The Gender Gap in Academic Anesthesiology and Critical Care Medicine: a Systematic Review

Overview

Journal Can J Anaesth

Specialty Anesthesiology

Date 2024 Dec 20

PMID 39707052

Authors

Alessandro De Cassai

Francesca Rubulotta

Marko Zdravkovic

Sindi Mustaj

Joana Berger-Estilita

Affiliations

Soon will be listed here.

Abstract

Purpose: Gender disparities in academia are a growing concern, impacting various disciplines, including health care. We aimed to investigate gender-based differences in academic performance, leadership roles, and academic distinction within anesthesiology and critical care medicine.

Source: We conducted electronic searches for relevant articles published in PubMed, CENTRAL, Scopus, Web of Science, Embase, Education Resources Information Center, PsychINFO, and ProQuest from database inception until 23 June 2024. Three researchers conducted blinded assessments using predefined inclusion and exclusion criteria, with discrepancies resolved through discussion. We reported descriptive statistics for quantitative data from the included research articles.

Principal Findings: Our initial screening identified 37,311 studies, 71 of which met the specified inclusion criteria and were therefore evaluated. Analysis of academic publishing trends revealed a gradual increase in the proportion of women as coauthors, first authors (in anesthesiology, the increase ranged from 7% to 17%, and in critical care medicine the increase was 4%), last authors, and corresponding authors. Despite these improvements, women remain underrepresented on the editorial boards of top journals. Although an increase in the representation of women as abstract presenters at conferences was noted, gender disparities persist in senior authorship roles.

Conclusion: Gender disparities are evident in academic leadership positions within anesthesiology and critical care medicine, with few women holding editor-in-chief positions and underrepresentation of women on editorial boards. We observed similar gaps in departmental and scientific society leadership roles. The distribution of awards, prizes, and grants remains skewed, indicating persistent gender imbalances in academic distinction. While progress has been made in certain areas, substantial gaps persist in scholarly publishing, leadership, and academic distinction.

Study Registration: PROSPERO ( CRD42022377524 ); first submitted 20 November 2022.

References

Vincent J, Juffermans N, Burns K, Ranieri V, Pourzitaki C, Rubulotta F . Addressing gender imbalance in intensive care. Crit Care. 2021; 25(1):147. PMC: 8051087. DOI: 10.1186/s13054-021-03569-7. View

Jahshan A, Aoun M, Dekhou A, Folbe A . The underrepresentation of women and ethnic minorities in anesthesiology. J Natl Med Assoc. 2021; 114(1):26-29. DOI: 10.1016/j.jnma.2021.09.005. View

Zdravkovic M, Osinova D, Brull S, Prielipp R, Simoes C, Berger-Estilita J . Perceptions of gender equity in departmental leadership, research opportunities, and clinical work attitudes: an international survey of 11 781 anaesthesiologists. Br J Anaesth. 2020; 124(3):e160-e170. DOI: 10.1016/j.bja.2019.12.022. View

Bosco L, Lorello G, Flexman A, Hastie M . Women in anaesthesia: a scoping review. Br J Anaesth. 2020; 124(3):e134-e147. DOI: 10.1016/j.bja.2019.12.021. View

Leslie K, Hopf H, Houston P, OSullivan E . Women, Minorities, and Leadership in Anesthesiology: Take the Pledge. Anesth Analg. 2017; 124(5):1394-1396. DOI: 10.1213/ANE.0000000000001967. View

Grogan K . How the entire scientific community can confront gender bias in the workplace. Nat Ecol Evol. 2018; 3(1):3-6. DOI: 10.1038/s41559-018-0747-4. View

Weiss B . Statement paper on diversity for the European Society of Intensive Care Medicine (ESICM). Intensive Care Med. 2019; 45(7):1002-1005. PMC: 6611745. DOI: 10.1007/s00134-019-05606-0. View

Lorello G, Gautam M, Barned C, Peer M . Impact of the intersection of anaesthesia and gender on burnout and mental health, illustrated by the COVID-19 pandemic. Anaesthesia. 2021; 76 Suppl 4:24-31. PMC: 8251311. DOI: 10.1111/anae.15360. View

Greenwood B, Carnahan S, Huang L . Patient-physician gender concordance and increased mortality among female heart attack patients. Proc Natl Acad Sci U S A. 2018; 115(34):8569-8574. PMC: 6112736. DOI: 10.1073/pnas.1800097115. View

10.

Wallis C, Jerath A, Coburn N, Klaassen Z, Luckenbaugh A, Magee D . Association of Surgeon-Patient Sex Concordance With Postoperative Outcomes. JAMA Surg. 2021; 157(2):146-156. PMC: 8655669. DOI: 10.1001/jamasurg.2021.6339. View

11.

Sun L, Boet S, Chan V, Lee D, Mesana T, Eddeen A . Impact of surgeon and anaesthesiologist sex on patient outcomes after cardiac surgery: a population-based study. BMJ Open. 2021; 11(8):e051192. PMC: 8388286. DOI: 10.1136/bmjopen-2021-051192. View

12.

Matot I, De Hert S, Cohen B, Koch T . Women anaesthesiologists' attitudes and reported barriers to career advancement in anaesthesia: a survey of the European Society of Anaesthesiology. Br J Anaesth. 2020; 124(3):e171-e177. DOI: 10.1016/j.bja.2020.01.005. View

13.

Parsons Leigh J, de Grood C, Ahmed S, Ulrich A, Fiest K, Straus S . Toward Gender Equity in Critical Care Medicine: A Qualitative Study of Perceived Drivers, Implications, and Strategies. Crit Care Med. 2019; 47(4):e286-e291. DOI: 10.1097/CCM.0000000000003625. View

14.

De Cassai A, Boscolo A, Zarantonello F, Pettenuzzo T, Sella N, Geraldini F . Enhancing study quality assessment: an in-depth review of risk of bias tools for meta-analysis-a comprehensive guide for anesthesiologists. J Anesth Analg Crit Care. 2023; 3(1):44. PMC: 10626791. DOI: 10.1186/s44158-023-00129-z. View

15.

Amrein K, Langmann A, Fahrleitner-Pammer A, Pieber T, Zollner-Schwetz I . Women underrepresented on editorial boards of 60 major medical journals. Gend Med. 2011; 8(6):378-87. DOI: 10.1016/j.genm.2011.10.007. View

16.

Aquino-Canchari C, Chavez-Bustamante S, Benites-Ibarra C, Quijano-Escate R, Arroyo-Hernandez H . Female participation in the editorial committees of medical journals in Latin America. Biomedica. 2022; 42(2):355-363. PMC: 9451002. DOI: 10.7705/biomedica.6120. View

17.

Bissing M, Lange E, Davila W, Wong C, McCarthy R, Stock M . Status of Women in Academic Anesthesiology: A 10-Year Update. Anesth Analg. 2018; 128(1):137-143. DOI: 10.1213/ANE.0000000000003691. View

18.

Boerman L, Bullens A, van der Wal R . Gender disparity in academic performance in anaesthesiology in the Benelux. Br J Anaesth. 2020; 124(3):e79-e80. DOI: 10.1016/j.bja.2019.12.009. View

19.

Campos L, Naus A, Rangel A, Brandao G, Faria I, Pierre T . Women Representation on Editorial Boards in Latin America Journals: Promoting Gender Equity in Academic Surgery, Anesthesia, and Obstetrics. World J Surg. 2022; 47(4):845-853. DOI: 10.1007/s00268-022-06872-8. View

20.

Chary S, Amrein K, Soeteman D, Mehta S, Christopher K . Gender disparity in critical care publications: a novel Female First Author Index. Ann Intensive Care. 2021; 11(1):103. PMC: 8253865. DOI: 10.1186/s13613-021-00889-3. View