For the first time, at the beginning of 2020, a Gender Equity Committee (GEC) has been appointed by the European Society of Anesthesia and Intensive Care (ESAIC). The idea of taking steps in establishing more structured actions in addressing gender equity evolved from the recognised underrepresentation of women within society leadership. Although the number of members did not differ significantly in terms of gender, the representation of women in scientific committees, both as chairs or members, reached a very low point in 2018 and 2019, with 6,5 % of chairs and less than 20% of members being women. In addition, those were the years with the lowest number of women speakers at Euroanesthesia congresses (less than 25%). A red flag has been raised, and a firm response was seen as necessary.
Underrepresentation of women has been unequivocally confirmed and recognized in the positions of decision-making, leadership, and academia in the medical profession overall, anesthesiology and intensive care just mirror broader trends. In a recently published survey, 30% of ESAIC members (1796 women, 1342 men) responded to questions exploring attitudes and barriers to career advancement in anaesthesia. (1) It has been confirmed that both women and men aspire to leadership equally and that they are confronting the same barriers, which seem to affect women more. Further, women still experience sexism at work and see childbearing as the most difficult to overcome.
However, in spite of the data accumulating, they are predominantly the result of retrospective studies and surveys and are mostly numeric. There is a research gap: the replication of insight that women are underrepresented, but with a lack of data on the reasons why and what are efficient measures to overcome the problem. On the other hand, recognizing reasons for underrepresentation may lead to proper interventions. It is obvious that departmental and cultural changes are necessary, but how to perform them is still vague.
Gender equity should be well established for various reasons. Gender inequality weakens health systems and the delivery of health care. Also, by 2030 a shortfall of 18 million health workers worldwide is expected. Certainly, it will affect anaesthesia and intensive care providers, although it is very difficult to predict how since there is a lack of systematical, comparable data on anaesthesia and intensive care workforce. Covid 19 pandemic has revealed new or already existing difficulties in the workforce, recruitment and education, burnout and problems of ageing doctors. More so, different countries deal with diverse issues, from infrastructure to efficiency of the healthcare systems, from the policies and regulations to cultural and social background. It will be very difficult to find solutions and deliver a high standard of care if all providers are not enabled to reach their professional goals and full potential.
Keeping this in mind, what could be the goals and objectives of the GEC within ESAIC? What is expected to be achieved?
Obviously, cultural change and broader community advancement toward gender equity is a long-term objective that is difficult to achieve through the Gender Equity Committee’s work only. However, raising awareness of equity and equality and empowering women within ESAIC society may be quite a realistic goal. Also, monitoring improvements and changing policies towards less biased promotion of women leaders is a task that is quite obtainable. The Committee’s primary assignment is to promote equal opportunities and representation of women and men within European anaesthesiology and intensive care medicine regarding
- recruitment for graduate and postgraduate training and examination
- clinical work and responsibility
- teaching and clinical supervision
- research, development, and scientific supervision
- formal representation in boards and committees
- leadership and decision-making.
Euroanesthesia 2022 in Milan has championed the number of women speakers, which was almost equal to the number of men speakers. Also, it is noticeable that more women applied for scientific grants than before. However, we should not be over-optimistic or overemphasise the numbers. First of all, this year’s result should prove to be sustainable and not just a one-time success. Further, counting the visible women should be seen as a targeted tool, not as an objective itself. Women leaders should be encouraged since they quite often confront increased mental burdens, a challenging work-life balance, sexist behaviour, or hit the glass ceiling. Women within our society represent different countries and come from different cultural backgrounds, socioeconomic situations, and ethnic, racial, or sexual orientations. It is important that they can be truly represented in leadership and decision-making positions in society and get the necessary reassurance to model equity in their own working environments. Diversity should be promoted and encouraged as one of the primary objectives of ESAIC.
Very few measures are proven to promote gender equity within different settings: systemic changes such as prohibiting all-male panels, holding senior leaders accountable, and favouring research funding according to transparent gender-equity policy. (2) Those measures could and should be implemented within ESAIC as well. More importantly, every member of our society may become unblind in implementing these interventions. To achieve the objectives of the GEC whole community should be united in the creation of a climate of gender equity and fairness. Everybody can become an upstander and advocate for equal opportunities for all anesthesiologists. Professionals may have a diversity of professional interests and advancement toward education, research, or a variety of subspecialties in anaesthesia or intensive care. But fairness and equal opportunities should be a common goal and interest for all of us. This is why the GEC should be more visible and broadly supported by all members of ESAIC. Each one of us can do more for our profession, ensuring that in everyday practice, gender equity is pursued. That will ultimately affect the well-being of working professionals and the standards of care for our patients.
- Matot, I., De Hert, S., Cohen, B., & Koch, T.. BJA, (2020). 124(3), e171–e177. https://doi.org/10.1016/j.bja.2020.01.005
- Ryan M. Nature (2022) .604, 403. doi: https://doi.org/10.1038/d41586-022-01045-y