Actionable companion · Leadership practice and organizational learning

From leadership research to district action: Sex-specific determinants of leadership aspirations among general internal medicine physicians in Switzerland

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.

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 A “leaky pipeline” exists in leadership for medicine in Switzerland, with majorities of women among resident or attending physicians, yet only 32% female senior and 16% chief physicians. Here, we examined factors associated with career ambitions of General Internal Medicine (GIM) physicians. Methods We performed a cross-sectional web-based survey among GIM physicians in Switzerland. Outcome was the intent of becoming senior or chief physician. Exposures included workplace-related factors including network, supervisor’s support and gender-related discrimination and personal factors including Physician Well-being index and family situation. Results The sample included 624 physicians, of which 60% were women. During medical school, career aspirations of men and women were comparable. Yet, in their current aspiration towards leadership, men more frequently reported high aspirations than women (17% vs. 11%) (p = 0.03). Higher career aspiration was present among those who were more satisfied with their work (OR: 3.26, 95% CI: 1.56–7.73). Among men, higher career aspiration was associated with a lower probability of pathological well-being (OR: 0.12, 95% CI: 0.02–0.50). Among women, higher career aspiration was associated with reporting gender discrimination or facing negative views on parenthood by their supervisors (OR: 7.48, 95% CI: 1.71–39.0). Conclusion Both female and male physicians reported to have held similar career aspirations at onset of their career, while sex differences emerged during career progression. Supervisors’ unfavorable views on parenthood and gender discrimination in association with female physicians’ career aspirations may guide workplace-tailored strategies to close the leak in the pipeline towards medical leadership. Supplementary Information The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-10044-w. Keywords: Career ambitions, Sex differences, Physician well-being, Work satisfaction Key points Question: A leaky pipeline describes the attrition of female physicians with increasing hierarchical positions, but the sex-specific factors associated with leadership aspirations are unclear. Findings: Comparable fractions of men and women reported to have aimed to attain a leadership position in the past, but currently 11% of women and 17% of men aiming for leading positions among physicians in Switzerland. In female physicians, leadership aspiration is associated with facing challenges such as gender discrimination or unfavorable views regarding motherhood at the workplace. Meaning: The observed sex differences in leadership aspiration among physicians is accompanied by potentially modifiable workplace-related challenges. Resolving these challenges may enable future initiatives to facilitate female career advancement in medicine. Supplementary Information The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-10044-w.

A 90-day district inquiry

1. 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.
2. 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.
3. 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.
4. 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

Jeanne Moor; Lena Woodtli; Christine Baumgartner; Karolina Kublickiene; Sven Streit; Christa Nater. Sex-specific determinants of leadership aspirations among general internal medicine physicians in Switzerland. BMC Medical Education (2026-08-01). https://doi.org/10.1186/s12909-026-10044-w

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.