The Clinical Neuropsychologist

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Women’s leadership in neuropsychology: historical

perspectives, present trends, and future directions

Bonnie C. Sachs, Andreana Benitez, Melissa T. Buelow, Amanda Gooding,

Lynn A. Schaefer, Anita H. Sim, Chriscelyn M. Tussey & Paula K. Shear

To cite this article: Bonnie C. Sachs, Andreana Benitez, Melissa T. Buelow, Amanda Gooding,
Lynn A. Schaefer, Anita H. Sim, Chriscelyn M. Tussey & Paula K. Shear (2018) Women’s
leadership in neuropsychology: historical perspectives, present trends, and future directions, The
Clinical Neuropsychologist, 32:2, 217-234, DOI: 10.1080/13854046.2017.1420234

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The Clinical Neuropsychologist, 2018
VOL. 32, NO. 2, 217–234
https://doi.org/10.1080/13854046.2017.1420234

Women’s leadership in neuropsychology: historical

perspectives, present trends, and future directions
Bonnie C. Sachsa, Andreana Benitezb, Melissa T. Buelowc, Amanda Goodingd, Lynn
A. Schaefere, Anita H. Simf, Chriscelyn M. Tusseyg,h and Paula K. Sheari
a
Department of Neurology, Wake Forest School of Medicine, Winston Salem, NC, USA; bDepartment of
Neurology, Medical University of South Carolina, Charleston, SC, USA; cDepartment of Psychology, The Ohio
State University Newark, Newark, OH, USA; dDepartment of Psychiatry, UC San Diego School of Medicine, San
Diego, CA, USA; eDepartment of Physical Medicine & Rehabilitation, Nassau University Medical Center, East
Meadow, NY, USA; fDepartment of Physical Medicine & Rehabilitation, Minneapolis VA Health Care System,
Minneapolis, MN, USA; gDepartment of Psychiatry, New York University School of Medicine, New York, NY, USA;
h
Private Practice, New York, NY, USA; iDepartment of Psychology, University of Cincinnati, Cincinnati, OH, USA

ABSTRACT ARTICLE HISTORY

Objective: Although psychology has become a female-dominated Received 6 January 2017
field, this pattern of gender representation has not held true within Accepted 8 December 2017
the specialty of neuropsychology. In recent years more women have
KEYWORDS
been pursuing careers in neuropsychology, and while the balance Gender; women; men;
of male and female neuropsychologists as a whole has shifted, leadership; neuropsychology
it is unclear whether the gender composition of leadership has
also changed. Our goal was to survey various neuropsychological
organizations, training programs, editorial boards, and organizations
granting board certification to determine the current gender
composition of leadership positions within neuropsychology.
Method: A literature review was conducted to examine past trends
of gender composition in neuropsychology, psychology, medicine,
and academia. Data on current gender compositions of the field
were culled from publicly available websites and through personal
communication with representatives from major psychological and
neuropsychological organizations. Results: We found that the overall
composition of the field has changed over time, but notable gender
disparities in leadership positions remain. Women still comprise the
minority of leadership positions within most neuropsychological
organizations, editorial boards for neuropsychology journals, and
fellow positions in major neuropsychological organizations. More
equitable representation has been achieved in the directorships of
training programs and ABPP/ABCN board certification. Conclusion:
We review the historical trends in gender discrepancies in leadership
in neuropsychology and discuss these within the broader arenas of
academia, research, and medicine. We conclude with a summary
addressing potential causes for these discrepancies, including work-
life balance issues, discrimination, institutional bias, and various other
factors. We also provide pragmatic suggestions to help address these
continued disparities.

CONTACT Bonnie C. Sachs bsachs@wakehealth.edu

© 2018 Informa UK Limited, trading as Taylor & Francis Group
218  B. C. SACHS ET AL.

Introduction
The number of women in neuropsychology has been increasing over the past three decades;
however, the number of women in organizational and academic leadership has not kept
pace with this trend (Hilsabeck & Martin, 2010). At the entry level, between 2005 and 2015
there was a 5.9% increase in the proportion of female post-doctoral fellows in clinical neu-
ropsychology (from 70.7% to 76.6%), and a 7.6% increase in the number of female profes-
sionals (from 48.1% to 55.7%) (Sweet, Benson, Nelson, & Moberg, 2015). Accordingly, the
proportion of women members among the largest professional organizations has grown.
Despite this increase in representation over time, gender disparities in neuropsychology
persist. Practice-wide survey results (from Sweet et al., 2015) show that fewer women than
men hold full-time neuropsychology positions (81.6% of women compared to 85.9% of men
in 2015), though notably this gap has decreased slightly over the past 10 years (4.3% gender
difference in 2015 compared to 7.6% in 2005). In the 2015 survey, men also consistently
reported greater levels of satisfaction as it relates to income, job, and work-life variables.
With regard to income, Sweet and colleagues (2018) found that women working full-time
as neuropsychologists earn less than men (as much as $48,000 less), even after controlling
for variables such as work setting, years in practice, and age. Furthermore, this pay gap has
not narrowed substantially over time since 2005. This trend mirrors the field of psychology
as a whole; the American Psychological Association’s (APA) Center for Workforce Studies
found that female psychologists may make $39,000 less than their male counterparts in
some work settings (‘Does the Gender Pay Gap …’, 2014). In addition, fewer women have
been elected as Fellows, Presidents, and Board Members in the largest professional psycho-
logical and neuropsychological organizations, and fewer still serve as chief or associate edi-
tors (Hilsabeck & Martin, 2010).
In response to gender disparities in leadership positions within the specialty, the Women
in Neuropsychology (WIN) Interest group was formed as a subcommittee of Division 40 of
APA in 2001 (Shear & Marcotte, 2002), and an electronic listserv was developed.1 The goals
of this group included increasing women’s representation in leadership positions and as
fellows, matching trainees and early career neuropsychologists with seasoned women men-
tors, and providing information and programming at professional meetings about topics of
interest to women. A similar committee, called Women in Leadership (WIL), was later devel-
oped in the National Academy of Neuropsychology (NAN). Both groups have witnessed an
increase in women becoming fellows and being elected to leadership positions as a result
of increased awareness and support, although disparities persist.
While published information on the underrepresentation of women in neuropsychol-
ogy leadership is limited, the disparity in this field likely parallels the trends and contributory
factors within academic medicine more broadly (Brzezinski, 2010). Yedidia and Bickel (2001)
interviewed clinical department chairs about the scarcity of women in leadership in academic
medicine, and they collectively recognized continued barriers to advancement including
sexism, limits of traditional gender roles, and lack of access to mentors. Bickel et al. (2002)
summarized the Association of American Medical Colleges (AAMC) Increasing Women’s
Leadership Project Implementation Committee data over four years, and concluded that
while some progress had been made to advance women in academic medicine, the progress
made thus far was inadequate and incomplete. For example, within the discipline of surgery,
 THE CLINICAL NEUROPSYCHOLOGIST  219

the number of female surgeons more than doubled between 1994 and 2015, but women
still made up less than 10% of full professors (Abelson, Chartrand, Moo, Moore, & Yeo, 2016).
Wright et al. (2003) studied significant gender differences in salary and rank within aca-
demic medicine as a whole, and found that women earned only 89% of their male colleagues’
salaries. Differences were initially thought to be attributable to differences in productivity
and commitment, but survey results did not identify any significant gender differences for
these variables. In another study, publically available salary data were examined for physi-
cians with academic appointments in 24 public medical schools in 12 states, with results
indicating significant gender differences in salary, even after accounting for age, specialty,
experience, faculty rank, and research productivity (Jena, Olenski, & Blumenthal, 2016). These
results are consistent with an experimental study where identical resumes were randomized
either with a male or female name, and both male and female faculty in the sciences review-
ing these resumes were more likely to underrate women’s compared to men’s credentials,
and to suggest lower starting salaries for women (Moss-Racusina, Dovidiob, Brescollc,
Grahama, & Handelsmana, 2012). One of the most highly respected scientific journals, Nature,
recently published an editorial recognizing gender disparities not only in the gender of the
authors’ work that was highlighted in their News and Views section, but also in the compo-
sition of their editorial board, which included only14% women (Nature, 2012).
Thus, the existing body of data presents a clear picture: despite better representation of
female students in training programs and at entry into the field, change has been exceedingly
slow at the leadership level where gender disparities continue to exist. There has been no
recent published data – besides that presented by Hilsabeck and Martin in 2010 – directly
examining the representation of women and men in various leadership positions within
clinical neuropsychology. The goal of this paper is to provide an updated examination of
whether gender disparities persist in the field of neuropsychology, particularly among its
leadership across different spheres of influence (i.e. involvement in national organizations,
editorial boards, recognized contributions to the field, and training directorships).

Methods
Data for this manuscript were culled from publicly available websites and through direct
queries to organizations. An attempt was made to obtain data regarding the historical and
current gender composition of membership, leadership, and fellows2 from major neuropsy-
chological organizations in North America, including the American Academy of Clinical
Neuropsychology (AACN), the International Neuropsychological Society (INS),
National Academy of Neuropsychology (NAN), and the Society for Clinical Neuropsychology
(SCN)/Division 40 of APA. However, some of this information was unavailable at the time
these data were collected, including the gender composition of the general membership
of AACN and INS. Portions of the data were also obtained from the websites of APA’s SCN/
Division 40, the Association of Psychology Post-doctoral and Internship Centers (APPIC), and
the Association of Post-doctoral Programs in Clinical Neuropsychology (APPCN). Data were
extracted from these websites and from personal correspondence with various office holders
and representatives within these organizations to identify women who serve as directors at
the doctoral, internship, and post-doctoral levels, as well as those who have achieved fellow
status, serve on the board of governors, or hold various other leadership roles. Information
about board certification in neuropsychology was obtained from both the American Board
220  B. C. SACHS ET AL.

of Clinical Neuropsychology (ABCN) and the American Board of Professional Neuropsychology

(ABN) websites, and from personal communications. Data were gathered from the earliest
time point at which they were available, generally through the end of 2015 calendar year.
Data regarding editors of neuropsychology journals were obtained from the websites of
select journals. Journals were chosen by searching for the term ‘neuropsych*’ in order to
capture journals that included the words ‘neuropsychological,’ ‘neuropsychology,’ etc. A
search of Journal Citation Reports returned 34 journals. Of those 34, 9 were excluded because
they were published in a language other than English or had not been active in the past 4
or more years. Of the remaining journals, 15 journals were selected based on their inclusion
of the word ‘neuropsychology’ in their title or primary description (as opposed to ‘neuropsy-
chiatry,’ which was excluded). These journals were then examined to determine the number
of women who held an editorial role.
Once data were obtained, proportional statistics examining the percentage of women
versus men were calculated and are presented in the results section and corresponding
tables and figures.

Results
Gender composition of organizational membership
Data obtained from APA reveal the proportion of women members in SCN has increased
from approximately 35 to 49% between 1997 and 2015 (T. F. Habash, APA Chief Business
Integration Officer & CIO, personal communication, 30 September 2016; (Figure 1)). While
SCN membership is not restricted to those with specialty training in neuropsychology, even
in this broad membership base there have tended, until recently, to be fewer women than
men. Data from NAN reflect similar gender composition: as of 2016, 51% of general NAN
members (1604 of 3129) were women (National Academy of Neuropsychology, personal
communication, 22 September 2016). While gender membership composition of other
organizations was not available, these data are thought to broadly reflect the general com-
position of women in our field at the present time.

Fellowship status
Fellow status is granted only to those who have applied for this distinction and have demon-
strated substantial accomplishment in the field. The data on the number of women fellows
who are members of SCN/Division 40 reveal only a modest change between 1997 and 2015,
with the percentage of fellows who are women increasing from approximately 23.2–30.8%
(T. F. Habash, APA Chief Business Integration Officer & CIO, personal communication, 30
September 2016). Within APA, fellows are nominated through sponsoring divisions, but
fellowship status is conferred by APA rather than the division. Thus, these percentages rep-
resent the total number of APA fellows who happen to be members of SCN/Division 40
(N = 263 in 2016), and do not exclusively represent individuals who have obtained fellowship
status from SCN. Of the individuals conferred fellowship status by SCN in 2016 (N = 170),
29.4% were women (The Society for Clinical Neuropsychology [Fellowships], (2015)). In NAN,
the proportion of women fellows has remained relatively stable over time (19% in 2002 to
22% in 2014), without any marked increase in women fellows across 12 years (C. Silver, former
Chair, NAN WIL Committee, personal communication, 13 October 2016) (Figure 2).
 THE CLINICAL NEUROPSYCHOLOGIST  221

Year Members Fellows President

1997 35.3% 23.2% 0
1998 35.5% 22.1% 0
1999 37.7% 22.9% 0
2000 38.5% 23.5% 0
2001 39.5% 24.7% 0
2002 39.9% 23.9% 0
2003 40.9% 24.9% 1
2004 41.2% 25.9% 0
2005 41.4% 25.5% 0
2006 42.2% 26.5% 0
2007 44.8% 26.7% 0
2008 46.4% 26.3% 0
2009 46.6% 27.3% 1
2010 47.4% 28.1% 0
2011 47.9% 29.1% 0
2012 48.9% 27.7% 0
2013 49.0% 28.9% 1
2014 48.4% 30.0% 0
2015 49.5% 30.8% 1

Figure 1. Proportion of women members versus fellows and the number of women presidents of Division
40-Society for Clinical Neuropsychology from 1997 to 2015.
Note: Cells were subjected to conditional formatting using a 3-color scale (red to white to blue), where 0% (or 0) is indicated
in red and 100% (or 1) is indicated in blue.

Organizational leadership
Data on the percentage of women holding national leadership positions in neuropsycho-
logical organizations are presented in Figure 3. The percentage of women serving on NAN’s
Board of Directors (BOD) increased slightly from 33.3% [the mean percentage over the first
five years (1994–1998) of available data] to 38.2% [the mean percentage over the last five
years of available data (2011–2015)] (National Academy of Neuropsychology [Past Presidents
and Board of Directors], n.d.). The percentage of women on AACN’s BOD increased substan-
tially from 26.0% to 45.4% over a similar time period (C. Silver, former Chair, NAN WIL
Committee, personal communication, 13 October 2016; The American Academy of Clinical
Neuropsychology [Executive Board and Board of Directors members], n.d.). Data on INS date
back to the 1970s, when the mean representation of women serving on the BOD for the first
five years of its existence (1978–1982) was 13.3%. In contrast, the mean representation of
women on their BOD over the last five years is now 50.5% (INS Executive Office representative,
personal communication, 8 October 2015).
222  B. C. SACHS ET AL.

Year NAN D40/SCN

1997 23.2%

1998 22.1%

1999 22.9%

2000 23.5%

2001 24.7%

2002 19.0% 23.9%

2003 8.0% 24.9%

2004 22.0% 25.9%

2005 38.0% 25.5%

2006 23.0% 26.5%

2007 29.0% 26.7%

2008 18.2% 26.3%

2009 19.1% 27.3%

2010 19.1% 28.1%

2011 19.1% 29.1%

2012 20.5% 27.7%

2013 21.7% 28.9%

2014 21.9% 30.0%

2015 30.8%

Figure 2. Proportion of women fellows in neuropsychology organizations over time. Cells were subjected
to conditional formatting using a 2-color scale (white to blue), where 0% is indicated in white and 100%
is indicated in blue.
Note: Gray cells indicate no available information. NAN = National Academy of Neuropsychology, D40/SCN = Division 40/
Society for Clinical Neuropsychology.

Few women have held the role of president of these organizations; 13 women have served
as president of INS since its inception in 1973; 6 women have served as president of SCN/
Division 40 since its inception in1986; 3 women have served as president of NAN [1995–2015];
and 1 has served as president (2-year term) of AACN [2002–2015] (American Academy of
Neuropsychology [History], n.d.; The International Neuropsychological Society [Past presi-
dents], n.d.; The Society for Clinical Neuropsychology [Past presidents], n.d., C. Silver, former
Chair, NAN WIL Committee, personal communication, 13 October 2016). The data are mixed
across organizations as to whether there has been a change in the gender composition of
the leadership over time, although the numbers of women in leadership roles remains small.
Women have served as president of INS 10–40% of the time by decade since the 1970s, as
president of Division 40/SCN 10–20% of the time by decade since the 1980s, and women
have served as president of NAN once per decade since the 1990s. One woman has served
as president of AACN since the 2000s (up to 2015).

Editorial board membership

Data on editorial board membership were obtained from the websites of 15 prominent neu-
ropsychology journals (Aging, Neuropsychology and Cognition [Editorial Board], n.d.; Applied
 THE CLINICAL NEUROPSYCHOLOGIST  223

INS NAN D40/SCN AACN

% of % of % of
Woman Women in Woman Women in Woman Woman Women in
Year President BOG President BOD President President BOD

1973 0
1974 0
1975 0 0

1976 0 0

1977 0 0

1978 0 33.3% 0

1979 1 33.3% 0 0

1980 0 0.0% 0 0

1981 0 0.0% 0 0

1982 0 0.0% 0 0

1983 0 33.3% 0 0

1984 0 33.3% 0 0

1985 1 66.7% 0 0

1986 0 33.3% 0 1

1987 1 33.3% 0 0

1988 0 0.0% 0 0

1989 0 0.0% 0 0

1990 0 0.0% 0 0

1991 0 33.3% 0 0

1992 0 16.7% 0 0

1993 1 42.9% 0 0

1994 0 33.3% 1 33.3% 0

1995 0 66.7% 0 33.3% 0

1996 0 57.1% 0 44.4% 1 25.0%

1997 1 57.1% 0 22.2% 0 25.0%

1998 1 33.3% 0 33.3% 0 26.7%

1999 0 0.0% 0 27.3% 0 26.7%

2000 1 57.1% 1 27.3% 0 26.7%

2001 0 83.3% 0 27.3% 0 26.7%

2002 1 42.9% 0 27.3% 0 1* 23.5%

2003 1 42.9% 0 30.0% 1 1* 20.0%

2004 0 16.7% 0 27.3% 0 0 23.5%

2005 0 57.1% 0 20.0% 0 0 17.6%

2006 1 42.9% 0 20.0% 0 0 22.2%

2007 0 16.7% 0 33.3% 0 0 26.3%

2008 0 14.3% 0 30.0% 0 0 35.3%

2009 0 14.3% 0 27.3% 1 0 43.8%

2010 0 50.0% 0 20.0% 0 0 31.3%

2011 0 42.9% 0 27.3% 0 0 37.5%

2012 1 71.4% 1 27.3% 0 0 42.1%

2013 1 66.7% 0 36.4% 1 0 47.4%

2014 0 42.9% 0 45.5% 0 0 50.0%

2015 1 42.9% 0 54.5% 1 0 50.0%

Figure 3. Proportion of women serving in organizational leadership roles over time. Cells were subjected
to conditional formatting using a two-color scale (white to blue), where 0% (or 0) is indicated in white
and 100% (or 1) is indicated in blue. Gray cells indicate no available information. INS = International
Neuropsychological Society, NAN = National Academy of Neuropsychology, D40/SCN = Division 40/Society
for Clinical Neuropsychology, AACN = American Academy for Clinical Neuropsychology.
Note: * = Indicates one president with a multi-year term.
224  B. C. SACHS ET AL.

% of Women
% Women % of Women
Journal Associate
Editors-in-Chief Consulting Editors
Editors

Aging, Neuropsychology & Cognition 50.0% (1/2) NA (0/0) 34.2% (13/38)

Applied Neuropsychology: Adult 0.0% (0/1) 0.0% (0/2) 15.9% (7/44)

Applied Neuropsychology: Child 0.0% (0/1) 0.0% (0/2) 24.4% (10/41)

Archives of Clinical Neuropsychology 0.0% (0/1) 33.3% (2/6) 16.7% (9/54)

Child Neuropsychology 0.0% (0/1) 0.0% (0/1) 51.7% (15/29)

The Clinical Neuropsychologist 100.0% (1/1) 40.0% (2/5) 37.5% (21/56)

Cognitive Neuropsychology 100.0% (1/1) 60.0% (3/5) 32.5% (13/40)

Developmental Neuropsychology 0.0% (0/1) 100.0% (1/1) 51.9% (14/27)

Journal of Clinical and Experimental

0.0% (0/1) 100.0% (2/2) 28.0% (14/50)
Neuropsychology

Journal of Neuropsychology 0.0% (0/1) 14.3% (1/7) 19.2% (5/26)

Journal of the International

0.0% (0/1) 33.3% (2/6) 35.6% (26/73)
Neuropsychological Society
Neuropsychiatry, Neuropsychol., &
0.0% (0/1) 0.0% (0/2) 5.3% (1/19)
Beh. Neurology

Neuropsychologia 0.0% (0/1) 38.5% (5/13) 25.8% (16/62)

Neuropsychology 0.0% (0/1) 66.7% (4/6) 37.5% (18/48)

Neuropsychology Review 0.0% (0/1) 50.0% (4/8) 46.0% (18/39)

Figure 4. Proportion of women serving as Editors-in-Chief, Associate, or Consulting Editors in

neuropsychology journals in 2016. Cells were subjected to conditional formatting using a two-color
scale (white to blue), where 0% (or 0) is indicated in white and 100% (or 1) is indicated in blue.
Note: NA = Not applicable.

Neuropsychology: Adult [Editorial Board, n.d.; Applied Neuropsychology: Child [Editorial Board],
n.d.; Archives of Clinical Neuropsychology [Editorial Board], n.d.; Child Neuropsychology
[Editorial Board], n.d.; Cognitive and Behavioral Neurology [Editorial Board], n.d.; Cognitive
Neuropsychology [Editorial Board], n.d.; Developmental Neuropsychology [Editorial Board],
n.d.; Journal of Clinical and Experimental Neuropsychology [Editorial Board], n.d.; Journal of
Neuropsychology [Editorial Board], n.d.; Journal of the International Neuropsychological Society
[Editorial Board], n.d.; Neuropsychologia [Editorial Board], n.d.; Neuropsychology [Editorial
Board], n.d.; Neuropsychology Review [Editorial Board], n.d.; The Clinical Neuropsychologist
[Editorial Board], n.d.) that are listed in Figure 4. Substantially more men than women hold
editorial roles of all types with these journals. When women do hold editorial roles, their rep-
resentation is higher in consulting or associate editorships, and fewer have served the role of
editor-in-chief. Approximately one-third of consulting or associate editors of 15 major neu-
ropsychology journals are women, while only one-fifth of the editors-in-chief are women.

Training program directorship

Data on the proportion of women serving as directors of training programs were gathered
from multiple sources (Association of Postdoctoral Programs in Clinical Neuropsychology
 THE CLINICAL NEUROPSYCHOLOGIST  225

Table 1. Proportion of women serving as directors of doctoral, internship, and post-doctoral programs
in 2015.
Training Program Percentage
Doctoral Programsa 36.6% (15/41)
Internship Programsb 53.5% (84/157)
Post-doctoral Programs (APPIC)c 52.6% (10/19)
Post-doctoral Programs (APPCN)d 47.4% (27/57)
a
As specified on the Division 40/SCN Training Programs website.
b
APPIC Internship Programs listed on APPIC website that denote ‘Neuropsychology Adult or Child’ as a training opportunity.
c
APPIC Post-doctoral Programs listing on APPIC website that denote ‘Neuropsychology Adult or Child’ as a training oppor-
tunity.
d
Post-doctoral Programs that are members of APPCN as listed on APPCN website.

(APPCN) Member Programs, n.d.; Association of Psychology Postdoctoral and Internship

Centers (APPIC), n.d.; The Society for Clinical Neuropsychology [Training Programs], 2015) and
are presented in Table 1. In general, women and men appear to serve in more equal percent-
ages in the training domain, with approximately 37, 54, 53, and 47% of women serving as
directors of doctoral, internship, and various post-doctoral programs, respectively.

Board certification
According to the American Board of Professional Psychology website (American Board of
Professional Psychology [Board Certification], n.d.), as of 2015, approximately half of
board-certified neuropsychologists through ABPP/ABCN were women (48.6%). Women make
up 21.1% of persons board certified through ABN (Karen Wilhelm, Ph.D., ABN, President Elect,
The American Board of Professional Neuropsychology, personal communication, 5 October
2015) (Table 2).

Discussion
This review represents the first comprehensive summary of women’s representation in neu-
ropsychology since 2010 and provides an important update on the current trends in our
profession. The longitudinal data obtained reveal a changing composition of the field, now
with relatively equal numbers of men and women as members of APA (SCN/Division 40) and
NAN. Encouragingly, cross-sectional data on the relative percentages of women who are
board-certified by ABPP/ABCN, and those who serve as directors of internship and post-doc-
toral training programs, are similar to the relative proportion of women in the specialty as
a whole. The mean percentages of women serving on the AACN and INS Board of Directors
in the most recent five years (2011–2015) also indicate increasing parity.

Table 2. Proportion of women board certified in neuropsychology in 2015.

Board Percentage
American Board of Clinical Neuropsychology (ABPP/ABCN) 48.6% (473/974)
American Board of Professional Neuropsychology (ABN) 21.1% (82/389)
226  B. C. SACHS ET AL.

Continued gender disparity in organizational and academic leadership

While men and women are serving in more similar capacities in training programs and are
attaining similar levels of clinical credentials (e.g. board certification), disparities still exist
with regard to the proportion of women who hold elected and appointed upper-level lead-
ership positions in neuropsychological organizations and on editorial boards, though we
acknowledge that additional women have taken office since our end date for data collection
for this manuscript. Specifically, there have been few women presidents of INS, SCN/Division
40, AACN, and NAN, and even fewer women who hold Editor-in-Chief positions on neuropsy-
chology journals. Similarly, the number of women fellows who are members of SCN/Division
40 and NAN has not kept pace with the overall number of women neuropsychologists.
Our data suggest that these persistent disparities in organizational leadership may not
simply be attributed to a ‘cohort effect.’ In other words, the dearth of women holding senior
roles is not entirely due to the fact that fewer women have had the opportunity to matriculate
into leadership positions. Sweet and colleagues (2018) present related data with respect to
neuropsychologists in academic leadership positions; despite similar rates of matriculation
in neuropsychology training programs, significantly more men than women hold titles of
Chair, Program Director, and Division Head. Men are 3.5 times more likely than women to
hold the rank of Professor, while twice as many women are at the Assistant Professor level.
Again, this trend parallels that of academic medicine, in that men and women have entered
medical schools at the same rate for roughly 40 years but women have yet to reach parity
with men in obtaining leadership positions in academic medicine (Carr, Gunn, Kaplan, &
Freund, 2015). In fact, among full-time medical school faculty, the only rank at which women
currently outnumber men is that of Instructor. Only 16% of medical school deans are women
and 21% are full professors, despite the fact that women currently make up 48% of medical
school graduates (Association of American Medical Colleges, 2014).

Factors maintaining gender disparities in leadership

An extensive body of literature has already demonstrated a variety of factors that may
account for these continued disparities, which include explicit gender bias, sexual harass-
ment, and/or marginalization or isolation in the workplace (Bickel, 2004, 2007; Buckley,
Sanders, Shih, Kallar, & Hampton, 2000; Brzezinski, 2010; Carr et al., 1998, 2000, 2015;
Hilsabeck & Martin, 2010; Levinson, Tolle, & Lewis, 1989; Pololi & Knight, 2005; Wright et al.,
2003; Yedidia & Bickel, 2001). In their recent survey of AAMC medical school faculty repre-
sentatives, Carr and colleagues (2015) identified additional, less obvious barriers to the
advancement of women faculty, including general lack of retention of women in academic
medicine (the ‘leaky pipeline’); continued gender inequity in compensation; and the fact
that women faculty/physicians frequently take on a disproportionate amount of family
responsibilities which often negatively impact women’s career progression. This latter theory
was borne out in a study of university professors that found that women who obtain tenure
are more likely to be single, without children, and/or have delayed motherhood (Mason &
Goulden, 2004). There is also evidence that differences in career aspirations, conflicts between
interpersonal and leadership styles, and organizational citizenship behaviors impact differ-
ences in leadership attainment of men and women (American College of Healthcare
 THE CLINICAL NEUROPSYCHOLOGIST  227

Executives, 2012). Finally, while outright bias is less commonplace now, implicit, or ‘second
generation’ bias still commonly occurs (Kubu, 2018).

Differences in expectations regarding work-life balance

The common belief that women fail to progress in their careers solely due to ‘ratcheting
back’ their time at work to instead focus on family may hold true for some proportion of
individuals, although it is likely that a more complex network of societal, family, and career
factors are at play. For example, a recent study identified similar career goals and aspirations
of male and female Harvard MBA graduates, but found differences in men and women’s
expectations about how they would ultimately balance career and family demands with
their spouse. Women tended to assume more egalitarian relationships and work/family
responsibilities, while men assumed their career would take priority over their spouse’s, who
would take on more family responsibilities. The author’s subsequent findings corroborated
the assumption of the men in their study. In their sample, women, who perhaps already felt
their career was on the back burner or who felt their prospects for advancement were dim
after starting a family, were subsequently more likely to spend more time at home with
children and less likely to seek out demanding roles at work. Men conversely felt more
pressure to excel and put their careers first (Ely, Stone, & Ammerman, 2014). When neuropsy-
chologists were asked about work-life balance and job satisfaction, men were more likely
to identify job-related factors as the primary causes leading to work dissatisfaction, whereas
women identified both work and personal/family issues (Sweet, Lee, Guidotti Breting, &
Benson, 2018).

Differences in career confidence

Another common contributor to the dearth of women in leadership is diminished self-effi-
cacy, self-confidence, and self-promotion skills (Silver, Benitez, Armstrong, & Tussey, 2018).
For instance, there is evidence that women often have lower career confidence than men,
which may subsequently lead to lower rates of volunteerism for positions. One study found
that 20% of men were willing to apply for a role despite only partially meeting its job descrip-
tion, compared to only 14% of women (Institute of Leadership and Management website
[Ambition and Gender at Work], 2011). This difference in confidence perhaps mirrors the
trend among research faculty, wherein women tend to submit fewer grants proposals than
men. This difference is more pronounced for investigator initiated projects (R01’s), suggesting
that women are less likely to apply for grants as independent investigators (Ley & Hamilton,
2008; Pohlhaus, Jiang, Wagner, Schaffer, & Pinn, 2011). However, once differences in submis-
sion rates are accounted for, funding for men and women is comparable (Ginther, Kahn, &
Schaffer, 2016).
Despite considerable efforts to increase transparency in federal grant funding, there is
no publicly available resource through which data on the number of clinical neuropsycholo-
gists who serve as Principal Investigators, and their demographics, can be easily collected
and reviewed. However, within the NIH, many Principal Investigators also serve on scientific
review panels. As such, the relative proportions of women in NIH Center for Scientific Review
panels may provide indicators of success in leadership, particularly in panels that commonly
review applications related to clinical neuropsychology. In 12 of such panels,3 42% are chaired
by women and, excluding these chairs, 44% of the members of these panels were women.
Thus, it is possible that women who conduct NIH research in areas relevant to clinical
228  B. C. SACHS ET AL.

neuropsychology may find that they are not grossly underrepresented among their peers.
Their mentorship will be critical to enhancing the number of women who conduct neu-
ropsychological research.

Differences in access to mentorship and sponsorship

Mentorship is considered crucial to successful career development; data show that early
career faculty who do not have adequate mentorship are more likely to ‘burnout’ and fail to
progress in their chosen fields of interest (Feigon et al., 2018; Hilsabeck, 2018). Indeed, in
the AAMC’s recent Faculty Forward Engagement survey, women (compared to men) more
specifically identified a greater need for mentors, mentoring programs, and professional
development programming (Association of American Medical Colleges, 2014). Hence, the
decision to subsequently pursue leadership roles is undoubtedly influenced by the availa-
bility of mentors, or lack thereof.
It is possible that even more than a lack of mentorship, women may experience inade-
quate sponsorship. Sponsorship is defined broadly as ‘the public support by a powerful,
influential person for the advancement and promotion of an individual within whom he or
she sees untapped or unappreciated leadership talent or potential’ (Hewlett, Peraino, Sherbin,
& Sumberg, 2011; Travis, Doty, & Helitzer, 2013, p. 1414). Sponsorship and mentorship differ
in important ways, which may be especially relevant for women. A sponsor is typically highly
placed in an organization and has significant influence on decisions regarding advancement
while mentors may serve at any level in the organization or institution. For instance, in neu-
ropsychology, assistant professors can often be valuable mentors but, because of their posi-
tion, are unlikely to be effective sponsors (the latter typically being reserved for more senior
faculty and/or those holding leadership positions). Second, sponsors usually act as advocates,
while mentors typically work by providing guidance focused on professional issues and the
development of topic or content-related expertise (Travis et al., 2013). While mentorship has
been shown to be highly effective in both business and academics/medicine for men and
women alike, women in particular tend to be ‘under-sponsored’ (Harvard Business Review,
2010; Hewlett et al., 2011). This likely occurs for a variety of reasons, such as different inter-
personal styles between men and women and a tendency toward wanting to mentor or
sponsor someone similar to oneself (Bickel, 2014). While men certainly can and do serve as
sponsors of women, sponsorship frequency is reduced by the dearth of women in high-level
leadership positions who can help advance their more junior female colleagues. However,
Hilsabeck (2018) reasons that neuropsychologists who serve in training capacities, given
their role as clinical supervisors and later on as potential references, are ideally poised to
serve as both mentors and sponsors of early career neuropsychologists.

Efforts to address gender disparities in leadership

Career development programs
In response to continued gender disparities and leadership needs, a variety of career devel-
opment programs (CDP) have been initiated to help women manage these myriad issues,
and to assist women in developing the necessary skills and networks needed for leadership
in their field. These programs have, in general, produced very positive results, with greater
retention of women faculty in their respective positions compared to non-CDP women. The
Executive Leadership in Academic Medicine (ELAM) program, one of the most widely known
 THE CLINICAL NEUROPSYCHOLOGIST  229

CDP’s that was founded in 1995, has consistently measured the success of their participants
over time. Their outcomes have demonstrated that their participants have had greater
advancement to positions such as dean, chair, provost, and president/CEO as compared to
non-ELAM alumnae (Chang et al., 2016; ELAM Fast Facts Webpage, n.d.).
Within psychology, the APA Leadership Institute for Women in Psychology (LIWP) is a
successful CDP for mid-career women that helps support and empower women psycholo-
gists, not only to become leaders in their field but also to create and sustain change in their
respective institutional settings (American Psychological Association Leadership Institute
for Women in Psychology, n.d.). The program was created in 2008 and is open to psychologists
across disciplines and work settings, and many neuropsychologists have graduated from
the LIWP. While the anecdotal reports of the benefits of LIWP abound, they are still in the
beginning stages of writing up and disseminating the outcome data on this program (R.
Fassinger, Chair of the Assessment, Evaluation and Publication Subcommittee, LIWP, personal
communication, 15 March 2017).

Organizational sub-committees
In addition to these formal training programs, various neuropsychological organizations
(SCN’s WIN Committee; NAN’s WIL Committee) have recognized the dearth of women leaders
in neuropsychology and provide excellent programming and resources to help women pur-
sue and achieve leadership within our field. WIN and WIL have offered dozens of seminars
and programs focused on negotiating and interviewing for jobs, ‘breaking the glass ceiling,’
balancing multiple roles, handling toxic workplace situations, and mentorship and
sponsorship.

Organizational leadership
Women can proactively leverage information that is currently publically available about
nominations and elections procedures for each neuropsychological organization to help
boost representation of women in leadership in these organizations. For instance, NAN, SCN,
and INS have either open nominations or provide the opportunity for members to write-in
individuals for consideration (The International Neuropsychological Society [By-Laws], 2014;
The Society for Clincial Neuropsychology [By-Laws], 2005; National Academy of
Neuropsychology [By-Laws], 1991). Thus, grassroots efforts to solicit and encourage members
to nominate women can help increase the chances of women members being placed on
the final ballot. An important consideration within such systems might be for members to
coalesce around just one or two individuals for nomination in order to increase the chances
that they will meet the nomination threshold (e.g. 1% of nominations, 40 or more nomina-
tions, etc.). The success rate of these approaches and the variability in organization-specific
procedures must be evaluated prior to every attempt. Within AACN, for example, officers
are elected from current members of the Board of Directors (BOD) (The American Academy
of Clinical Neuropsychology [Articles and Bylaws], 2015). As such, the initial step toward
increasing women in leadership within this organization would be to first encourage and
support women for nomination and election to the BOD. Lastly, the influential role that the
Nominations and Elections Committee plays in the selection of possible candidates is
well-defined. As all of the organizations similarly compose their Nominations and Elections
Committee with past presidents, the election of women particularly into the role of President
230  B. C. SACHS ET AL.

can be especially important to help influence or shape the composition of women on

ballots.

Transparency of diversity statistics

The field of neuropsychology as a whole can progress forward if organizations and educa-
tional institutions commit to regularly publishing easily accessible diversity statistics for their
members and leadership. Additionally, if neuropsychology as a field committed to regularly
exploring issues of diversity by supporting important publications such as this, and others
in this edition, it could potentially distinguish itself as a model of diversity and progress.

Limitations of the present study

While we believe this paper provides a meaningful description of the role of women in our
field, these data have limitations to note. First, because the largest neuropsychological organ-
izations are open to interested professional regardless of their training and experience in
clinical neuropsychology, it is not possible to capture the total gender composition of the
specialty in a comprehensive way. A related problem is that because women leaders are
members of multiple organizations and boards (in some cases concurrently), the statistics
reported here may over-estimate the actual number of individual women leaders.
Nevertheless, general membership data from SCN and NAN show relatively equal percent-
ages of men and women in the field. Second, data were not subjected to inferential statistics
to test for significance or longitudinal trends. This descriptive approach was chosen to be in
line with past published manuscripts in this area, and was believed to be the most pragmatic
approach to presenting data of this type.
Last, this is not an exhaustive review of spheres in which female clinical neuropsycholo-
gists serve in leadership roles. We restricted our review to entities for which data are publicly
available and from whom we could reliably obtain information (in the case of organizations
and training programs). We did not, for example, search for the number of federally funded
women neuropsychologists. It is possible to query databases within the public domain for
federally funded research (i.e. NIH RePORTER), but such a search would require considerable
effort to devise a search strategy and record review process that we felt to be outside the
scope of this paper. Nonetheless, we encourage future efforts to collect these data and to
extend our preliminary findings suggesting relatively comparable gender composition of
neuropsychology-relevant NIH review panels.

Conclusion
Altogether, these data reveal critical information about the changing demographic of our
profession and demonstrate ways in which women have, in some cases, successfully pursued
and obtained leadership and recognition within their various work and practice settings.
However, the data also highlight notable disparities that continue to exist within the field.
We hope that these data will empower both women and men to proactively recognize
existing barriers to advancement, to seek and to serve as mentors or sponsors, to pursue
formal or informal leadership training, and to advocate for equal opportunities for advance-
ment for themselves and their female colleagues.
 THE CLINICAL NEUROPSYCHOLOGIST  231

However, as highlighted by Magrane et al. (2012), pathways to advancement are affected

not only by individuals’ choices and decisions, but also by organizational policies, practices,
and culture, as well as societal expectations that mediate institutionalized gender bias.
Accordingly, institutions and organizations need to take a multi-pronged approach to tack-
ling the issue of women’s career advancement. As was the goal of this paper, the natural first
step involves making diversity statistics more transparent, and proactively studying and
confronting persistent disparities in a systematic fashion. We hope that these data can help
guide efforts to recruit and retain female leaders, and perhaps promote the implementation
of institutional-based mentoring, skills building, and professional development programs
and solutions to address gender disparities in leadership.

Notes
1. 
Although this was the first WIN interest group to exist within the SCN structure, it was long
predated by an informal Woman in Neuropsychology group that included many woman who
were pioneers in the field of clinical neuropsychology.
2. 
According to the APA website, fellow status is an honor bestowed upon an APA member who
has made a national impact through unusual and outstanding contributions or performance
in the field of psychology.
3. 
Data on representation of women were reviewed online by co-author PKS from the 2017 National
Institutes of Health rosters for the scientific review groups (SRG’s) that receive the majority of
funding proposals related to clinical neuropsychology. Twelve were identified: Behavioral and
Social Consequences of HIV/AIDS; Adult Psychopathology and Disorders of Aging; Biobehavioral
Regulation, Learning and Ethology; Cognition and Perception; Child Psychopathology and
Developmental Disabilities; Language and Communication; Biobehavioral Mechanisms of
Emotion, Stress and Health; Motor Function, Speech and Rehabilitation; Neurobiology of
Learning and Memory; Mechanisms of Sensory, Perceptual and Cognitive Processes; Addiction
Risks and Mechanisms; Interventions to Prevent and Treat Addictions. We acknowledge that
relevant proposals are also reviewed in Special Emphasis Panels or through panels outside the
NIH Center for Scientific Review that are not captured here.

Acknowledgments
We would like to thank the editors of TCN for the opportunity to contribute to this special edition. We
would also like to express our deep gratitude to all of the women pioneers in neuropsychology from
whom we have learned so much.

Disclosure statement
No potential conflict of interest was reported by the authors.

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