On the basis of sex 2: gender balance at Association of Anaesthetists events | Association of Anaesthetists

On the basis of sex 2: gender balance at Association of Anaesthetists events

On the basis of sex 2: gender balance at Association of Anaesthetists events

In 2019 the Association of Anaesthetists published an analysis of the gender of speakers at Association events from 2012-18 [1]. This analysis showed a trend towards increased representation of female speakers, peaking at the Winter Scientific Meeting. The proportions were, however, still low, with a nadir of 14% at one meeting. Since then we have actively encouraged organisers of events to consider the diversity of speakers, and all Association Committees are asked to consider the possibility of any equality and diversity issues as part of standard activity reporting.

The social sciences have found that greater visible female representation reduces elements of bias within the wider community

Gender equity is a prominent and relevant issue within the medical profession. Disparity has been well documented in recent years with regard to evaluation, hiring, compensation, and career advancement [2]; for example, 55% of UK graduates are women, but < 25% of the most influential global healthcare leadership positions are held by women [3]. There are a multitude of contributors towards this inequity that we cannot hope to fully explore in this article: implicit and explicit bias; cultural elements; and representation of women are but a few.

Visibility is a vital element in narrowing any inequity. The social sciences have found that greater visible female representation reduces elements of bias within the wider community [4]. This can include anything from workplace visibility of women in senior positions to speakers at academic meetings. A low representation of female physicians at academic conferences has been recognised globally over the last decade. A cross-sectional analysis of 701 meetings in the USA and Canada from 2007-17 found an average of 31.8% of female speakers, with the lowest being 24.6% in 2007 [5].

Women in anaesthesia

The proportion of female consultant anaesthetists in the UK increased from 28% in 2007 to 38% in 2020, also reflected in an increase to a 39% female SAS workforce. The gender of anaesthetists in training and non-consultant non-training roles is 47% female [6]. Despite this, women remain under-represented in positions of leadership and academic practice within the specialty. Bosco et al. performed a scoping review of 30 articles to identify gender issues within anaesthesia [7]. They describe the contributions of both micro- and macro-inequities that contribute to gender disparity. Micro-inequities may be daily, intrusive gender biases within the workplace. Macro-inequities, however, are related to systemic issues such as promotion criteria and positions of leadership. Membership of the Association of Anaesthetists is currently recorded as 58% male and 42% female.

Speakers at Association events

For a number of years, we have targeted a 40% proportion of female speakers at Association events to reflect the overall membership. Through conscious and consistent effort, this has increased over the last nine years from 21% to 35.4% (Figure 1). Four of our events since 2012 have had > 40%, and 12 events have had > 35% female speakers. Our Winter Scientific Meeting in 2021, run as a virtual meeting, enjoyed 41% female speakers, and inspired by the technology industry we are planning a Winter Scientific Meeting 2022 with a 50:50 speaker gender split.

The trainee membership of the Association is 48% female, and we therefore aim for a higher proportion of female speakers at trainee events; however we are yet to achieve this consistently.

Below: Figure 1. Speaker gender balance at Association meetings. Blue - female

On the basis of sex 2 Figure-1

Delegates at Association events

Our proportion of female delegates for all events has increased significantly over the last nine years from 35% to 47% (Figure 2). Notably, female delegates find our webinars, webinar recordings and seminars most popular. Online learning and delivery of CPD appear to attract more female engagement, and this mode of delivery of CPD is likely to stay with us after the pandemic. We will continue to work to make our face-to-face meetings as accessible as possible.

Below: Figure 2. Delegate gender balance at Association meetings. Blue - female

On the basis of sex 2 Figure-2

Changes during the COVID-19 pandemic

The Association moved quickly to providing online webinars and educational resources in 2020. The number of delegates increased from nearly 15,000 (2019/20) to > 34,000 (2020/21), and the proportion of female delegates rose from 40% to 47% (Figures 3 and 4).

Below: Figure 3. Delegate gender balance at Association meetings in 2019-20. Blue - female

On the basis of sex 2 Figure-3

Below: Figure 4. Delegate gender balance at Association meetings in 2020. Blue - female. SALG - Safe Anaesthesia Liaison Group

On the basis of sex 2 Figure-4

While the gender balance of our webinar speakers did not see such a distinct rise, the proportion of females is higher than other comparable education providers. Hall et al. reviewed anaesthesia and intensive care medicine online webinars from March - May 2020. Women were grossly under-represented, however the Association showed the highest female speaker proportion at 36% compared with the lowest value of 20% [8].

The future

From September 2021 the Association will be requesting information from members regarding protected characteristics, which will help us to see where we need to work harder to represent our membership to the best of our ability. The provision of information is voluntary, will be confidential, and secure.

We will continue to promote a range of inspiring anaesthetists from different backgrounds, and look forward to our first 50:50 gender-balanced conference at Winter Scientific Meeting 2022.

Conclusion

Gender equity is a pressing issue within anaesthesia. The Association of Anaesthetists recognises its responsibility in providing a platform for female speakers and delegates alike in order to display the true gender balance within our specialty. The hope is that continued and consistent efforts in this area will improve access and encouragement for a more balanced representation of women in medical leadership and academia (‘If you can’t see it, you can’t be it’). There is always more to do, and we welcome input from our membership in driving the equality and diversity agenda forward.

Stuart Edwardson
Elected Member of Association of Anaesthetists Trainee Committee
ST4 Anaesthetics and Intensive Care Medicine, South East Scotland 

Tei Sheraton
Honorary Membership Secretary Association of Anaesthetists
Chair of Equality and Diversity Task Group Consultant Anaesthetist, Department of Anaesthesia, Aneurin Bevan University Health Board, Newport

Twitter: @scotgasdoc; @liberian_girl01

Read our Diversity and Equality Policy

References 

  1. Miller K, Sheraton T. On the basis of sex: speakers at Association conferences. Anaesthesia News 2019; Issue 382: 10-1. 
  2. Cooke M. Implicit bias in academic medicine. #WhatADoctorLooksLike. JAMA Internal Medicine 2017; 177: 657-8. 
  3. General Medical Council. The state of medical education and practice in the UK, 2020. https://www.gmc-uk.org/about/what-we-do-and-why/data-and-research/the-state-of-medical-education-and-practice-in-the-uk (accessed 13/4/2021). 
  4. Beaman L, Chattopadhyay R, Duflo E, Pande R, Topalova P. Powerful women: does exposure reduce bias? Quarterly Journal of Economics 2009; 124: 1497- 540. 
  5. Ruzycki SM, Fletcher S, Earp M, Bharwani A, Lithgow KC. Trends in the proportion of female speakers at medical conferences in the United States and in Canada, 2007 to 2017. JAMA Network Open 2019; 2: e192103. 
  6. Royal College of Anaesthetists. Medical workforce census report 2020, 2020. https://rcoa.ac.uk/training-careers/working-anaesthesia/workforce-planning/medical-workforce-census-report-2020 (accessed 13/4/2021). 
  7. Bosco L, Lorello GR, Flexman AM, Hastie MJ. Women in anaesthesia: a scoping review. British Journal of Anaesthesia 2020; 124: e134-47. 
  8. T Hall, C Dangoisse, V Metaxa. Where did all the women go? The underrepresentation of women in educational resources during COVID‑19. Intensive Care Medicine Experimental 2020; 8 (Suppl 2): 001215.

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