|Ahead of print publication
Does gender gap exist in Indian rheumatology? Analysis of faculty gender representation at its annual conferences
Kavitha Mohansundaram1, Velu Annamalai Sowndhariya2, Vinod Ravindran3
1 Department of Rheumatology, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India
2 Department of Rheumatology, MIOT Hospital, Chennai, Tamil Nadu, India
3 Centre for Rheumatology, Kozhikode, Kerala, India
|Date of Submission||07-Feb-2021|
|Date of Acceptance||25-Mar-2021|
|Date of Web Publication||08-May-2021|
Centre for Rheumatology, Kozhikode - 673 009, Kerala
Source of Support: None, Conflict of Interest: None
Background: Ensuring gender equality in faculty representation at medical academic meetings is important as it is linked to career development, building networks, increasing visibility, and reputation. The objective of this study was to analyze the gender representation among the faculty and abstract presenters at the Indian Rheumatology Association's (IRA) Annual Conferences (IRACONs).
Methods: Gender representation among faculty (speakers and chairpersons from India and abroad) and the first author among abstract presenters in the past 10 years (IRACONs 2010–2019) was tabulated. Ratio and proportion of gender representation in these categories were calculated and compared in the two time frames of 2010–2014 and 2015–2019. Trends of female gender representation as faculty and abstract presenters were also compared with trend of enrollment of female life members of the IRA.
Results: Female faculty from India constituted 127/627 (20%) and 91/567 (16%) as speakers and chairpersons respectively, with combined representation (speakers and chairpersons) of 18.5% ± 2.34% (mean) over the past 10 years with only few orations (4 out of 29). Widening of gender gap in speaker representation was noted in the latter 5 years' time period of 2015–2019 (23% [3.3:1] vs. 18% [4.6:1]). More females became life members of the IRA in the period 2015–2019, and though a similar positive trend was also noted in female abstract presenters, it was not seen in the female faculty representation.
Conclusion: This study confirms that gender gap exists in the representation of female faculty at IRACONs. A systematic approach is required to address this issue by sensitizing the members and developing relevant policies.
Keywords: Empowerment, gatekeepers, gender bias, gender equality, glass ceiling, professional recognition
|How to cite this URL:|
Mohansundaram K, Sowndhariya VA, Ravindran V. Does gender gap exist in Indian rheumatology? Analysis of faculty gender representation at its annual conferences. Indian J Rheumatol [Epub ahead of print] [cited 2021 Jun 18]. Available from: https://www.indianjrheumatol.com/preprintarticle.asp?id=315685
| Introduction|| |
Gender disparity in science, technology, engineering, mathematics, and medicine and allied fields across several developed countries including Europe has been quite often analyzed and debated in the recent years.,, An analysis of 13 Canadian institutes covering 15 years reported that compared to men scientists, women had significantly lower grant success as well as lower personnel award success rates and this differed by institutes not time. In another study, which was a cross-sectional analysis carried out to examine the gender of speakers of medical conferences held in Canada and the United States over 5 years, found that women continue to be underrepresented. A larger study of medical conference programs from over 18 months in 2017–2018 across 20 specialties in five regions (Australasia, Canada, Europe, the UK, and the US) reported that a proportion of female speakers at medical conferences were lower than that of male speakers, and more than one-third of panels were comprised of men only. Recently, rheumatology colleagues from the USA have also reported similar trends their annual conferences. Smaller numbers (32%) of females as the first authors of guidelines and recommendations in rheumatology published between 2004 and 2019 with an improving trend in the recent years have also been highlighted. Such data from developed world may be considered surprising given the much empowered positions traditionally held in their society by women, with gender disparity being actively discouraged both in the society and institutions alike.
In India, women constitute little over 50% of students joining medical colleges; however, this figure drops to one-third at postgraduate and postdoctoral levels. Subsequently, a substantial further attrition occurs and current figures state that only 22% of doctors practicing modern medicine are females in India. Conventionally popular fields for postgraduation for women in India have been gynecology and obstetrics, pediatrics, ophthalmology, dermatology, and anesthesia. Among the newer subspecialties, currently, rheumatology appears to be represented well by female gender not only as trainees but also as faculty in many teaching institutions. However, it is unclear whether they are adequately represented as speakers and other faculty in the annual conferences of the Indian Rheumatology Association (IRA), which is the professional organization of clinical immunologists and rheumatologists in India (https://www.indianrheumatology.org), with little over 1300 members. As more visibility of women enhances the sustainability of women in the field and attracts them to get enrolled in research and other academic traits, it is important to assess the current gender dimensions in IRA Annual Conferences (IRACONs).
The primary objective of our study therefore was to analyze the gender representation among the faculty and abstract presenters at IRACONs.
| Methods|| |
Published or advertised final programs of the past 10 year's IRACONs (2010–2019) were analyzed. Last minute changes in the program were not taken into account. The main programs, as well as the preconference continuing medical education sessions including panel discussions and orations were analyzed; presidential orations were however excluded. Sessions outside the main events; workshops, quiz, meet the experts/professors were excluded. Gender of faculty was identified using their first names as per the norm in India; when in doubt we used the image matching, scientific connection networks such as linkedin.com and researchgate.net or took the help of the organizers. This study has been presented according to the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines (https://www.equator-network.org/reporting-guidelines/strobe/).
Faculty (speakers and chairpersons) from India and abroad
The numbers of speakers and chairpersons from India and abroad were extracted and separately grouped. Gender representation in each of aforementioned groups and among orations was separately recorded. The repetitions in the list were counted as one entry and categorized in their respective gender under appropriate category (e.g., if Mr. X held the role of a chairperson and a speaker – he was listed once under chairperson and once under speaker; however, if he had been a speaker twice – he was taken as one person under the speaker category).
First author of the abstracts
The gender of the first author of abstracts was extracted from the supplements of the official publication of the IRA, Indian Journal of Rheumatology (indianjrheumatol.com) for IRACONs 2010–2019. In doing so, we assumed that such first author would be the presenting author for that abstract as per the convention.
Life members of the Indian Rheumatology Association
From the IRA members' directory (2019 version), the details of life members of IRA from 2010 to 2019 were extracted and the trends in gender-based enrollment were noted.
Descriptive statistics was used to present the data. Ratio and proportion of female faculty and first author of abstracts were calculated. Gender representation in IRACONs was compared with the trends in IRA life members for two time frames; 2010–2014 and 2015–2019. For this, only life members from within India were included.
As this study was not a human subject research, it did not require ethics review.
| Results|| |
Gender representation among faculty (speakers and chairpersons) from within India
The overall representation of female faculty (speakers and chairpersons combined) from within India in IRACONs was 18.5% ± 2.34% (mean) over the past 10 years.
Female speakers from India constituted 127/627 (20%) as speakers ranging from 3 to 19 (interquartile range [IQR], 4) of all faculty and as chairpersons 91/567 (16%) ranging 2–18 (IQR, 8) [Figure 1]. In the two 5-year time periods, the proportion of female faculty as speakers was far less in the latter period of 2015–2019 [Table 1].
|Figure 1: Representation of female faculty at Indian Rheumatology Association's Annual Conferences 2010–2019|
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|Table 1: Females as speaker or chairpersons from within India over two time frames|
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Although the maximum female representation as speakers was noted at IRACON 2019, with as many as 19 female speakers, it had a male female ratio of 4.8:1 which was less than the 10-year average. The best ratio was observed in IRACON 2011, which had 14 female and 39 and male speakers, respectively (26% with M:F ratio of 2.8:1).
In these 10 years, only 4 females (14%) gave orations compared to 25 males.
Gender representation among the faculty (speakers and chairpersons) from abroad
Both as speakers (15%) and chairpersons (7%), females from abroad constituted a miniscule part of the whole female faculty [Figure 1]. Even when combined with female faculty from within India, the overall representation neither as speakers (19%) nor as chairpersons (15%) improved substantially. Although, in couple of IRACONs, a larger number of male faculty from abroad contributed, female as faculty remained far less (24 vs. 1, 4% in 2014, and 35 vs. 5, 12.5% in 2019).
Gender representation among the abstract presenters
Females as abstract presenters overall were 398 compared to 1085 male presenters (27% with an M:F ratio of 2.7:1) in the last 10 IRACONs, with a perceptible improvement in the ratio in the 2015–2019 period [Table 2].
|Table 2: Gender representation among abstract presenters in Indian Rheumatology Association's Annual Conferences 2010-2019|
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Gender representation among the life members of Indian Rheumatology Association
Till 2009, the female life members comprised 13% of total members from India. Since then, in the two time periods of 2010–2014 and 2015–2019, though the number of new male members has remained steady (162 and 165), the number of female new members doubled in the same period (31 and 60) with every fourth person inducted into IRA in the latter period was a female [Table 3]. When these trends were compared to the trends in faculty (from within India) representation in IRACONs, it was noted that though the gender gap narrowed down among the new IRA inductees, it was not reflected in the faculty representation in the last 5 years [Figure 2]. On the other hand, the trend improved among abstract presenters [Figure 2].
|Table 3: Gender analysis of life members of Indian Rheumatology Association|
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|Figure 2: Trends in the representation of female faculty, abstract presenters, and new inducted Indian Rheumatology Association life members 2010–2019|
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| Discussion|| |
Our study has found that female gender from within India was underrepresented at IRACONs (only 18.5% ± 2.34%) as faculty throughout the 10 years from 2010 till 2019. Even when combined with female faculty from abroad, this gender gap remained substantial. Another worrying observation was that compared to the trends in faculty (from within India) representation at IRACONs, it was noted that though the gender gap has narrowed down among the new inductees with every fourth new member of IRA now being female (31 and 61 new female life members in period 2010–2014 and 2015–2019, respectively), it did not reflect in the overall representation of female faculty in the last 5 years (18.4% vs. 18.1% in the period 2010–2014 and 2015–2019, respectively) and actually fell in the speaker representation from 23% to 18% in the same periods.
Education is regarded as the pathway for empowerment and gender equality. Sustained attrition in women workforce in modern medicine (from 51% in medical colleges to 22% as practicing doctors) in India is attributed to the struggle females have to face to balance career with family needs and societal patriarchy, where men are not only generally considered to be more skillful but also as having better potential to succeed. Even those females who do continue practicing medicine, a further barrier is faced in terms of peer recognition translating into opportunities to participate as faculty in their learned societies' meetings and conferences. A recent WHO paper has pointed out that although women represent around 70% of the health workforce, they earn on average 28% less than men. Occupational segregation (10%) and working hours (7%) can explain most of this gap, but even when considering “equal work” and “equal pay,” a gap of 11% remains. In this context, our study brings out some pertinent observations regarding the existing gender disparity at IRACONs.
Participation in academic conferences as a faculty is important not only for the feedback and the improvement of the work, but it is also linked to career development, building networks, and increasing visibility. They also enhance the scientific and social reputation in the scientific community.
In their recent commentary, Kibble and Kapadia have underscored why gender gap in faculty in academic conferences can have multiple detrimental effects. They have pointed out that a lack of diversity deprives a conference of varied opinions, better ideas, and innovation, all being the hallmark of a well-rounded academic event, and potentially limits the perspectives shared on important issues, which may lead to the wrong messages being conveyed to the delegates. An even more worrying result is that junior colleagues, trainees, and other attendees may perceive that the particular professional/organization, and/or organizers do not care about diversity and this may in turn unknowingly help strengthen prevalent societal stereotypes. Finally, lack of such peer recognition by the way of invitations to speak further propagates the glass ceiling that exists for women in academia.
Female faculty representation in the American College of Rheumatology (ACR) meetings in 2017–2018 has been reported as 44.9% against the female rheumatology workforce in the USA comprised 41% female rheumatologist in 2015 (projected to increase to 57% by 2020)., In comparison, if the life membership of IRA is taken as indicative of rheumatology workforce in India, females by 2019 constituted 16% of a total workforce in India. At a casual glance, therefore, female gender representations of 18% at IRACONs may appear adequate; in reality, such gross under-representation highlights the apparent lack of pro-active thinking to improve female gender representations in our conferences. The need for the underprivileged and disadvantaged in any society to be nurtured, supported, and promoted to enable them in overcoming hurdles and realizing their full potential is widely accepted and the same is required for females in medicine in our country; however, on the whole, gender gap in medicine has not been studied systematically in our country.
The gender representation among speakers seems heavily skewed in favor of men at IRACONs. This worrying trend is a common one as noted in several studies from the west; however, there is a dearth of such data from developing countries.,, It has been suggested that inclusion of women in scientific committee might lead to improvement in the female gender representation. This approach has its validity as it has been noted that individuals who make decisions about who will gain recognition and advance in academia may have innocuous schemas or stereotypes about men and women which may lead to substantially different expectations and behavioral confirmations. While these biases may not be conscious, they may become conducive to lingering disparities. We do not have any data on the composition of scientific committees of IRACONs during the period studied. If already not in place, a robust and structured mechanism geared to ensure adequate female gender representation in the future IRACON scientific committees is important in addition to sensitizing all members to actively consider balanced gender representation when drawing up the scientific program. For the IRA as an organization, it is timely now to consider making explicit equality policies governing the IRACONs and beyond.
On a more positive note, our study has found that the proportion of female gender as the abstract presenters in IRACONs have shown an improving trend (2.3:1 in 2019 vs. 4.5:1 in 2010; and 24% vs. 28% in the periods 2010–2014 and 2015–2019, respectively) [Figure 2]. This probably is a result of females comprising bulk of the trainees now in this specialty and their resultant enhanced participation in the research activities. However, if this increasing trend is not matched by a similar increase in the female faculty and in the orations at the IRACONs, there is a possibility that it would have a demoralizing effect on the female trainees and researchers. As they feel to share a common work pattern at home and in the work place, women are inspired by fellow women speakers and the absence of women in specific positions and limited opportunities for them to develop specific roles for themselves has the potential to negatively influence the ambitions of other women.,
One limitation of the present study is a lack of analysis of any peculiar causes of gender gap at IRACONs such as invited but declined with reasons, preferred one role over the other, prevalence of male networks, or a difficulty in finding female experts due to unavailability of relevant information. To enable such analyses, a tool to monitor and assess academic events has been proposed which may be considered and adopted for future IRACONs.
In conclusion, our study of the gender gap at IRACONs as faculty and abstract presenters has shown that there is a wide scope to improve the female faculty participation. Further, the present study provides information on an important subject which does not appear to have been studied in India yet. One of the key findings of our study is that whereas more females as abstract presenters are contributing, similar trends are lacking in their representation as faculty and in orations. As now every fourth new member of IRA is female, as a learned society, it would be important for the IRA to take conscious steps to address gender gaps in its annual conferences. It is important to remember that as such, diversity should not be limited to gender and should include diversity of race, ethnicity, religion, sexual orientation, and age.
| Acknowledgment|| |
We would like to thank scientific chairs and organizing secretaries of IRACONs for sharing the final scientific programs. All authors are life members of the IRA. VR has served as member of scientific committee of IRACONs (2016, 2017, and 2018) and as an elected member of IRA's executive committee for two terms (2016–2019).
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3]