Methods: This qualitative descriptive study, grounded in an interpretivist paradigm, used purposive sampling to recruit female junior faculty members (< 40 years) and senior leaders from university-affiliated hospitals in Beijing, China. In-depth, semi-structured interviews were conducted, audio-recorded, and transcribed verbatim. All interviews were conducted either online or by phone in participants’ preferred language (Mandarin or English). Transcripts were analyzed using thematic analysis, with NVivo 11.0 used to support systematic coding and data management.Results: We interviewed 18 junior faculty members and 7 senior faculty leaders from five university-affiliated hospitals in Beijing. The main outcomes of interest were barriers and facilitators to female leadership development in the Chinese medical field. Three major themes emerged: (1) the current status of women’s leadership in academic medicine, characterized by the underrepresentation of women in leadership positions; (2) multi-level barriers to advancement at the policy/structural, social, and individual levels, including gendered retirement policies that truncate careers, stereotypes regarding women’s professionalism and competence, disproportionate family responsibilities, and a confidence gap; and (3) essential skills, individual characteristics and facilitators for leadership development, with particular emphasis on leadership training and the importance of female role models.Conclusion: This study reveals context-specific structural barriers, such as gendered retirement policies, alongside pervasive social stereotypes within Chinese academic medicine context. Women in academic medicine continue to face systematic constraints that limit their advancement into leadership roles. A multi-level approach should be applied to mitigate informal barriers, and cultural interventions that challenge deep-seated gender norms.Keywords: women’s leadership, academic medicine, qualitative methods, barriers