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Khursheed T, Ovseiko P, Dyball S, Nakashima R, Gonzalez AMA, Babini A, Kalla AA, Hill C, Danda D, Dey D, Traboco L, Nikiphorou E, Harifi G, Badshah H, Hmamouchi I, Marie Von Feldt J, Farani JB, Andreoli L, Guimarães MP, Toro Gutiérrez CE, Sieiro Santos C, Duftner C, Alpizar Rodriguez D, Ziadé N, Palominos PE, Haq SA, Bautista-Molano W, Tanaka Y, Gossec L, Agarwal V, Wright GC, Coates L, Gupta L. Coalition for Health and Gender Equity (CHANGE)-a protocol for a global cross-sectional survey of health and gender equity in rheumatology. Rheumatol Adv Pract 2024; 8:rkae021. [PMID: 38560641 PMCID: PMC10980588 DOI: 10.1093/rap/rkae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/31/2023] [Indexed: 04/04/2024] Open
Abstract
Objectives The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology. Methods The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR's gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations. Conclusion This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.
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Affiliation(s)
- Tayyeba Khursheed
- Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Pavel Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sarah Dyball
- Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ana Maria Arredondo Gonzalez
- Colombian Association of Rheumatology, Bogotá, Colombia
- Department of Rheumatology, Faculty of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | - Alejandra Babini
- Rheumatology Unit, Hospital Italiano de Cordoba, Cordoba, Argentina
| | - Asgar Ali Kalla
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Catherine Hill
- Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, SA, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Dzifa Dey
- Rheumatology Unit Department of Medicine and Therapeutics, Korle bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Lisa Traboco
- Department of Medicine, Section of Rheumatology, St Luke’s Medical Center-Global City, Taguig, Philippines
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King’s College London, London, UK
- Rheumatology Department, King’s College Hospital, London, UK
| | - Ghita Harifi
- Department of Rheumatology, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Humeira Badshah
- Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
| | - Ihsane Hmamouchi
- Clinical Epidemiology, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
- Department of Rheumatology, Provincial Hospital of Temara, Temara, Morocco
| | | | - Júlia Boechat Farani
- Division of Rheumatology, Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, Brazil
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Carlos Enrique Toro Gutiérrez
- General Director, Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Cali, Colombia
| | | | - Christina Duftner
- Internal Medicine, Clinical Division of Internal Medicine II, Medizinische Universität Innsbruck, Innsbruck, Austria
| | | | - Nelly Ziadé
- Rheumatology Department, Hôtel-Dieu de France Hospital, Saint Joseph’s University, Beirut, Lebanon
| | | | | | - Wilson Bautista-Molano
- Rheumatology Division, University Hospital Fundación Santa Fé de Bogotá, Bogota, Colombia
- School of Medicine, Universidad El Bosque, Bogotá, Colombia
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Laure Gossec
- Sorbonne Université, INSERM, IPLESP, AP-HP, Pitié-Salpetrière Hospital, Paris, France
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Grace C Wright
- Association of Women in Rheumatology; United Rheumatology, New York, NY, USA
| | - Laura Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Latika Gupta
- Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Barajas-Ochoa A, Peláez-Ballestas I, Ramirez-Trejo M, Gradilla-Magaña P, Cisneros-Barrios A, de Lara AM, Gastelum-Strozzi A, Ramos-Remus C. Gender representation in rheumatology journals: an assessment of editors, editorial boards, and authors. Rheumatol Int 2023; 43:1811-1819. [PMID: 37433928 DOI: 10.1007/s00296-023-05390-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023]
Abstract
Diversity is widely recognized as a driver of excellence and innovation. In recent years, women have become an increasingly significant part of the rheumatology workforce. We aimed to assess the gender representation of the leading rheumatology journals' editors and to explore whether editors' gender correlates with the gender of the first and last authors of published articles. We conducted a cross-sectional study and extracted editorial members of rheumatology journals in quartiles 1 to 3 (Clarivate Analytics) from each journal's website. We categorized editorial positions according to the level of influence in manuscript acceptance decision-making (levels I to III). The gender of editors and of the first and last authors in all 2019 original articles published in a sample of 15 rheumatology journals was assigned using a combination of digital gallery and manual searches. There were 2242 editors' names retrieved from 43 journals, 24 (26%) of the 94 editors at level I, 139 (36%) of 385 editors at level II, and 469 (27%) of 1763 at level III were female. The imbalance between journals was heterogeneous. Females were the first authors in 1342 (48%) and the last authors in 969 (35%) of the 2797 published articles. However, we found no significant correlation between editors' and authors' gender. Our data showed uneven gender representation on the editorial boards of most rheumatology journals, but we did not find any apparent vertical segregation or influence on publishing by gender. Our findings suggest that a generational transition may be occurring among authors.
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Affiliation(s)
- Aldo Barajas-Ochoa
- Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Ingris Peláez-Ballestas
- Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148. Col. Doctores.Cuahtémoc, 06720, Mexico City, Mexico
| | - Manuel Ramirez-Trejo
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Paloma Gradilla-Magaña
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | | | - Amaranta Manrique de Lara
- Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148. Col. Doctores.Cuahtémoc, 06720, Mexico City, Mexico
| | - Alfonso Gastelum-Strozzi
- Instituto de Ciencias Aplicadas y Tecnológicas (ICAT), Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Cesar Ramos-Remus
- Unidad de Investigacion en Enfermedades Cronico-Degenerativas, 44620, Guadalajara, Jal, Mexico.
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Kuhlmann E, Bruns L, Hoeper K, Witte T, Ernst D, Jablonka A. [Health workforce development in rheumatology : A mapping exercise and wake-up call for health policy]. Z Rheumatol 2022; 81:717-729. [PMID: 34003376 PMCID: PMC8129704 DOI: 10.1007/s00393-021-01012-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Health workforce shortage in German rheumatology has been identified as a healthcare service and delivery problem. Health policy has increased staffing targets, yet effective intervention strategies are lacking. This research aimed to systematically map the rheumatology workforce to improve the evidence for interventions and explore possibilities for more effective health workforce management. METHODS The WHO National Health Workforce Accounts provided a conceptual framework for the mapping exercise. Four major sets of indicators were selected, comprising staffing levels, health labor market flows, composition and education/training. A comparison of age groups and time series was applied to explore trends. Public statistics and other secondary sources served our analysis using descriptive methodology. RESULTS In Germany there are 1076 physicians specialized in internal medical rheumatology. Absolute numbers have nearly doubled (91%) since 2000 but with a strong demographic bias. Between 2000 and 2019 numbers markedly increased in the group aged 50 years and older but only by 9% in the younger group under 50 years; since 2010 the group aged 40-50 years even faces a decrease. In 2019, the absolute numbers of rheumatologists in retirement age exceeded those aged 40 years and under. Since 2015 an expanding workforce trend has overall flattened but this was strongest in the hospital sector; the numbers in resident training did not show any relevant growth. CONCLUSION Health workforce trends reveal that an available number of rheumatologists cannot meet new health policy planning targets. There is a need for effective health workforce management, focusing on innovation in resident training, improved task delegation and gender equality.
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Affiliation(s)
- Ellen Kuhlmann
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Luzia Bruns
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Kirsten Hoeper
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
- Regionales Kooperatives Rheumazentrum Niedersachsen e. V., Hannover, Deutschland
| | - Torsten Witte
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Diana Ernst
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Alexandra Jablonka
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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Hassan N, van Mens LJ, Kiltz U, Andreoli L, Delgado-Beltran C, Ovseiko PV, Gossec L, Coates LC. Gender equity in academic rheumatology: is there a gender gap at European rheumatology conferences? RMD Open 2022; 8:e002131. [PMID: 35246471 PMCID: PMC8900061 DOI: 10.1136/rmdopen-2021-002131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 02/09/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To obtain an overview of gender equity at European rheumatology conferences. METHODS The proportion of women invited as either moderators or speakers to the European Alliance of Associations for Rheumatology (EULAR) annual congresses and national conferences in Europe was calculated from the published congress materials from EULAR annual congresses (2015-2019) and the 2019 national conferences of France, Germany, Italy, Spain and the UK. Data from EULAR congresses were further categorised by type of session. Significance testing was conducted using χ2 tests with the level of statistical significance set at p<0.05. RESULTS The proportion of combined women moderators and speakers at EULAR varied from 40% to 43% between 2015 and 2019 with no obvious trend over time. There were higher proportions of women in the Health Professionals in Rheumatology and People with Arthritis and Rheumatism sessions (>50% consistently). However, these sessions represent <25% of EULAR congress invitations. Representation of women at the EULAR congress in 2019 (39.6%) was significantly higher than at the national congresses in France (28.6%) and Germany (29.6%) but similar to that observed in Italy (33.7%), Spain (41.7%) and the UK (42%). CONCLUSION Women account for less than half of invited moderators and speakers at the conferences reviewed. Compared with historical EULAR data in 2003 (16%) and in 2004 (19%), the gender gap at EULAR congresses has narrowed considerably, but there remains a need to monitor and improve women's representation.
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Affiliation(s)
- Neelam Hassan
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
- Department of Rheumatology, North Bristol NHS Trust, Bristol, UK
| | - Leonieke Jj van Mens
- Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Uta Kiltz
- Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Pavel V Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France
- APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
| | - Laura C Coates
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Kuhlmann E, Bruns L, Hoeper K, Richter M, Witte T, Ernst D, Jablonka A. Work situation of rheumatologists and residents in times of COVID-19 : Findings from a survey in Germany. Z Rheumatol 2021; 82:331-341. [PMID: 34535820 PMCID: PMC8448391 DOI: 10.1007/s00393-021-01081-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/28/2022]
Abstract
Background and objective The work situation is an important dimension of professional life and wellbeing, and a policy lever to strengthen recruitment and retention. This study aims to explore the work situation of physicians and residents in internal medical rheumatology, considering the impact of the coronavirus pandemic COVID-19. Methods A questionnaire-based online survey was conducted in early 2021 at the Hannover Medical School, supported by the German Society of Rheumatology. Target groups were all rheumatology physicians and residents in Germany. The main areas of investigation included work hours, task delegation, and collaboration; workload and mental health issues; discrimination and sexual harassment experiences; and the impact of COVID-19. Descriptive statistical analysis was performed for the standardized items and qualitative content analysis for the free-text information. Results The respondents (n = 101) expressed positive attitudes towards cooperation and task delegation to medical assistants, especially those specialized in rheumatology, while attitudes towards cooperation with GPs pointed to blockades. There was a strong mismatch between actual and desired work hours both in the group of women and in the group of men. 81% rated their workload as high or very high; every sixth rheumatologist has suffered from stress or burnout syndromes at least once in the past. Experiences of gender discrimination and sexual harassment/violence were frequently reported, mostly by women. COVID-19 was an amplifier of stress, with major stressors being digitalization and increased demand for communication and patient education. Conclusion There is an urgent need to improve the work situation of rheumatologists and reduce stress and mental health risks. Supplementary Information The online version of this article (10.1007/s00393-021-01081-5) includes the survey questionnaire in German.
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Affiliation(s)
- Ellen Kuhlmann
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Luzia Bruns
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kirsten Hoeper
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Regionales Kooperatives Rheumazentrum Niedersachsen e. V., Hannover , Germany
| | - Marianne Richter
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Regionales Kooperatives Rheumazentrum Niedersachsen e. V., Hannover , Germany
| | - Torsten Witte
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Diana Ernst
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Alexandra Jablonka
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, OE 6830, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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