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An eye on gender equality: A review of the evolving role and representation of women in ophthalmology

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Women in ophthalmology
Woman in ophthalmology

Nowadays, women account for 25-30% of all ophthalmologists and 35-45% of trainees around the world. Despite the progress in recent years, women continue to be underrepresented in crucial areas, such as professional and academic leadership, as well as ophthalmic surgical sub-specialization. Furthermore, data showed that women in ophthalmology face more prejudice and discrimination than men in a variety of areas.

Leadership

Female leaders are frequently regarded as initiators for corporate culture change and advocates for fostering supportive career experiences for diverse medical education and healthcare workforce. With data proving that effective administration of diverse and inclusive departments requires diversity among leaders, increasing female participation in leadership remains a key priority for training and departmental boards. Furthermore, the scarcity of female leaders to serve as role models decreases the possibility of junior women in early career positions aspiring to leadership positions.

A recent study looked at the gender distribution of awardees from ophthalmic societies. In the 50 years between 1970 and 2020, women won 25.3% of major ophthalmic associations’ prizes, according to the authors. Camacci and colleagues discovered that just two of the 15 ophthalmic associations reviewed had female presidents (13.3%), and only one of the 20 top-ranked ophthalmic publications had a female editor-in-chief (4.2%). In 2021, the American Academy of Ophthalmology will elect its fifth female president (the first was in 2005), continuing a favorable trend in which three of the previous five presidents have been women. The Royal Australian and New Zealand College of Ophthalmologists appointed their first female president in 2020 in Australia and New Zealand. According to a recent survey of ophthalmologists, the number of women in senior positions has increased (48% of men and 39% of women). Even though just 17 women were named to the Ophthalmologist’s Power List of the top 100 most prominent persons in ophthalmology in 2020, this is significantly more than the 6 women who were named to the list in 2015.

Female leaders in ophthalmology.

Academics and Research

The position of women in a research field can be a good measure of the scientific community’s inclusion. According to studies, male researchers receive more research funding than their female counterparts across countries and specialties. A study from 2014 in the US, female main investigators were less likely to receive grants than men in their early careers. Female ophthalmologists also formed fewer industry connections and received less industry support, according to Reddy and colleagues.

Income

Various studies have found that female doctors are paid less than men, and ophthalmology is no exception. US data from 2020 found out that female ophthalmologists earn 12.5% percent less than males in their first year of clinical practice. There is also a wage disparity between academics and salaried positions. After accounting for specialty, rank, leadership responsibilities, publications, and research time, Jagsi and colleagues found that female ophthalmic researchers earned 84% of men’s salary.

Why do salary disparities happen?

The reasons for salary disparities between men and women are numerous and complex. Women are underrepresented in surgical subspecialties, perform less procedural work, and have fewer operating hours than men, to name a few differences.

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Patterns of consultation and treatment are also likely to contribute to the gender wage gap. Female ophthalmologists see fewer patients and get less money from Medicare. Despite the fact that male and female ophthalmologists charge identical prices for equivalent procedures, the revenue gap might be due to women delivering longer consultation hours.

Women are also less likely to operate private practices or work in regional hubs with better earning potential. Finally, it has been indicated that female physicians put less emphasis on salary negotiations than male physicians. For a variety of factors, including differing family obligations, child-rearing, and personal choices linked to work-life balance, more women than men work part-time during their careers. Even after adjusting for part-time work, practice profile, and specialization, there is still a gender discrepancy in pay.

Surgical exposure and subspecialization

Women’s surgical experiences are expected to differ significantly from men’s. Female trainees claim to have fewer surgical opportunities, resulting in discrepancies in the number of surgical operations performed. Lower surgical exposure could explain why fewer female trainees choose surgical subspecialization. Compared to men, who are more likely to pursue fellowships in surgical retina, oculoplastics, and cornea, women are more likely to subspecialize in medical retina, uveitis, and pediatrics.

Harassment

Bullying and harassment in medicine, which has been related to increased rates of burnout and suicide in the medical sector, have gotten a lot of attention in recent years. Furthermore, when compared to men, 40% of female trainees reported receiving less respect from their medical team members.

According to a 2020 poll of ophthalmology trainees, 66% of women had encountered bullying or harassment throughout their training, compared to 43 % of men, with male supervising ophthalmologists regarded as more frequent sources of these behaviors than females (35% vs 12%). Additionally, when compared to men, 40% of female trainees reported receiving less respect from their medical team members. Lastly, women in medicine are also more likely than men to be harassed by patients.

Career satisfaction

Despite the fact that female and male ophthalmologists have quite different clinical and life experiences, several studies have found no disparities in professional satisfaction.

Family differences

Jinapriya and colleagues discovered that, although working equivalent hours to their male counterparts, female ophthalmologists devote much more time to child care. One factor contributing to longer child-rearing hours is that spouses of female ophthalmologists are more likely to work full-time than spouses of male ophthalmologists, requiring child-rearing responsibilities to be shared. The very vast majority of female ophthalmologists who worked part-time did so for child-rearing (88%), whereas male ophthalmologists who worked part-time cited lifestyle-work balance, family, or personal preferences roughly equally.

Female ophthalmologists devote much more time to child care.

Conclusion

Gender equality is a difficult goal to achieve, thus solutions will have to be comprehensive. There is no doubt that tremendous progress has been accomplished; however, conversations about solutions should focus on building on those achievements. Any strategy should have several underlying ideas. To begin, plans must be evidence-based in order for initiatives to effectively address the issues. Second, because gender equality has numerous dimensions, a comprehensive strategy is required.

Source: An Eye on Gender Equality: A Review of the Evolving Role and Representation of Women in Ophthalmology. (2022, April 1). ScienceDirect. https://www.sciencedirect.com/science/article/pii/S000293942100372X

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