Perspectives on Gender Equity: A National Survey of Pediatric Hospital Medicine Division Leaders

Abstract

OBJECTIVE: To assess pediatric hospital medicine (PHM) division leaders' perspectives on gender equity in their divisions and organizations. METHODS: In 2025, we conducted a cross-sectional Research Electronic Data Capture survey distributed via email to 236 PHM division leaders. The survey consisted of 53 items on division and leader demographics, promotion, leadership, benefits, and gender-related experiences. Descriptive statistics summarized numeric responses, and qualitative content analysis identified emerging themes in free-text responses. RESULTS: Responses from 125 PHM division leaders (53% response rate) were received. Leaders were predominately women (69%) and held PHM subboard certification (84%), with a median of 15 years of practice as a hospitalist. According to leaders, 76% of their faculty were women. No gender differences were reported in faculty rank or leadership roles. Compensation analysis by gender was reported by only 26% of responding institutions. Similarly, although wellness support was common, gender-stratified analyses of outcomes were rarely performed (19%). Mean paid parental leave offered to birth parents was 8 weeks. Qualitative analysis of leaders' suggestions to drive change toward gender equity revealed 6 major themes: (1) compensation transparency, (2) caregiver support, (3) career development, (4) countering gender bias through education and allyship, (5) fostering psychological safety, and (6) advancing institutional accountability. CONCLUSIONS: Division leaders reported gaps in gender equity practices alongside systemic challenges in PHM. Identified priorities include transparent compensation practices, caregiver-inclusive benefits, career pathways, and leadership accountability. As the first national assessment of PHM leaders' perceptions, these findings highlight opportunities to strengthen structural support for gender-equitable advancement for all clinicians.