A139 Canadian Gastroenterology Career Pathway Experiences: A Gender Divide Under Examination

Abstract

Background The number of Canadian gastroenterologists has been on the rise in the last 20 years but female representation has stayed disproportionately low (30%). Gastroenterology has remained a male dominated subspecialty despite research showing as early as 1990’s that systemic gender-based barriers exist. Aims To determine whether GI career profiles differ between male and female gastroenterologists and understand barriers to career advancement related to gender in order to help shape future interventions to counteract these issues. Methods A 51-question survey was disseminated to gastroenterologists practicing in Canada. Using provincial College of Physicians and Surgeons websites, an electronic survey was sent to GIs with email addresses and a paper copy to those with fax numbers. The Canadian Association of Gastroenterology sent our survey link in their September 2019 membership email. The survey included questions pertaining to personal, professional, financial and practice characteristics of participants. Data was analyzed using SAS statistical program, and descriptive analysis with 95% confidence intervals was used to compare proportions of men and women. Nonparametric tests were used for continuous data. Qualitative thematic analysis was applied for short answer responses. Results Total 98 responses received (14.7% response rate) with 35% female respondents. Majority had adult, urban practices (86%) but males reported significantly more endoscopy time (42% v. 30%) vs. females who spent more time on research (23% v. 10%). Men were more likely to be married and have children than females. Women were more likely to not only have to choose between their marriage and their career, but more chose marriage compared to men specifically taking time off for maternity or childcare needs. Men were more likely to leave childcare predominantly to their spouse whereas women were more likely to share responsibility of childcare with spouse and hired help. Even after adjusting for age, males earned a significantly higher income than females (>$100,000 difference). 40% of men reported a salary over $600,000, compared to only 4% of women. Several gender-based biases were cited by females during their staff GI career: receiving less recognition for their work, challenging relationships with senior colleagues and support staff, inferior promotion opportunity, more difficulty publishing research and having their competency challenged by peers. Conclusions This survey shows that there are still many differences in the Canadian GI career pathway experience based on gender. Female GIs are disproportionately negatively affected in their clinical and academic practices, renumeration and work-life balance. Understanding these disparities is the first step towards remedying gender inequality in GI workplace culture. Funding Agencies None

Perceived Barriers to Professional Equality Among Women in Gastroenterology

“…In 2020, Jawaid and colleagues demonstrated low female gastroenterology representation at all stages of gastroenterology career development ( 18 ). In particular, between 2018 and 2020 GI division heads at academic institutions have ranged from 0% to 13% and program directors from 29% to 36%.…”

“…Females still comprise of only 30% of the Canadian gastroenterologist population ( 18 ). Only 29% of female gastroenterologists held senior faculty positions compared to 50% of their male colleagues ( 19 , 20 ).…”

“…Forty-three per cent of Gastroenterology programs did not have female representation at any leadership level. Female gastroenterologists were more likely to report having to choose between their family and their careers, often being required to tend to childcare and maternity needs ( 18 , 20 ). Female gastroenterologists were also found to be less likely to have children than male gastroenterologists ( 18 ).…”

Time for a Gut Check: A Qualitative Study of Proposed Interventions to Address Gender Inequality in Gastroenterology

“… 20 In Canada, approximately 70% of practicing gastroenterologists are men. 21 A small body of literature has examined gender inequalities within gastroenterology, observing similar inequalities to other fields of medicine. For example, women in gastroenterology experience differences in academic productivity than men, such as fewer number of publications and funded grants.…”

“…For example, women in gastroenterology experience differences in academic productivity than men, such as fewer number of publications and funded grants. 20 , 21 Men also receive more endoscopy time, whereas women gastroenterologists receive more research time. 21 Further, women earn significantly less (>$100,000) than men in gastroenterology, receive less peer recognition, report greater conflicts with senior colleagues, and have their competency challenged in the workplace.…”