The question of why women continue to be underrepresented in the top ranks of academic science—despite their rapidly growing numbers among both recipients of advanced degrees and junior faculty members in scientific subjects—has attracted intense attention. A paper in Academic Medicine raises an intriguing possibility: Women on medical faculties, at least, may prefer teaching and treating patients to publishing research papers. That, in turn, could partly explain their underrepresentation in the field's top ranks.

Although 47% of new medical students, 44% of new full-time medical faculty hires, and 37% of full-time permanent medical faculty members were women in 2011, only 14% of department chairs and 12% of deans were female, write Anita Mayer of the Mayo Clinic in Scottsdale, Arizona, and co-authors. Why? At the same time that the female percentage of entering medical classes and medical school faculties has risen, the authors note, a second category of full-time academic jobs—the clinician-educator track (CET)—has grown rapidly, alongside the traditional tenure track (TTT).

"The CET type offers both men and women the opportunity to contribute as academic faculty without the demanding timetable for research and publication that is typically associated with TTT appointments," the authors write. "These newer faculty track types have various requirements for promotion and tenure but typically contrast sharply with the rigorous time limitations of the TTT type. … Without the defined academic productivity and rank requirements of the TTT type (e.g.,'publish or perish'), clinician–educator faculty who face ever-increasing clinical demands may put less emphasis on producing measurable academic products, such as publications in peer-reviewed journals or grant-funded research."

Two other important differences separate the two tracks. First, "female faculty are more likely than their male colleagues to be on the CET type, if one is available, and less likely to be on the TTT type, if one is available." Second, "promotion rates for clinician–educators continue to lag behind those for their TTT type colleagues." This set of circumstances very likely reduces women's chances of reaching the highest academic echelons, because "advanced academic rank is often a prerequisite for leadership positions," the authors note.

Whether women take CET jobs because they prefer them or are shunted into them despite preferring the TTT appointments is a question that the authors say they cannot answer. They do note, however, that "women more often report an interest in teaching as the primary reason for entering academic medicine," which may imply less interest in research-intensive careers.

As we have reported previously, research has found that women who pursue education in scientific fields have, on average, different motivations from their male counterparts; women tend to place a higher value on service and helping people than men do, on average. Is this also true of faculty members at medical schools? Can this explain women's greater likelihood to take positions on the CET track? The possibility, as the authors write, "deserves further analysis."

Beryl Lieff Benderly writes from Washington, D.C.

10.1126/science.caredit.a1400005