Earlier this year, I was named the first female dean of the Duke University School of Medicine, an event that National Public Radio summed up in the headline:“Andrews Makes History at Duke Med School.” Why should the appointment of a woman dean still be big news in 2007? Perhaps because, with a few localized exceptions, there has been little change since the 1970s in the barriers to women’s full participation in academic medicine. I happen to believe strongly that diversifying all levels of academic medicine is not only politically correct, it is also the way to make our institutions better. The history of Harvard University, for example, where I spent many years before moving to Duke, is one of gradually increasing diversity, which I see as a necessary ingredient of an outstanding institution. When the university was young, 300 or so years ago, its faculty and students were Puritan men from good local families. Over the centuries, the Harvard community gradually became diversified in terms of geographic origin, religion, socioeconomic background, sex, race, nationality, and other personal characteristics. It has always seemed to me that it was only by choosing to recruit the individual scholars whom it viewed as the best, regardless of such characteristics, rather than limiting itself to a narrow circle of candidates, that Harvard was able to build a world-class faculty and student body worthy of the reputation it now enjoys. After all, brilliance and ability are not restricted to certain groups, so it seems logical that if they draw from the widest possible talent pool, the very best institutions will naturally have diversity at all levels.

And yet most do not, despite efforts to begin with a diverse population of students. Given that the proportions of men and women in medical school classes have been similar for some time, it seems puzzling that there are not more women in leadership positions in academic medicine. I suspect that some of the reasons for this disparity are the same as those that apply at the entry level for physician-scientists—concerns about balancing work and family, perceptions that women need to be better than men at their professions in order to be considered equal, and a dearth of female role models. 1 But I also believe that if we are to have more female deans, we must be able to envisage female deans.