Over the past twenty-five years, steadily increasing numbers of women have graduated as physicians, in sufficient numbers to be well represented in senior and leadership positions in the nation’s academic medical centers. Yet women’s expected advancement has stalled. Women rarely hold decision-making positions, and female department chairs or deans continue to be exceedingly rare. Why is this the case? Pololi’s study, based on extensive interviews, illuminates medical school culture and shows a sharp disconnect between the values of individual faculty members and the values of academic institutions of medicine. Pololi looks closely at women medical faculty’s experiences as outsiders in medicine, opening a window into medical culture. She argues that placing more women and people of color in leadership positions would provide transformative and more effective leadership to improve health care and would help address current inequities in the health care provided to different racial and cultural groups.