Cultural change is needed to increase the number of women in healthcare and medical leadership in Australia, according to Australian researchers.

Women continue to be under-represented in health care and medical leadership in Australia, with experts labelling the disparity an issue of “equity and social justice”.

The burden of addressing barriers on a woman’s path to leadership should not sit with individuals, but with changing the culture, organisations and systems where women work, according to a new Perspective article published in the Medical Journal of Australia.

A renewed push is under way to improve the disparity, writes paediatrician Dr Jenny Proimos and colleagues, through the Advancing Women in Healthcare Leadership (AWHL) initiative, funded by the National Health and Medical Research Council (NHMRC).

A key focus of the AWHL initiative is recognising the role played by member organisations, including professional associations and medical colleges.

Eight colleges and member organisations partnered with the AWHL to explore the systems and policies they have in place to help advance women in the field.

The feedback from member organisations on the AWHL initiative has been very positive, with more funding now secured from the NHMRC.

Extensive engagement continues with member organisations as one way to improve the representation of women in health care and medical leadership.

The experts say that women in medicine face a persistent “glass cliff” when trying to obtain leadership positions.

Although more women took on medical leadership positions during the COVID-19 pandemic, there appears to be an uncrossable threshold in Australia, Dr Melissa Wheeler from RMIT University and Dr Laksmi Govindasamy wrote.

Women tend to be appointed to leadership positions in times of crisis, where they are often put under increased demands, they argue.

“The glass cliff phenomenon, drawn from the glass ceiling concept, refers to the tendency for women and other minoritised people to be appointed to leadership positions in times of crisis, compared with periods of stability,” Dr Wheeler and Dr Govindasamy wrote.

“This is because, when circumstances are bad, change is both desired and needed, and women and other minoritised people are often pushed forward as visible signals of change.”

Many gender equity initiatives fail to improve women’s representation in medical leadership, they argue, with too many initiatives aimed at professional development for individuals who are seeking or holding leadership positions.

This approach “ignores the structural barriers that continue to be unchallenged with such supply side approaches,” Dr Wheeler and Dr Govindasamy wrote.