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Purpose and Method: The authors surveyed U.S. and Canadian medical school deans regarding organizational climate for faculty, policies affecting faculty, processes deans use for developing faculty leadership, and the impact of the Executive Leadership in Academic Medicine (ELAM) Program for Women., Results: The usable response rate was 58% (n = 83/142). Deans perceived gender equity in organizational climate as neutral, improving, or attained on most items and deficient on four. Only three family-friendly policies/benefits were available at more than 68% of medical schools; several policies specifically designed to increase gender equity were available at fewer than 14%. Women deans reported significantly more frequent use than men (P = .032) of practices used to develop faculty leadership. Deans' impressions regarding the impact of ELAM alumnae on their schools was positive (M = 5.62 out of 7), with those having more fellows reporting greater benefit (P = .01). The deans felt the ELAM program had a very positive influence on its alumnae (M = 6.27) and increased their eligibility for promotion (M = 5.7)., Conclusions: This study provides a unique window into the perceptions of medical school deans, important policy leaders at their institutions. Their opinion adds to previous studies of organizational climate focused on faculty perceptions. Deans perceive the organizational climate for women to be improving, but they believe that certain interventions are still needed. Women deans seem more proactive in their use of practices to develop leadership. Finally, deans provide an important third-party judgment for program evaluation of the ELAM leadership intervention, reporting a positive impact on its alumnae and their schools.