Opportunities in science and medicine are unequal. Recent years have seen a new and welcome focus on equality, diversity and inclusion across health services and academia, and there has been progress on levelling the playing field, though much remains to do. Understanding where the bias or unfairness lies is important, because it provides an evidence base for interventions to tackle these issues.

Medicine is often classed as a ‘feminised’ profession, yet women remain underrepresented in clinical academia. Often referred to as the ‘leaky pipeline effect’, there is still disparity between the proportion of female professionals in junior roles versus senior positions. There has been much research surrounding the causes of female attrition leading to underrepresentation, but fewer studies have identified interventions to reverse it.

Fewer than 20% of clinical professors in the UK are women.¹ There have been a number of initiatives in the UK to improve female retention along academic career pathways, such as the Athena SWAN movement. However, women are still victims of discrepancies in the professional environment. Studies that investigate why fewer women reach professorship found that women tended to have more concerns over work–life balance than their male peers, which negatively impacted their career progression.² The pandemic has also led to a greater burden on women due to caregiver responsibilities, leading to greater rates of women dropping out of academic research.³ With fewer papers published by women during the pandemic, there is a chance that the same career progression of junior female academics will suffer.

OUR WORK SO FAR

Previous pieces by others and ourselves in The Endocrinologist have discussed the importance of the visibility, involvement and engagement of members from different genders and ethnicities across the Society. Conferences allow academics to network and raise their profiles, and may therefore be a useful place to introduce interventions that redress gender imbalances. We have described how women were less likely to contribute in discussions after talks at our national annual meeting, the SfE BES conference, in 2017. We found that women asked fewer and shorter questions than men, and had a more empathetic and self-deprecating question style.⁴

At the 2018 conference, an intervention was implemented where more female members were invited to chair sessions, and Chairs were encouraged to open questions to female members when the opportunity presented itself.. This intervention showed promising results, increasing the number of questions from women in 2018.

Building on this work by studying the SfE BES conference 2021 in Edinburgh, we found that, despite a gender-balanced delegacy (54% of delegates were females), women asked fewer questions than men (42.9%), and that the proportion of questions from females increased in the presence of female moderators. Moreover, men used more aggressive and challenging questions than women. These findings were similar to those from the 2017 and 2018 conferences, although it was of note that the gender imbalance in questions was smaller than in previous years.

The proportion of questions from women was nearly equal to those from men in sessions with a female senior Chair and in which the first question was asked by a female, suggesting that increased visibility of women, particularly of higher professional rank, can increase female participation. This is in accordance with work showing that female academic role models aided women in achieving their own professional success, leading to these women publishing more papers and spending time on research.⁵

Differences in the way men and women asked questions persisted. Women more often stated that their question was ‘quick’ or ‘simple’ and junior women tended to be more self-deprecating. However, more encouragingly, certain categories of questioning were no longer imbalanced between men and women. This may partly reflect the actions of moderators in trying to open up sessions to a wider range of participants. For example, one Q&A session involved a ‘competition’ between two Chairs to see who could elicit more questions from trainees.

FUTURE PLANS

This work illustrates the potential impact of simple interventions in increasing the contribution of women in academic conferences. We intend to continue with this work, and are hoping to widen the remit of our studies, investigating, for example, whether the ethnicity of speakers and Chairs has an impact on the demographics of questioners. Evidence suggests that doctors from ethnic minorities are underrepresented in consultant, clinical director and medical director roles, but overrepresented at other grades.⁶

The Society’s Equality, Diversity and Inclusion Working Group is currently investigating how we can gather data to understand whether we might need to act to ensure that all of our members are fairly represented and given the opportunity to flourish, and you may have been asked to complete an online survey at SfE BES 2022 about your background and your engagement with the conference.

We hope that, together, this work will help to increase the engagement and visibility of historically underrepresented member groups at the SfE BES conference and, in doing so, make a contribution to bringing down the barriers present in science and academic medicine. You too can make difference. If you attended the conference in 2022 and didn’t complete a survey, please log on using the QR code; it only takes a minute. And if you see us approaching you next year to ask some questions, please don’t run away…

DEEPIKA KUMANAN, Medical Student

VICKY SALEM, Clinical Senior Lecturer in Diabetes and Endocrinology

KEVIN MURPHY, Professor of Endocrinology and Metabolism, Imperial College London

REFERENCES

1. Penny M et al. 2014 Journal of the Royal Society of Medicine 107 259–263.
2. Varpio L et al. 2021 Medical Education 55 582–594.
3. Davis PB et al. 2022 Nature Medicine 28 436–438.
4. Salem V et al. 2021 Lancet Diabetes & Endocrinology 9 556–559.
5. Levinson W et al. 1991 Western Journal of Medicine 154 423–426.
6. Rimmer A 2021 BMJ 374 n1844.

 

Find out more about the Society's Equality, diversity and inclusion working group