Quantitative Analysis
The gender-based distribution of academic leaders in medical and dental colleges of KP (n = 28) is presented in supplementary table 1 & 2 and summarized in Fig. 2. Overall, women remain under-represented at all leadership tiers. Gender-based differences were highest at top leadership positions, including principal/deans/directors, where women occupy only 15.5% of the total leadership positions. However, women are relatively well represented in mid-level leadership positions. The mid-level leadership positions are further categorized into three groups (basic sciences, clinical sciences, and medical/dental education departments). Across the three categories at the mid-level, the leadership gap tends to be narrower in the medical/dental education department, where more than 40% of the heads of the departments are females.
We next assessed gender-based differences in academic leadership positions in medical and dental colleges. At top-level management in dental colleges (Fig. 3), the percentage of women leaders is twice that of women leaders in medical colleges (Fig. 4)
Gender-based disparities were also observed at the level of the department as well as whether the institute is private and public sector institutes (supplementary table 1&2). In general, except for medical education, the female-to-male ratio was higher in public sector medical and dental colleges of the KP province. Similarly, in certain clinical fields such as obstetrics gynaecology, and prosthodontics, leadership positions were entirely occupied by only one gender.
Qualitative Analysis
Demographic characteristics of the participants are presented in Table 1. Wide variations exist among the participants in terms of age, experience, academic credentials and number of years in a leadership position. The mean age of the participants was 45.4 ± 5.2 years and average experience was 16.4 ± 5.3 years.
Table 1
Demographic characteristics of the study participants
Participant ID | Gender | Current institution | Age (years) | Qualification | Experience (Years) | Current role/Position | Years as leader |
ID − 1 | Male | Public | 43 | MBBS, MPhil, MPH | 17 | HOD | 6 |
ID − 2 | Female | Public | 54 | MBSS, FCPS, MHPE | 23 | Principal | 10 |
ID − 3 | Male | Public | 47 | BDS, FCPS, CHPE | 20 | Principal | 4 |
ID − 4 | Female | Private | 49 | MBBS, MHPE | 13 | Director | 10 |
ID − 5 | Female | Private | 36 | PhD | 5 | Director | 2 |
ID − 6 | Female | Public | 49 | BDS, FCPS, CHPE | 18 | HOD | 2 |
ID − 7 | Male | Public | 42 | BDS, PhD | 12 | Director | 5 |
ID − 8 | Female | Public | 50 | MBBS, FCPS, PhD | 21 | Director | 10 |
ID − 9 | Male | Public | 42 | MBBS, PhD | 15 | Director | 5 |
ID − 10 | Male | Private | 42 | MBBS, MCPS, FCPS, MSN, PhD, CHPE | 20 | HOD | 10 |
Qualitative findings
The experiences of the participants can be described under four main themes and eleven subthemes as presented in Table 2.
Table 2
Themes and Sub-themes of qualitative analysis
Theme | Sub Theme |
Leadership attributes | - Guiding leaders of tomorrow - Flexibility and adaptability - Teamwork and unity |
Journey | - Making use of opportunities - Gender discrimination - Benefits of leadership |
Challenges | - Work life balance - Family Issues - Overcoming Challenges |
Support | - Role of mentor - Building resilience |
Theme 1: Leadership attributes:
The participants identified various attributes that are important for a leader. Both male and female participants expressed that a leader is internally motivated to substantially impact the lives of those around them. A vast majority of the participants agreed that they possessed a clear and strong desire to bring about positive transformations in the lives of others through their leadership but also to witness and experience the visible results of their efforts personally.
“If you are a leader, you are required to influence people and guide them properly.” (ID-1 Male)
Another leadership attribute identified by participants was good teamwork.
“…One of the leadership qualities is working with your colleagues and subordinates as a team. And when you take them into confidence, they support and encourage you and facilitate you in every way…” (ID7- Male)
Positive mindset, flexibility, diplomacy, and self-awareness are were also cited as essential traits for leaders. A Difference in opinion was found among female participants as they mentioned increased cooperation, support, and collaboration among female colleagues.
“Yes, and not only that, they give me support at my workplace. We give support to each other…” (ID-5- Female)
Theme 2: Leadership Journey:
The participants in the study shared their views on leadership, stating that it involves multiple responsibilities and requires a both education and practical experience. The path to leadership was seen as challenging, but male and female participants had different perspectives on how they achieved it. Female leaders were found to actively seek opportunities, while leadership roles were more readily offered to male participants.
“The transition into leadership roles as a male has been easy” (ID9-Male)
Female leaders also struggle to balance their domestic responsibilities with their leadership roles, which was not the case for male leaders.
“..I had to do all the house chores myself. The cleaning, the cooking, the washing, the daily activities, and then return home to do more work with the kids..” (ID5-Female)
Both male and female participants acknowledged the existence of gender discrimination in leadership roles despite societal norms that suggest otherwise. Participants also highlighted various advantages of leadership in their career growth, including training, financial stability and autonomy.
“…but then they got some advantages to their financially stable, they are socially responsible, you have a strong social background…” (ID4- Male)
Theme 3: Challenges
Both male and female participants highlighted the underrepresentation of women in leadership positions.
“Yes, because our society is male-dominated. In my own opinion if there was a female in my place, she would have surrendered and said that she would have forgiven that….” (ID6- Male)
Moreover, female participants faced discrimination while pursuing leadership positions. They were able to overcome these challenges by relinquishing some degree of control and seeking assistance from other individuals.
“When I was going for my PhD, in my interview, they said, oh, you're a woman. OK, you're married. Ohh. You have kids. What are you going to do with your kids…” (ID8-Female)
…. “However, within the limited end available resources, I made efforts with the support from the institute and high-ups.” (ID7- Female)
The challenge of work-family balance was identified by both male and female participants. However the male participants reported that their families were taken care of by their spouses, which allowed them to focus on their work but the female participants had to balance multiple responsibilities.
“My wife is a housewife, so that she can give the family time. And my parents are also looked after by my wife. So, if financially I'm supporting them, the emotional support is always there, and it doesn't make any difference if I am busy” (ID1-Male)
“…. Yes, a terrible effect. It has badly affected my health. My family has excluded me from their social activities and their social circle…” (ID2-Female)
Theme 4: Support:
Mentoring was found to be vital to leaders for their personal growth and advancement as they provided focused guidance and support to aspiring leaders, helping them reach their fullest potential. It was interesting to note that most female participants acknowledged the mentoring role of their father during their leadership journey.
“Mentor for me as a person is my father. He retired as the Chief Secretary of the province. He was a very senior bureaucrat, a very well-read person, and a scholar…” (ID5- Female)
Both male and female participants stressed the importance of developing systems of support to build resilience. These include the role of institution, family, administration, and collaborative work environment. Interestingly most female participants highlighted that support from female colleagues is necessary to sustain leadership roles.
“My husband has supported me a lot…” (ID-3 Female)
“Of Course, we don't get to wherever we are until we have somebody as support, especially in academics..” (ID2- Female)