the concept of having a work-life balance being more challenging for women. patient sexism furthermore, female physician narratives have described instances of sexism. female physicians are often mistaken for nurses by patients. patients have also been reported to have less trust in their physician if they are female and instead ask for a second opinion from a male physician. women physicians, on the other hand, have also been found to partake in sexist actions. female clinicians often treat women patients differently than they do men. women physicians were found to admit less female patients to intensive care units because they were proactive in treating them in the emergency room, rendering their admittance to more intense care units unnecessary. medical school sabotage female physicians also face gender bias in medical schools. in 2018, tokyo medical university lowered the test scores of its female applicants. since 2006, the university has been subtracting points from the exams of female applicants while adding, on average, 20 points to the exams of male applicants. unfair testing scores are not the only thing that are troubling in medical school; women, especially in more recent times, have been the majority group at medical school, they still face discrimination as men are often given the "decision-making" positions/ supervising positions at medical institutions. this creates a gap for mistreatment through faulty (sexist, discriminating,& etc.) supervisors. more recently, the percentage of women being admitted to medical school (50.5%) is higher than men (48.5%). even with an increase in racial and ethnically diversity amongst both genders, there is still underrepresentation in the actual medical profession. women in leadership positions cardiovascular medicine from a broad perspective, women hold a large number of leadership roles in politics and in the workforce than ever in the united states. yet, the cardiology specialty remains dominated by men, being that in 2015, only 13.2% of cardiologists were women. surveys have shown that the reasoning behind this may be due to a desire for a better work–life balance for women and a negative perception of cardiology. although there is a discrepancy in the number of female physicians specialized in cardiology, women in cardiology have become more involved in leadership roles. these roles may be in research science, health systems administration, professional societies and clinical practice. in scientific research, women have made an impact in scientific inquiry and investigation into the causes and treatments of cardiovascular disease. in leadership roles for the professional cardiology societies, women have increasingly become more involved worldwide. in educational systems, women have become more involved in cardiovascular service and in serving as clinical chiefs and program directors. however, there is still a gap in the number of women serving as deans, chairs of departments, and university presidents. women make up only 15% of medical school deans and interim deans. studies have found that women tend to not advance at the same rate as men in the medical field. this could be due to women not receiving independent grants, publications, and leadership positions. additionally, differences in pay could be attributed to implicit gender and maternal bias. implicit bias can affect hiring and promoting of women in the medical field because of a belief that women should be held at a higher standard than their male peers. overall, underrepresentation in the medical field could influence patient care and outcomes. diversity promotes health equity, and the medical field is continually improving its efforts toward finding the root of the problem of under-representation of women in the medical field. wage gap communal specialties, which women are more likely to go into, often have a lower pay than the specialties in which men typically go into. women have been found to have a larger representation than men in lower-paying specialties, such as pediatrics and men lave a larger representation in higher-paying specialties, such as cardiology and surgery. in new york state between 1999 and 2008, the average starting salary for men was $187,385 whereas the mean starting salary for women was $158,727. in 2001, it was found that male physicians earned roughly around 41% more than their female colleagues. as of 2017, an updated version then found that the percentage had dropped to roughly around 27.7%. that is roughly around a 100,000 dollar difference in salary per year. however, women who work in radiology are the only women who make more than their male colleagues—the difference is only about 2,000 dollars. a study published in 2005 found that women physicians in the us had an annual earning gap of 11% if they were married, 14% if they had one child, and 22% if they had more than one child. women typically had household obligations that affected their ability to work as much as men and therefore led to a trade-off of higher earnings for family-friendly jobs. stereotype threats a stereotype threat is observed when a stigmatized group is in a situation where negative stereotypes are often used in interpreting their behavior, and the risk of being judged by these stereotypes can elicit a disruptive state that undermines performance and aspirations. as discussed earlier, there are less women in leadership positions in academic medicine. descriptive and prescriptive gender stereotypes affect women in these roles. a descriptive component consists of beliefs about the inherent characteristics of men and women. at the center of these beliefs is that women are more nurturing, sympathetic kind and caring. men are often described as agentic or assertive, ambitious and independent. stereotype threats against women are especially common for women in leadership roles. the stereotype-based perspective towards women has been used to explain the lack of fit for leadership roles in medicine. these stereotypes canter on perceived characteristics, skills and aspirations of women and how they have been perceived to not coincide with what us valued for effective leadership. in a twenty-year study done on stereotype threats, researchers found that stereotype threats can increase feelings of anxiety, mind-wandering, negative thinking, and can decrease the function of working memory. a functional working memory is needed to successfully execute a task in many scenarios. this study also found that individuals experiencing stereotype threats may find it necessary to negate these threats and put forth effort to suppress these thoughts which can be inconsistent with the goals of the task. many women face various forms of harassment due to stereotypes held by male coworkers/supervisors as well as their own patients. in a twitter tweet, dr. marjorie stiegle asked her fellow healthcare peers to share their stories on gender bias in medicine. although she only needed 30 replies, over 200 replies (mainly women) stated they faced a lot of harassment over wanting to or to not have children. some women quoted they were told that they could not be a mother and a doctor. some women share their experiences with patients bringing up their body, looks, and the topic of children in unnecessary situations. although the tweet was supposed to originally be used for a podcast, it ended up showing the different forms of harassment that women and men face in the medical field. male clinicians males make up approximately 12% of nurses in the united states. unfortunately, when men enter the profession of nursing, they may encounter barriers that limit their choice of specialty. they run the risk of being labeled and stereotyped, in addition to being relied upon excessively for their strength in lifting patients. these gender biases and role stereotyping occur because many people retain the notion that caring for others is a feminine task, and thus beneath the status of the male. in a british study, it was reported that the majority of subjects assumed that a nurse referred to a female. this type of stereotyping of men is related to nursing being considered a profession for women. men tend to face two common stereotypes when it comes to being nurses. the first being the stereotype that male nurses are gay since they are in a "feminine occupation". the other common stereotype is that men are generally hypersexual and that this will inhibit them from being able to provide intimate care to women in nonsexual ways. male nurses report being told that a female nurse is preferred and being teased as a child for wanting to be a nurse. other questions are often asked of male nurses such as 'why did you go into nursing'? or they are asked if they are gay, failed medical school, or became a nurse because it was easier. sometimes a male nurse can be asked if he is a nurse so that he can see undressed women. in some instances male nurses were assumed to be the 'muscle' for other female nurses. male nurses may be passed over for work with female patients, or disallowed on birthing or gynecological units, while male physicians are completely welcome in these situations. in addition, male nurses find that they are pushed toward tasks that are stereotypically consistent with their gender role. some of these might include heavy lifting, administrative roles, or psychiatric nursing. despite these drawbacks, male nurses on average make more money than their female counterparts, mostly due to them performing higher-paying tasks.