There are significantly more men with moustaches than women in academic medical leadership positions in the top US medical schools, according to a study published in The BMJ Christmas issue.

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Men with moustaches outnumber women in US medical leadership.

While medicine has historically been dominated by males, in recent decades, female representation has increased dramatically.

In 1960, only 9% of US medical students were women, but for the past 15 years, almost 50% of medical students have been female.

However, the proportion of women in academic medicine remains low, with only 21% full professors being women.

Having low numbers of women in leadership positions is a problem because it implies a lack of equality and also because, in other fields, a larger number of female leaders has been linked with better performance, say the US researchers who conducted the study.

Counting moustaches to assess equality

The team, from the University of Pennsylvania and the University of California, examined the number of women in academic medical leadership positions at the top medical schools funded by the National Institutes of Health compared with the number of men with moustaches.

Moustaches were chosen because they are rare, and the team wanted to see if women were even rarer. They measured the proportion of women and men with moustaches across institutions and specialties.

Overall, they analyzed 1,018 medical department leaders by searching the institutional websites of the selected medical schools to identify leaders such as the chair, chief or head of each specialty.

For each department leader, they collected details on their medical specialty, institution and gender. They also recorded the presence of moustache in men, defined as "the presence of hair on the upper lip."

Thickest moustache density in psychiatry

Moustaches included both stand-alone ones, such as the Copstash Standard, Pencil, Handlebar and Supermario, as well as moustaches in combination with other facial hair, such as the Van Dyke, The Balbo and Napoleon III Imperial.

Results showed 13% of department leaders were women, while 19% of department leader positions were held by moustachioed men. The proportion of women department leaders ranged from 0-26% across institutions, and 0-36% across specialties, while moustachioed men held 0-37% of department leadership positions and 2-31% of those in medical specialties.

Five specialties had more than 20% female department leaders: obstetrics and gynecology (36%), pediatrics (31%), dermatology (23%), family medicine (21%) and emergency medicine (21%).

Ten specialties had more than 20% moustachioed department leaders, with the thickest moustache density found in psychiatry (31%), pathology (30%) and anesthesiology (26%).

The "Moustache Index" was calculated as the proportion of women compared with the proportion of moustaches. The overall moustache index of all academic medical departments studied was 0.72.

Redressing the balance

The team suggest all departments should reach a moustache index of more than 1 and propose two ways of achieving this: either "by increasing the number of women in leadership positions or by asking men in leadership positions to shave their moustaches."

However, they note that asking men to shave their mustaches could be seen as "discriminatory" with potentially "detrimental effect on workplace satisfaction and emotional well-being."

Therefore, they call for increased representation of women in academic medical leadership, starting by drawing attention to existing gender disparities.

Policies that could help include those preventing discrimination and sexual harassment, the introduction of family benefits, paid parental leave, flexibility in work scheduling, job sharing, shiftwork, mentorship and tenure-clock extensions.

The researchers conclude:

"We hope that these solutions will help increase moustache indices across all specialties by raising the number of women leaders while maintaining sufficient facial hair in our workplaces."

Medical News Today recently reported that female doctors are less likely to face legal action than their male counterparts.