{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:06:36Z","timestamp":1784282796990,"version":"3.55.0"},"reference-count":86,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Although almost two-thirds of medical students in Germany are female, medical leadership positions remain predominantly held by men. This study investigated gender-specific career progression in psychiatry\/psychotherapy and neurology, two closely related clinical specialties, using spatio-temporal analyses over a 20-year period. Methods: The study analyzed five time points (2004, 2009, 2014, 2019, and 2024) to evaluate the temporal and spatial distribution of gender representation across Germany. Data on medical students, hospital-based specialists in psychiatry\/psychotherapy and neurology, and department chairs were obtained from the Federal Statistical Office, the Federal Chamber of Physicians, and the medical faculties of 38 universities. Female-to-male ratios (f:m) were calculated for each career stage and applied to the established academic Br\u00fcggmann-Groneberg (BG) Index and to a newly developed clinical leadership version introduced in this study (BGclin Index). Results: In 2024, 64.9% of German medical students were female. Gender parity was reached among hospital-based specialists in psychiatry\/psychotherapy and neurology, with f:m ratios increasing from 0.71 (2004) to 1.17 (2024) and from 0.40 (2004) to 1.00 (2024), respectively. Women remained markedly underrepresented in clinical leadership roles (2024 psychiatry\/psychotherapy: 0.48; neurology: 0.23) and among department chairs (2024 psychiatry\/psychotherapy: 0.15; neurology: 0.14). BG Indices reflected these disparities, with the highest academic BG Index observed in psychiatry\/psychotherapy in 2019 (0.112) and in neurology in 2019 (0.091), while BGclin values remained higher, around 0.199 in psychiatry\/psychotherapy and around 0.120 in neurology. Spatial analysis revealed substantial regional variation across Germany, with persistent gender disparities across federal states. Conclusions: Despite achieving gender parity at the specialist level, substantial gender disparities persist in both academic and clinical leadership in the examined specialties. The BG Indices highlighted a sustained disparity in women\u2019s advancement, which was more pronounced in neurology than in psychiatry\/psychotherapy.<\/jats:p>","DOI":"10.3390\/jcm15145608","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:00:52Z","timestamp":1784278852000},"page":"5608","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A 20-Year Spatio-Temporal Analysis of Gender Workforce in Medical Departments of Psychiatry\/Psychotherapy and Neurology in Germany"],"prefix":"10.3390","volume":"15","author":[{"given":"Lisa","family":"J\u00f6rgens","sequence":"first","affiliation":[{"name":"Department of Prevention, The Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"L\u00f6ffler","sequence":"additional","affiliation":[{"name":"Department of Prevention, The Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4979-0587","authenticated-orcid":false,"given":"Stefanie","family":"Mache","sequence":"additional","affiliation":[{"name":"Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-9872","authenticated-orcid":false,"given":"Doris","family":"Klingelh\u00f6fer","sequence":"additional","affiliation":[{"name":"Department of Prevention, The Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5106-2012","authenticated-orcid":false,"given":"Isabelle Marie","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Prevention, The Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4799-3391","authenticated-orcid":false,"given":"D\u00f6rthe","family":"Br\u00fcggmann","sequence":"additional","affiliation":[{"name":"Department of Prevention, The Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1097\/ACM.0000000000002146","article-title":"Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey","volume":"93","author":"Carr","year":"2018","journal-title":"Acad. 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