From leadership research to district action: Gender-based differences in the representation and experiences of academic leaders in medicine and dentistry: a mixed method study from Pakistan

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Background Research evidence suggests gender-based differences in the extent and experiences of academic leaders across the globe even in developed countries like USA, UK, and Canada. The under-representation is particularly common in higher education organizations, including medical and dental schools. The current study aimed to investigate gender-based distribution and explore leaders’ experiences in the medical and dental institutes in a developing country, Pakistan. Methods A mixed-method approach was used. Gender-based distribution data of academic leaders in 28 colleges including 18 medical and 10 dental colleges of Khyber Pakhtunkhwa, Pakistan were collected. Qualitative data regarding the experiences of academic leaders (n = 10) was collected through semi-structured interviews followed by transcription and thematic analysis using standard procedures. Results Gender-based disparities exist across all institutes with the greatest differences among the top-rank leadership level (principals/deans) where 84.5% of the positions were occupied by males. The gender gap was relatively narrow at mid-level leadership positions reaching up to as high as > 40% of female leaders in medical/dental education. The qualitative analysis found gender-based differences in the experiences under four themes: leadership attributes, leadership journey, challenges, and support. Conclusions The study showed that women are not only significantly under-represented in leadership positions in medical and dental colleges in Pakistan, they also face gender-based discrimination and struggling to maintain a decent work life balance. These findings are critical and can have important implications for government, organizations, human resource managers, and policymakers in terms of enacting laws, proposing regulations, and establishing support mechanisms to improve gender-based balance and help current and aspiring leaders in their leadership journey. Supplementary Information The online version contains supplementary material available at 10.1186/s12909-024-05811-6. Keywords: Women, Leaders, Qualitative study, Pakistan

Study methods

Based on the study objectives, a mixed-method sequential study design [21] including (a) survey of the gender-based distribution of academic leadership positions in medical and dental colleges (b) qualitative interviews with selected individuals occupying leadership positions to explore gender-based differences in their experiences were employed. Integration occurred during development of the interview protocol and results description of both phases to gain an in-depth insight into the extent and experiences of gender based distribution in academic medicine and dentistry. The ethics approval of the study was granted by the institutional research board of Khyber Medical University (Ref No: 1–11/IHPER/MHPE/KMU/23–62) and the study design followed GRAMMS (Good Reporting of a Mixed Methods Study) guidelines.

Limitations

Our study provides a multi-faceted perspective on the extent and experiences of gender-based disparities in medical and dental institutes in Pakistan. The inclusion of all medical and dental institutes increased the generalizability of the study findings while the more than 93% response rate of the survey reduced the selection bias thus increasing validity. Moreover, the qualitative arm of the study provided deep insights into the experiences of academic leaders in a developing and strictly patriarchal society. However, our study has some limitations. The study findings cannot be generalized across Pakistan due to widely prevalent differences across different ethnicities, cultures, and socioeconomic background. Another limitation of the study that should be considered is that the survey information was collected based on department-wise availability of leadership roles. However, the subdivisions in some academic departments for example Medicine & Allied were not included in our study and therefore, variations are expected in the exact female-to-male ratio in the medical and dental colleges.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one recurring leadership practice described in the source. Map its participants, incentives and constraints to a district setting, then design a small reversible staff pilot with an accountable owner. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Record implementation fidelity, staff review time, task quality and unintended burdens against a baseline. Use a comparison team where feasible and document alternative explanations before expanding. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Muhammad Shahzad; Brekhna Jamil; Mehboob Bushra; Usman Mahboob; Fayig Elmigdadi. Gender-based differences in the representation and experiences of academic leaders in medicine and dentistry: a mixed method study from Pakistan. BMC Medical Education (2024-08-16). https://doi.org/10.1186/s12909-024-05811-6

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.