Are Women Proportionately Represented as Speakers at Orthopaedic Surgery Annual Meetings? A Cross-Sectional Analysis

Abstract

Background In spite of efforts to improve gender diversity in orthopaedic surgery, women remain underrepresented, particularly with increasing academic rank. Opportunities to speak at society meetings are an important component of building a national reputation and achieving academic promotions. However, little is known about the gender diversity of orthopaedic society annual meeting speakers. Data on this topic are needed to determine whether these speaking roles are equitably distributed between men and women, which is fundamental to equalizing professional opportunity in academic orthopaedic surgery. Question/purposes (1) Is the gender diversity of invited speakers at annual orthopaedic subspecialty society meetings proportional to society membership? (2) Are there differences in the proportion of women invited to speak in technical sessions (defined as sessions on surgical outcomes, surgical technique, nonsurgical musculoskeletal care, or basic science) versus nontechnical sessions (such as sessions on diversity, work-life balance, work environment, social media, education, or peer relationships)? (3) Does the presence of women on the society executive committee and annual meeting program committee correlate with the gender diversity of invited speakers? (4) Do societies with explicit diversity efforts (the presence of a committee, task force, award, or grant designed to promote diversity, or mention of diversity as part of the organization’s mission statement) have greater gender diversity in their invited speakers? Methods Seventeen national orthopaedic societies in the United States were included in this cross-sectional study of speakership in 2018. Each society provided the number of men and women members for their society in 2018. The genders of all invited speakers were tabulated using each society’s 2018 annual meeting program. Speakers of all credentials and degrees were included. All manuscript/abstract presenters were excluded from all analyses because these sessions are selected by blinded scientific review. A Fisher’s exact test was used to compare the proportion of women versus men in nontechnical speaking roles. The relationship between women in society leadership roles and women in all speaking roles was investigated using a linear regression analysis. A chi square test was used to compare the proportion of women in all speaking roles between societies with stated diversity efforts with societies without such initiatives. Results Overall, women society members were proportionately represented as annual meeting speakers, comprising 13% (4389 of 33,051) of all society members and 14% (535 of 3928) of all annual meeting speakers (% difference 0.6% [95% CI -0.8 to 1.5]; p = 0.60); however, representation of women speakers ranged from 0% to 33% across societies. Women were more likely than men to have nontechnical speaking roles, with 6% (32 of 535) of women’s speaking roles being nontechnical, compared with 2% (51 of 3393) of men’s speaking roles being nontechnical (OR 4.2 [95% CI 2.7 to 6.5]; p < 0.001). There was a positive correlation between the proportion of women in society leadership roles and the proportion of women in speaking roles (r = 0.73; p < 0.001). Societies with a stated diversity effort had more women as conference speakers; with 19% (375 of 1997) women speakers for societies with a diversity effort compared with 8% (160 of 1931) women speakers in societies without a diversity effort (OR 2.6 [95% CI 2.1 to 3.1]; p < 0.001). Conclusions Although the percentage of women in speaking roles was proportional to society membership overall, our study identified opportunities to improve gender representation in several societies and in technical versus nontechnical sessions. Positioning more women in leadership roles and developing stated diversity efforts are two interventions that may help societies improve proportional representation; we recommend that all societies monitor the gender representation of speakers at their annual meetings and direct conference organizing committees to create programs with gender equity. Clinical Relevance Society leadership, national oversight committees, invited speakers, and conference attendees all contribute to the layers of accountability for equitable speakership at annual meetings. National steering committees such as the American Academy of Orthopaedic Surgeons Diversity Advisory Board should monitor and report conference speaker diversity data to create systemwide accountability. Conference attendees and speakers should critically examine conference programs and raise concerns if they notice inequities. With these additional layers of accountability, orthopaedic surgery annual meetings may become more representative of their society members.

Greater Gender Diversity Observed at Orthopaedic Conferences in the Caribbean Than in the United States or England

“…We reported that compared with men, women presented fewer clinical papers (52.6%vs 73.9%), more general topics (63.2% vs 31.2%) and were less likely to moderate a session (2.7% vs 97.3%). While these results are disturbing, they are not unique, and similar findings have been reported by several studies [12][13][14]. Krahelski et al found that men presented twice as many clinical topics as women (42.4% vs 20.7%) while the most common session for female presenters was education.…”

“…Academic faculty and residents benefit from presenting their research at annual conferences as the first step towards publication. While several studies have shown that women publish at lower rates than their male colleagues, more recently, it has emerged that women are also less likely than men to present their work at annual conferences [12][13][14].…”

“…As invited speakers, women fared marginally better. In a crosssectional study, Gerulli et al found that women comprised 14% of all invited speakers but were more likely to have nontechnical speaking roles than men [14].…”

A 15-Year Report on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States

“…There is a strong correlation between the percentage of women in an orthopaedic subspecialty society and the percentage of women on the society's board of directors 42 . Representation of female speakers at annual meetings has been shown to be largely proportionate to the membership of women in societies 43 . Increased numbers of women in leadership and as speakers in societies with greater female representation may be a chicken and egg paradox, that is, which existed first and which caused the other.…”

Commentary: Winds of change? Not really…not yet!

“…The literature is flooded with studies demonstrating unequal representation of women as session leaders in national and international scientific meetings in all fields, including surgery. [1][2][3][4] In the current study, Shemanski and colleagues 5 extend this well-established fact to cardiothoracic surgery. Their article is not just another study about the same thing.…”