Deciding to lead: a qualitative study of women leaders in emergency medicine

BACKGROUND: The aim of this study is to highlight career paths of senior women leaders in academic emergency medicine (EM) to encourage younger women to pursue leadership. METHODS: This was a qualitative study using semi-structured interviews with female EM leaders. We interviewed 22 recognized female leaders selected using criterion-based sampling and a standardized script of open-ended questions derived from the Intelligent Career Model. Questions were related to job purpose, skills, and networking. Interviews were transcribed verbatim and three trained reviewers analyzed transcripts following grounded theory principles and using Dedoose®. Researchers used an iterative process over several meetings to produce the final set of codes and themes. RESULTS: Our iterative process identified four themes: women leaders made an intentional decision to pursue opportunities to influence emergency medicine, women sought out natural mentors and sponsors to facilitate career development, women leaders intentionally planned their out of work life to support their leadership role, and an important focus for their work was to help others achieve excellence. CONCLUSIONS: Our study provides insights from senior female leaders in EM; supporting the value of women pursuing leadership. There is a widely acknowledged need to diversify leadership and support gender-specific needs to develop women leaders in medicine. Becoming a woman leader in EM means making intentional decisions and taking risks. Leaders found benefits in natural mentors and sponsors. Those relationships have power to change the trajectory of emerging women leaders by identifying and reinforcing potential. Work/life balance remains an area which requires intentional planning. Woman leaders encourage succession planning and corroborate the need for increasing the percentage of women leaders to benefit the organizational culture. Leadership in academic medicine is changing with reorientation of a largely autocratic, vertically oriented hierarchy into a more democratic, consensus-driven, and horizontally organized management structure which should complement the strengths women bring to the leadership table.