Gender Bias and Discrimination Still Prevalent in Pediatrics
Mon, April 19, 2021

Gender Bias and Discrimination Still Prevalent in Pediatrics

In pediatrics, the researchers found that women make up 72.3% of residents, 63.3% of active physicians, and 57.4% of academicians. / Photo by: scyther5 via 123rf


Researchers from Drexel University College of Medicine debunked the three common justifications of prevalent discrimination and gender bias hindering women from progressing to top positions in pediatrics. In a special article published in the journal Pediatrics, the researchers presented evidence to discredit the claims that power gender disparities.

They also noted how previous efforts to improve gender equity failed. The researchers believed that a "scientific and data-driven approach will accelerate progress and help pave a pathway to better health care and science."

Debunking the Claims

The three erroneous justifications often used to uphold the continuing gender disparity in pediatrics are that there are not enough women in the field, women don't seek a leadership role because of family or lifestyle, and that women don't have the adequate skills needed for such positions.

In debunking the first claim, the researchers looked into 2017 US data, which showed that the number and proportion of women (50.7 percent) matriculating as first-year medical students exceeded that of men. In pediatrics, they found that women make up 72.3 percent of residents, 63.3 percent of active physicians, and 57.4 percent of academicians.

Women have also been found to aim for higher roles in the field as they account for 18 percent of medical school deans, 18 percent of medical school chairs, and 26 percent of chairs in pediatrics. This discredits the justifications that women don't seek and are not adequately skilled in leadership roles.

But even with high-ranking roles, these numbers still demonstrate disparities in the highest level of leadership in academic medicine. Higher positions for women are mostly focused on education and mentoring (49 percent) and institutional public image (57 percent) than in leadership (15 percent) and corporate decision-making (39 percent).

Gender disparities were also evident in organizations like the Federation of Pediatric Organizations (FOPO) and its associated pediatric societies, where women make up merely 37.5 percent of the president-equivalent positions despite comprising 54.5 percent of the board positions.

This indicates that progress in promoting women in pediatrics for most senior levels of leadership is not enough and therefore needs enhancement.

Why Previous Efforts Failed

Institutions have developed programs that aim to enhance women's presence in the field. For instance, the National Institutes of Health (NIH), through the efforts of the Office of Research on Women’s Health and Working Group on Women in Biomedical Careers, conducted a series of programs that sought to help women in career reentry, mentoring, and development.

There were also actions to decrease the gap in gender pay. A 2019 report by online networking service Doximity found that the compensation gap between men and women physicians are starting to close as salaries for women are increasing while wage for men remains constant.

However, medical news site MedicalXpress reported that the authors of the study noted that earlier efforts to enhance gender equity were not as successful as the mentioned initiatives. One reason for this is that actions were mainly volunteer-driven at the "grassroots" level, and institutions give little effort for them to succeed.

Diversity "task forces" and similar groups also risk "providing an illusion of fairness." MedicalXpress notes the authors saying this might worsen inequities if such groups are unable to gather reliable data to convince authorities to implement measurable changes.

"The field of pediatrics is often cited as a brighter spot in the pervasive bias and discrimination felt by women throughout academic medicine, particularly those belonging to multiple underrepresented groups, such as by gender or race," said Nancy Spector, a professor of Pediatrics in Drexel's College of Medicine. "Although career equity is greater than in years past, our research shows no time left for excuses aimed at legitimizing inequality."


In 2019, the compensation gap between men and women physicians are starting to close as salaries for women are increasing while wage for men remains constant. / Photo by: Hyejin Kang via 123rf


Enhancing Equity and Diversity in Pediatrics

To meet equity, the authors recommended involving basic scientific principles used to address other issues: leadership accountability, dedicated financial and human resources, and an evidence-based, data-driven approach to evaluation and reporting.

"Like safety data, gender-equity data must also be collected, analyzed, and reported accurately to stakeholders on a regular basis, not just as part of a one-time or irregular spot check," the authors noted, adding that "organizational leaders must be actively engaged in creating and sustaining initiatives that advance progress because data collection is necessary but not sufficient to drive change."

For years, institutions have placed strategic initiatives to improve diversity and inclusion for women physicians—from creating leadership development programs to policy statements for diversity and inclusion, publications, and special interest groups. These efforts took much work and have resulted in progress. However, many reports still suggested that medicine—including pediatrics—isn't paving the way for gender equity. Attempts to decrease and eventually close the gaps also are either slow, stalled, or even regressing.

More than analyzing gender data and disparities, implementation of strategic interventions, monitoring metrics, and reporting outcomes, efforts to enhance equity should include enforcement of a climate of transparency and accountability, along with prioritizing financial and human-resource support for workforce gender equity.