Gender equity within medical specialties of Australia and New Zealand: cardiology's outlier status

Does gender still matter in the pursuit of a career in anaesthesia?

A survey sent to fellows of the Australian and New Zealand College of Anaesthetists (ANZCA) aimed to document issues affecting gender equity in the anaesthesia workplace. A response rate of 38% was achieved, with women representing a greater proportion of respondents (64.2%). On average women worked fewer hours than men and spent a larger percentage of time in public practice; however, satisfaction rates were similar between genders. There was a gender pay gap which could not be explained by the number of hours worked or years since achieving fellowship. The rates of bullying and harassment were high among all genders and have not changed in 20 years since the first gender equity survey by Strange Khursandi in 1998. Women perceived that they were more likely to be discriminated against particularly in the presence of other sources of discrimination, and highlighted the importance of the need for diversity and inclusion in anaesthetic workplaces. Furthermore, women reported higher rates of caregiving and unpaid domestic responsibilities, confirming that anaesthetists are not immune to the factors affecting broader society despite our professional status. The overall effect was summarised by half of female respondents reporting that they felt their gender was a barrier to a career in anaesthesia. While unable to be included in statistics due to low numbers, non-binary gendered anaesthetists responded and must be included in all future work. The inequities documented here are evidence that ANZCA's gender equity subcommittee must continue promoting and implementing policies in workplaces across Australia and New Zealand.

A Systematic Review of Gender Disparity in the Authorship of Clinical Trials and Clinical Practice Guidelines in Various Medicine Subspecialties

Authorship in clinical trials and clinical practice guidelines is considered prestigious and is associated with broader peer recognition. This systematic review investigated female representation among studies reporting authorship trends in clinical trials or clinical practice guidelines in different medicine subspecialties. Our search strategy yielded 836 articles, of which 30 met the inclusion criteria. Our findings indicate that females are severely underrepresented in authorship of clinical trials and clinical practice guidelines. Although the proportions of females may have improved in the past decade, the gains are marginal. Notably, studies in this domain predominantly focus on first/last authorship positions, and whether females are underrepresented in other positions as collaborative partners is currently unknown. Also, authorship trends in clinical trials or clinical practice guidelines of most medicine subspecialties besides cardiovascular medicine remain under-researched. Hence, standardizing the methodology for studying gender disparity in research output for comparative analysis between different subspecialties is as urgent as addressing the gender disparity in authorship.

Perceptions of work-life balance and gender issues in private radiology in Australia

INTRODUCTION

Women comprise almost 30% of practising clinical radiologists in Australia. Despite three-quarters of clinical radiologists working in private practice, there is limited research regarding the experience of female radiologists in private practice and issues surrounding work-life balance. The primary aim of this study was to identify gender issues within private radiology and investigate work-life balance, focusing on issues relevant for female practitioners.

METHODS

Clinical radiologists working in private practice at five major Australian private radiology service providers were sent an email on behalf of the researchers, containing study information and a link to an online questionnaire. Descriptive statistics, chi-square analysis and Fisher's exact test were used. Binary logistic regression was used to determine odds ratios and 95% confidence intervals. Responses to short-answer questions were analysed manually and grouped into themes.

RESULTS

There were consistent gender differences in perceptions of gender and its implication upon working and career progression in radiology private practice. There was near unanimous agreement that private radiologists should be able to work flexible/reduced working hours for a proportionate decrease in pay. Two themes with distinct gender differences related to pay equity and transparency. Key themes relating to work-life balance for private radiologists included workload, setting boundaries and flexibility of work hours in private radiology.

CONCLUSION

This preliminary survey highlights areas related to work-life balance and gender issues relevant for female practitioners in private practice radiology in Australia that can be targeted for further investigation and improvement, namely pay equity and transparency, and part-time leadership opportunities.

Gender Differences in Medical Student Perceptions of a Career in Cardiology

BACKGROUND

Worldwide, the cardiology profession has an under-representation of women. We assessed medical students' perceptions of cardiology as a career choice with the aim of identifying barriers to gender diversity.

METHOD

An anonymous survey was distributed to medical students studying at three Australian medical universities. Questions pertained to demographics, year and stage of medical training, desire to pursue cardiology, and perceived barriers to a cardiology career. Results were analysed according to identified gender and desire to pursue or not pursue a cardiology career. Multivariable logistic regression evaluated for independent associations. The primary outcome were barriers identified to pursuing a career in cardiology.

RESULTS

From 127 medical student respondents (86.6% female, mean age 25.9±4.8 years), 37.0% stated they wanted to pursue a career in cardiology (39.1% of women versus 23.5% of men, p=0.54). The top four perceived barriers to a cardiology career included: poor work-life balance (92/127, 72.4%), physician training process (63/127, 49.6%), on-call requirements (50/127, 39.4%) and lack of flexibility (49/127, 38.6%), with no gender differences. Women were more likely to report gender-related barriers (37.3% versus 5.9%, p=0.01) and less likely to identify procedural aspects as a barrier (5.5% women versus 29.4% men, p=0.001). Students in their pre-clinical years were more likely to want a career in cardiology (odds ratio 3.0, 95% confidence interval 1.2-7.7, p=0.02).

CONCLUSIONS

A high proportion of female and male medical students want to pursue a career in cardiology with both genders identifying major barriers of poor work-life balance, lack of flexibility, on-call requirements and the training process.

Looking beyond workforce parity: addressing gender inequity in pathology

While women pathologists have made up over one-third of pathologists in the Australian workforce for over 15 years and at least 50% since 2019, they are under-represented in senior leadership roles, scientific publications, grant recipients, editorial boards, key presentations, and professional awards. This is not unique to pathology and is seen in the broader medical and academic community. Barriers to gender equity and equality in pathology, medicine and academia include gender stereotypes, gender-based discrimination, structural and organisational barriers as well as broader social and cultural barriers. A diverse leadership reflective of the whole professional body and the broader community is important for optimal health outcomes. It is the responsibility and moral duty of individuals and organisations to address any gender disparities, inequities, and inequalities by monitoring, identifying, and acting on gender biases and systemic barriers that hinder appropriate levels of representation by women.

Female representation in radiology subspecialty interest groups in Australia and New Zealand

INTRODUCTION

Women comprise 31% of the Australian and New Zealand radiology workforce, and 35% of radiology trainees. To date, there has been no study of female representation within clinical radiology subspecialties in Australia and New Zealand. This study aims to quantify female representation among the clinical radiology subspecialty interest groups (SIGs) in Australia and New Zealand.

METHODS

A list of SIGs was compiled using the Royal Australian and New Zealand College of Radiologists (RANZCR) website. The executive of each SIG or the RANZCR Standards committee was contacted with a request to provide the number of female versus male members for each subspecialty group and their executive.

RESULTS

Six out of 10 SIGs reported a low proportion of female members; this was most pronounced for IRSA (interventional radiology; 7% women), AMSIG (musculoskeletal imaging; 13% women) and CCINR (interventional neuroradiology; 13% women). Female radiologists accounted for >50% of membership in four SIGs: OGSIG (obstetrics/gynaecology imaging; 87% women), BIG (breast imaging; 73% women), ARGANZ (abdominal imaging; 69% women) and ANZSTR (thoracic imaging; 69% women). Female executive representation ranged from 0% (IRSA (interventional radiology) and ANZSNR (neuroradiology)) to 100% (OGSIG (obstetrics/gynaecology imaging)).

CONCLUSION

Female representation within the membership and representative leadership of some SIGs is well below parity and active initiatives to improve female representation should be considered.

Female Representation: Australian Diabetes and Endocrinology Societies

BACKGROUND

Endocrinology has one of the highest proportions of female specialists and trainees, however females have traditionally been underrepresented in leadership positions and as speakers at scientific meetings.

HYPOTHESIS

Females would represent less than half of invited speakers (plenary, symposium sessions) at endocrinology conferences and in leadership positions of endocrinology societies.

METHOD

An audit of Australian diabetes and endocrinology societies and their respective annual scientific meetings between 2016 - 2020. Analysis of the gender of conference speakers across oral, symposium and plenary sessions, session chairs, program organising committees and society committees.

RESULTS

A total of 1638 speakers (females 856, 52.3%) across 550.4 hours (females 273.6, 49.7%) of presentations at the conferences were identified. Among plenary sessions of all 3 societies there were more male (61%) than female speakers. A total of 608 session chairs were identified, with 313 (51.5%) females. The majority of organising committee members (n=116) were female (56%), however the representation across each organising committee varied. There was a low proportion of society female council members (39% female).

CONCLUSION

There was an equal representation of females and males as conference speakers and session chairs. However, there was an underrepresentation of women in more prestigious roles of plenary speakers and society council members. We implore conscious efforts to address this disparity.

Sex Differences in Cardiovascular Research: A Scientometric Analysis

Background We sought to investigate sex-specific differences in authorship of cardiovascular research over the past decade. Methods and Results All 387 463 cardiovascular publications between 2010 and 2019 were retrieved from Web of Science. Articles increased from 19 960 to 29 604 articles per year (P>0.001). The number of articles written by female first authors increased by 76.3% (6434-11 343 articles) and by 35.0% for male first authors (13 526-18 261) (P<0.001). The first author was more likely to be a female author in articles with female last authors. The median impact factor (IF) for articles by female first authors was lower (2.46 [interquartile range, 7 1.11-4.03] versus 2.51 [interquartile range, 1.17-4.10]; P<0.001). Female authorship articles reached the highest IF in North America (average IF, 3.7), with the lowest in Africa (average IF, 1.8). Conclusions Publications in cardiovascular research have increased over the past decade, particularly by female authors. Female researchers are cited less often compared with their male peers. The IF remains lower for articles by female researchers.

Sex, Gender, and Equity in Cardiovascular Medicine, Surgery, and Science in Canada Challenges, Successes, and Opportunities for Change

Background

A previous review of sex, gender, and equity within cardiovascular (CV) medicine, surgery, and science in Canada has revealed parity during medical and graduate school training. The purpose of this study was to explore sex and gendered experiences within the Canadian CV landscape, and their impact on career training and progression.

Methods

An environmental scan was conducted of the Canadian CV landscape, which included an equity survey using Qualtrics software.

Results

The environmental scan revealed that women remain underrepresented within CV training programs as trainees (12%–30%), program directors (33%), in leadership roles at the divisional level (21%), and in other professional or career-related activities (< 30%). Our analysis also showed improvements of career engagement at these levels of women at over time. The thematic analysis of the equity survey responses (n = 71 respondents; 83% female; 9.7% response rate among female Canadian Cardiovascular Society members) identified the following themes reported within the socio-ecological framework: desire to report inequities vs staying the course (individual level); desire for social support and mentorship and challenges of dual responsibilities (interpersonal level); concerns over exclusionary cliques and desire for respect and opportunity (organizational level); and increasing awareness and actions to overcome institutional barriers and accountability (societal level).

Conclusions

Although women face challenges and remain underrepresented in CV medicine, surgery, and science, this study highlights potential opportunities for improving access of female medical, surgical, and research trainees and professionals to specialized cardiovascular training, career advancement, leadership, and research.