Gender disparities in advanced endoscopy fellowship

Abstract

Background and study aims Women remain underrepresented in gastroenterology, especially advanced endoscopy. Women represent 30 % of general gastroenterology fellows; yet in 2019, only 12.8 % of fellows who matched into advanced endoscopy fellowship (AEF) programs were women. Methods We administered a web-based survey to the program directors (PDs) of AEF programs that participated in the 2018–2019 American Society for Gastroenterology (ASGE) match. We assessed PD and program characteristics, in addition to perceived barriers and facilitators (scale 1–5, 5 = most important) influencing women pursuing AEF training. Results We received 38 (59.3 %) responses from 64 PDs. 15.8 % (6/38) of AEF PDs and 13.2 % (5/38) of endoscopy chiefs were women. By program, women represented 14.8 % (mean) ± 17.0 % (SD) of AEF faculty and 12.0 % (mean) ± 11.1 % (SD) of AEF trainees over the past 10 years. 47.4 % (18/38) programs reported no female advanced endoscopy faculty and 31.6 % (12/38) of programs have never had a female fellow. Percentage of female fellows was strongly associated with percentage of female AEF faculty (ß = 0.43, P < 0.001). Inflexible hours and call (mean rank 3.3 ± 1.1), exposure to fluoroscopy (2.9 ± 1.1), lack of women endoscopists at national conferences/courses (2.9 ± 1.1) and lack of female mentorship (2.9 ± 1.0) were cited as the most important barriers to recruitment. Conclusion We utilized a survey of AEF PDs participating in the ASGE match to determine program characteristics and identify contributors to gender disparity. Women represent a minority of AEF PDs, endoscopy chiefs, advanced endoscopy faculty and AEF trainees. Our study highlights perceived barriers and facilitators to recruitment, and emphasizes the importance of having female representation in faculty, and leadership positions in endoscopy.

A portrait of Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound training programs in Europe: Current practices and opportunities for improvement

“…Although it was not possible to obtain a justification for this result, it is true that women remain underrepresented in Gastroenterology, especially in ERCP/EUS. A recent study 19 confirmed that women represent a minority in this field, corre- acceptance into the fellowship. Given the limited number of training vacancies available, it makes sense to attribute these to those with the highest likelihood of continuing their ERCP/EUS practice.…”

“…Although it was not possible to obtain a justification for this result, it is true that women remain underrepresented in Gastroenterology, especially in ERCP/EUS. A recent study 19 confirmed that women represent a minority in this field, corresponding to 14% of current ERCP/EUS fellows and to 13.2% of endoscopy chiefs. Inflexible hours and calls, exposure to fluoroscopy during childbearing age, lack of women endoscopists at conferences/courses, and lack of mentorship for female trainees were perceived barriers to recruitment.…”

“…Trainers have been performing ERCP/EUS independently for less than three years in19.5% (n = 8), between 3 and 10 years in 39%F I G U R E 1 Geographical distribution of respondents to Endoscopic retrograde cholangiopancreatography (ERCP)/ endoscopic ultrasound (EUS) training survey: Austria (n = 1), Croatia (n = 1), Czech Republic (n = 1), Denmark (n = 1), Northern Ireland (n = 1), Norway (n = 1), Poland (n = 1), Sweden (n = 1); Hungary (n = 2), Portugal (n = 2), Romania (n = 2), United Kingdom (n = 2); Belgium (n = 3), Italy (n = 3); Germany (n = 4), Spain (n = 4); The Netherlands (n = 5), France (n = 6). (n = 16), and more than 10 years in 41.5% (n = 17).…”

Women in gastroenterology: the UK trainee experience

“…In the USA, 24.7% of female fellows plan to pursue advanced endoscopy compared with 37.5% of male fellows 17. Women were more likely to be deterred by perceived gender bias, family planning, lack of flexible hours, fertility/pregnancy risks from radiation and lack of ergonomic equipment 17 18. An absence of same-sex mentors and the lack of visibility of female endoscopists at national conferences/courses were also cited as barriers 3 17–19.…”

“…Women were more likely to be deterred by perceived gender bias, family planning, lack of flexible hours, fertility/pregnancy risks from radiation and lack of ergonomic equipment 17 18. An absence of same-sex mentors and the lack of visibility of female endoscopists at national conferences/courses were also cited as barriers 3 17–19. Women also face unique physical challenges in endoscopy.…”