Researchers working with the organisers of our annual flagship event, the Society for Endocrinology BES conference, suggest that this microcosm of the academic environment could be a beacon for improving female inclusion.

Endocrinology is frequently described as a female-friendly clinical specialty. Indeed, gender parity has recently been achieved at training (registrar) grades (data from the Royal College of Physicians). Endocrinology is also popular amongst female research scientists, and very close to half the delegates at our national meeting, the annual Society for Endocrinology BES conference, are women.

However, female academics (both clinical and non-clinical) in endocrinology remain a much smaller minority than should be expected for the gender split at the entry point or the perceived culture of the specialty. The field of endocrinology is therefore a particularly pertinent one in which to examine female academic attrition in more detail.

A number of causes have been suggested for the ‘leaky pipeline’ of female academics along the academic career trajectory or the lack of women in top clinical or decision-making roles. One widely held belief is that the current proportions amongst senior positions reflects past gender ratios, such that the problem will inevitably correct itself over time (given the increasing proportions of female undergraduates). In fact, the expected improvement has not materialised, and it seems that the continued lack of diversity at senior levels propagates a structural or cultural inertia, in which women continue to fail to progress.

THE CONFERENCE AS A MICROCOSM

Academic conferences are a key element of academic career progression, and are also important for clinicians to remain up-to-date and connected to their specialty. In particular, conferences provide opportunities for increasing visibility. Networking with peers can help generate new research ideas and, importantly, help develop recognition as an expert in one’s field.

Mirroring the broader academic landscape, numerous studies suggest that women participate less in academic conferences. For example, women are less likely to be invited as a speaker, and also more likely to decline the invitation. They are more likely to give a poster presentation but less likely to give a talk.

We approached the organisers of the Society for Endocrinology BES conference, to allow us to examine female participation at our national event. We made transcripts of all questions that were asked at the 2017 and 2018 conferences (over 400 questions per conference, spread across more than 40 sessions). We noted the gender of the questioner, whether they were an audience member or a Chair at the session (most conference sessions are moderated by two people), and undertook a qualitative analysis of the language used.

SfE BES 2017: THE ANALYSIS

Despite a gender-balanced audience at the conference in 2017, only 21% of all questions asked at the SfE BES 2017 came from women. Strikingly, only 6 out of 20 sessions chaired by male-only moderators involved a woman asking a question and, in 5 of these, only a single question came from a woman (range 7–18 questions per session). In the other session in which women asked questions, almost half of those questions (5/12) came from women; interestingly, this was the only example where the opening question came from a woman. Overall, only 6% of questions asked at sessions with male-only chairs were from women.

Conversely, we studied the sessions at the 2017 conference that were chaired by two women. In this group, 45% of the questions asked were from women, with no instances of a session where either women or men were entirely excluded from asking a question. Removing the questions asked by the female Chairs themselves, a much lower proportion of questions came from women in the audience (15%), but this was still more than double the proportion that occurred in the sessions chaired only by males, suggesting that female audience members feel more empowered to speak up when there is a female Chair.

THE VIEW AT SfE BES 2018

In 2018, we were very grateful to the conference organisers for attempting to alter the gender balance of the Chairs. Thus, the proportion of sessions with male-only moderators fell from 31% to 21% and the proportion with female-only moderators remained the same at 25%.

It should be highlighted that there were not actually more female Chairs in 2018; rather, women were asked to moderate more than one session. In both 2017 and 2018, 49% of all Chairs were female, thus the visibility of female Chairs was enhanced.

Remarkably, the proportion of questions coming from women at the 2018 conference rose to 37% (from 21% in 2017). The analysis from the 2018 conference also confirmed a significant effect of question order – if the first question in a session came from a man, only 29.6% of subsequent questions came from a woman. However, if the first questioner was female, this increased to 46.8%.

Increasing the number of female Chairs is a simple and effective way of improving female inclusion at conferences, and we would strongly recommend that all sessions in future have at least one female Chair.

A QUESTION OF STYLE

The qualitative analysis of the questions asked at the conference, blinded to the gender of the questioner, revealed that men were significantly more likely to ask questions deemed to be aggressive or formulated to display their own knowledge or expertise in a field, as assessed by the blinded observers. Conversely, women were more likely to ask questions that displayed more empathy (for example mentioning specific patients or cases) and, interestingly, to ask more questions about the sexual dimorphic implications of research findings.

One would hope that, with time, increased female visibility will fuel and empower more questions from female audience members. Just as importantly, we would urge all our colleagues to moderate the tone of  their questioning style, bearing in mind that more aggressive posturing  may dissuade certain groups, more than others, from making themselves heard. If national conferences mirror the broader academic culture, then perhaps we can begin to reflect back a more inclusive image and send a better message to the next generation.

We will be publishing the full results and conclusions of this interventional study shortly. To our knowledge, it is the first of its kind at a national medical conference. We would very much like to extend our gratitude to the organisers of the Society for Endocrinology BES conferences for their help in facilitating this work.

Victoria Salem, Elizabeth Avis, Jordan Mcdonagh and Kevin Murphy, Section of Endocrinology and Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London