Sex distribution in academic ophthalmology leadership in the United States

Purpose: To analyze sex distribution and assess sex-based differences in academic profiles among leadership positions in United States (US) ophthalmology departments in 2024. Design: Retrospective cross-sectional study. Subjects/Participants: Department chairs, program directors (PDs), associate program directors (APDs), and directors of medical student education (DMSEs) from 117 ACGME-accredited ophthalmology residency programs. Methods: Demographic and academic data were collected from publicly available resources. Categorical variables were compared by sex using Chi-square tests, and continuous variables were compared using Student's t-tests or Mann-Whitney U tests, as appropriate. Results: A total of 22/117 (18.8%) department chairs, 52/117 (44.4%) PDs, 64/107 (59.8%) APDs, and 63/102 (61.8%) DMSEs were female. A greater proportion of female chairs completed fellowships in neuro-ophthalmology (27.3%) and pediatric ophthalmology (18.2%) compared with male chairs (p < 0.001). No differences were observed between female and male chairs in age, geographic distribution, years since residency or appointment, degrees, academic rank, or research productivity. Among PDs, female representation was higher in the Northeast (p = 0.03), while age, degrees, years since residency, fellowship training, academic rank, and research indices did not differ by sex. Among APDs and DMSEs, no sex-based differences were identified in age, geographic location, degrees, fellowship training, academic rank, or research indices. Conclusions: Despite similar research productivity and academic experience, sex disparities persist in senior academic ophthalmology leadership roles. Strategies to promote the advancement of female faculty to these positions are warranted.