Women have made strides in medicine, but a leadership gap persists in clinical trial staffing, which could affect the research that shapes disease diagnosis and treatment.
At the 2026 Women in Medicine Summit, cognitive neurologist Neelum T. Aggarwal, MD, highlighted just how big that gap remains. According to a Healio report, women led only one-third of nearly 246,000 clinical trials conducted between 2005 and 2023. Men, by contrast, led 64 percent of those trials.
Women lead just 20 percent of cardiology trials and 21 percent of hepatology trials. In other specialties, the numbers were higher: 49 percent in rheumatology and 44 percent in obstetrics and gynecology.
Why does that matter? The people leading research often help decide which questions get asked, which outcomes matter most, and who gets included in a study.
Research published in JAMA Network Open has also pointed to a possible connection between women’s representation in research leadership and the number of women who participate in cardiovascular studies. Studies led by women investigators have been associated with greater enrollment of women participants, suggesting that having women at the helm could help researchers better understand how diseases affect women.
Without women in leadership roles, important questions about women’s health could go unanswered. Researchers may miss opportunities to explore why certain conditions affect women and men differently or whether treatments work equally well for both.
No single reason explains why women remain underrepresented in clinical trial leadership. Mentorship, professional connections, research funding, and opportunities to lead major studies can all contribute.
Work-life demands can also make it harder to move up. Female physicians and researchers may balance caregiving responsibilities with demanding careers, leaving less time to conduct research. Without dedicated research time and strong institutional support, leading a clinical trial becomes even harder.
Over time, these barriers can add up. Although more women are entering medicine, that progress doesn’t always translate into senior academic positions or leadership roles in major research studies.
Addressing the disparity requires more than increasing the number of women entering medical school or joining research teams. Institutions must also create clear pathways for women to advance into leadership.
That could include formal mentorship and sponsorship programs, transparent criteria for selecting principal investigators, equitable access to research funding, and opportunities to serve on trial steering committees. Hospitals, universities, pharmaceutical companies, and research funders all have a role.
For patients, more inclusive research leadership could help ensure that clinical studies consider a broader range of experiences and health needs. Currently, Black people make up five to seven percent of clinical trial participation. Seeing themselves in leadership may help combat mistrust, especially given historic exclusion.
Representation alone cannot guarantee better outcomes, but it is an important part of building evidence that reflects the people who will ultimately rely on it. But representation alone isn’t enough. Researchers must also make clinical trials more accessible by addressing barriers such as transportation, time away from work, childcare, and limited awareness of available studies. Building trust requires consistent community engagement, transparency about risks and benefits, and a genuine commitment to including diverse participants.
Women have made significant progress in medicine. Ensuring that progress extends to clinical trial leadership is an important next step toward more representative research and better-informed healthcare.
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