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Despite progress, the demographics of those in leadership positions remain far from representative of the demographics of the general population. Indeed, there are cracks in the glass ceilings, but pipelines from junior to senior positions still show a major narrowing trend across medicine, science, and publishing: while women start with near parity in entry-level and training positions, the numbers drastically narrow at executive, full professor, and dean levels.
Therefore, it’s important to consider the internal and external barriers that remain for traditionally underrepresented demographics in STEM and publishing. I recently had the opportunity to sit down with our Scientific Editorial Director, Tiffany Leung, my manager at JMIR Publications, to get her perspective on leadership and representation through a discussion about her own career journey.
The Unexpected Turn: Driven by Data Needs
As an internal medicine physician in the United States, Tiffany noticed several pragmatic barriers to practice in retrieving basic information of her patients as individuals or as a whole: there were no consistent systems or centralized tools to obtain summary information of their demographic, clinical condition, and needs.
This recognition of a systemic problem coincided with a time of policy changes in the country, with federal incentive programs launched to implement electronic health records across health systems nationally. This situation motivated Tiffany to pursue a medical informatics fellowship at the Department of Veterans Affairs in Palo Alto, California. This step connected her with professional organizations like the American Medical Informatics Association (AMIA), where she found a community dedicated to solving these exact issues, among others that hadn’t yet come to the forefront.
Breaking Barriers: From Awareness to Action
Tiffany's work in professional societies became crucial not only for her career growth but also for her awareness of systemic inequalities. As a Chinese American woman now living in Europe and outside the protective bubble of training, she began to recognize, witness, and experience subtle microaggressions and forms of discrimination. This realization fueled her involvement with Women in AMIA (WIA), which grew rapidly because the need for support was so evident. Their mission focused on tackling both the internal and external barriers to women's advancement.
One major internal barrier is self-stigma and imposter syndrome. Women often compare themselves strictly against job or award criteria and disqualify themselves if they don't meet every single bullet point, a pattern less common among male counterparts. WIA developed a strategy to provide active, external intervention. Tiffany worked on the Awards and Leadership Subcommittee, where they proactively identified deserving women and helped them navigate the nomination process, recognizing that a firm, supportive nudge can be the catalyst needed to overcome self-doubt.
Implicit bias is a major external barrier to self-nomination. To address systemic issues, the group focused on the writers of letters of support or recommendation. They created resources like "tip sheets" to educate people—especially those writing letters of recommendation or nomination—on recognizing and minimizing implicit bias in their language. This is vital to ensure that formal documents used for advancement are as fair and objective as possible.
Equity Over Sameness
Tiffany's experience in WIA and her growth into a managerial role have shaped her leadership philosophy. The goal isn't to treat everyone the same; the goal is equity.
She strives to be explicit about performance expectations for everyone. In her current publishing role, she prioritizes building a diverse scientific editor team, hiring based on talent, mindset, and a commitment to teamwork and growth.
She also credits her trajectory to the importance of building a diverse professional network. Having a "stable of mentors"—people from different industries, standings, and experiences—provides essential sounding boards and perspectives that a single mentor cannot offer.
The Call for Systemic Change
Tiffany emphasized that the pipeline leak of women in leadership is a societal problem rooted in factors like life phases and social expectations.
Tiffany highlighted the need to push for effective policies at every level, including organizational policies to establish fair promotion practices, transparent hiring, and supportive leave practices within companies, and regional/national policies, such as governmental input and laws on gender pay parity and equitable leave.
This conversation with Tiffany, along with the opportunity to witness the thriving WIA community at the recent AMIA 2025 Symposium, allowed me to reflect on my own career journey from biology researcher to scientific editor.
I first encountered the term “imposter syndrome” during a guilt-procrastination cycle of thesis writing at the end of my PhD. Although I learned that both my male and female peers experienced self-doubt, it seemed to hinder the women more as a block to their own professional development. My internal strategy to push past self-doubt and pursue leadership was to "think like a man."
As I built my career over the next two decades and the workforce became more diverse, that mantra became less necessary. And yet, I still found myself self-selecting out of applying for my current position given my apparent lack of qualifications. However, this time, I didn't need the old mantra; instead, I could draw inspiration from women already in leadership roles.
Tiffany also emphasized that progress requires active involvement from everyone, beginning with ourselves. Overall, she believes that continuous engagement, respectful dialogue, and a push for equity are essential aspects of the blueprint towards change.
While the gender ratio of my mentors didn't cause my confidence shift, my journey from needing to "think like a man" to finding inspiration in female leadership highlights that representation is an essential component to breaking internal barriers, enabling true self-empowerment, and allowing all to think like themselves.
References:
1. https://pubmed.ncbi.nlm.nih.gov/39176693/
2. https://www.sciencedirect.com/science/article/abs/pii/S1048984324000432
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