By Lisa Rapaport

(Reuters Health) – Even as women make up larger proportions of college athletes and medical school graduates in the U.S., a new study suggests the vast majority of head team physicians at the college level are still male.

Researchers examined data on head team physicians and athletic trainers in the National Collegiate Athletic Association (NCAA) member directory for the 2018-2019 academic year. Excluding teams with unfilled positions, just 11.2% of head team physicians and 31.7% of head athletic trainers were women, the study found.

The findings “suggest that the executive leadership of NCAA institutions should identify organizational and social barriers to gender equity in sports medicine leadership roles,” Dr. Caitlin Lewis of the Cleveland Clinic in Ohio and colleagues write in JAMA Internal Medicine.

“Colleges and universities should implement strategies to promote inclusion and career development, and appoint more women as head team physicians and head athletic trainers,” Lewis and colleagues write.

In 2019, about 44% of student athletes were female, the researchers note. And about 35% of working physicians in the U.S. were women as of 2016, the study team notes.

But gender disparities persist in many areas of medicine, with women often receiving lower compensation, achieving lower academic rank at universities, and getting fewer medical society awards and opportunities to be keynote speakers and conferences, Lewis and colleagues note.

In the study, there weren’t meaningful differences between different NCAA divisions in the proportion of female head physicians. About 9% to 14% of head physician posts were held by women.

For head athletic trainers, about 20% were female in Division I, compared with roughly 36% in Division II and 40% for Division III.

The researchers weren’t able to determine what factors might have contributed to gender disparities in sports medicine hiring at the college level.

They also lacked data on people with nonbinary gender expression and on any changes in the proportion of female physicians and athletic trainers over time.

Gender equity in NCAA sports was a key feature of federal legislation known as Title IX passed in 1972, Dr. Ann Sheehy of the School of Medicine and Public Health at the University of Wisconsin and colleagues write in an editorial accompanying the study.

“Improving the leadership of sports medicine at colleges and universities is central to improving the programs for student athletes,” Sheehy and colleagues write.

Colleges and universities should strive to place more women in leadership roles and make these roles more visible to student athletes, they write. Job ads and performance standards should also be assessed to ensure they don’t include wording that promotes male gendered stereotypes.

“Moreover, the NCAA should issue repeated and clear statements that it is striving to nurture the careers of diverse and excellent leaders for the health of athletes, and that research shows no influence of sex or gender on the ability to be effective in leadership roles,” Sheehy and colleagues conclude.

SOURCE: JAMA Internal Medicine, online November 4, 2019.