It’s rare that we see overt acts within institutions that actively block women from leadership roles. Though I am sure it happens, these are not frequently the binds that hold us back in modern society. No, it’s more subtle than that. In fact, “the system” is not made for women; and therefore does not lend itself to promoting female leadership. In an article in the Harvard Business Review, Women Rising: The Unseen Barriers, the authors discuss the second-generation gender biases that often lead to the unbalanced rise of predominantly male leaders.

Lack of role models. How do we all learn to be leaders? In medicine this question is of particular importance, because often we get into our leadership roles by happen-stance, and we are not formally taught how to be leaders. We emulate our role models; and for women much of this modeling is from male leaders who held the positions before us.

Career paths that are male oriented. When we think of timelines to promotion, we automatically create scenarios that are more male orientated. How often in our academic promotion guidelines are times of child-bearing and rearing considered? Rarely, if at all. Nor are there realistic expectations of work-life balance instituted for either gender to consider prioritizing family over work, allowing for more lax expectations to promotion.

A woman without a sponsor. Often we think of the golf course (a male dominated activity) as the unconventional place where business deals are made. This concept of out-of-office networking allows for our male colleagues to develop relationships that naturally exclude women (of course in this example the implication is that women do not enjoy golf). When asked, many leaders will say that having a sponsor is the key to their achievements. Having someone who often nominates you for a position, a role, or an award; or accompanies you into networking events is an often unacknowledged pathway to success.

The Double Binds. Finally, it’s the double binds that create double standards of how female leaders should behave. If we take on more masculine leadership characteristics then we are deemed unapproachable or unlikeable, and often told to be “softer” in our approach. If we express more feminine leadership, we are told to be more aggressive in order to gain respect. In the simplest of examples of the double binds is when women are told to smile more. Often times I am criticized for not smiling, particularly if I am interviewing a candidate. My response is usually, how often are my male colleagues asked to smile more? My resting face is very similar to everyone else’s in that I am intent on listening to their responses, which does not require a smile plastered on my face. Yet, my likability is rated based on my smiling, or not, and not the content of my character.

While we have highlighted the problems, the challenge then becomes for departments and institutions to break these hidden chains that create barriers to gender equality. In a New York Times Article in 2011 titled, Should Women Be Doctors?, Belkin starts the conversation, which should in my opinion become a movement to cut these invisible binds. Her opinion piece is in direct response to an essay written by a female anesthesiologist who charges that as physicians, women need to place their patients above all else. And, that as physicians we are not granted the freedom to work part-time or to have work-life balance. Belkin rebels against this notion. In fact, she states that women shouldn’t, nor can they change their needs, but that systems must change. We must create infrastructures that encourage well-balanced lives and promote alternative options for family rearing professionals, female and male. Hwang writes in Forbes that instead of teaching women to conform into “the system,” we must change “the system.” The contradictory point is that the work-force will be left with men working full-time supporting their female colleagues while they are off rearing children. No, work life-balance, part-time options, slow course promotions, working from home, work schedules with high practice times crunched to allow for slower practice times, are not gender specific. These options will allow for more career satisfaction for everyone. This may, in fact, be the direct combat to burn-out.

It is the invisible binds that break women, leading them to believe that they cannot excel as leaders in systems that are built for men. These binds may be invisible, but they are reality. But, if we want more gender equality we must break the binds that “the system” creates, and create new systems.


Belkin, L. Should Women be Doctors? Motherlode Adventures in Parenting, New York Times, June 13, 2011

Ibarra H, Ely RJ, and Kolb D. Women Rising: The Unseen Barriers. Harvard Business Review, September 2013

Hwang VW. Are Feminine Leadership Traits The Future of Business? Forbes, August 30, 2014