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Are there too few women presenting at paediatric conferences?

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Sometimes, we have a great idea for a paper, but as we might, we cannot get it published in the traditional way.

So what better means of disseminating knowledge than publishing it here, on the Don’t Forget the Bubbles website?

Given that this is the week of FIX18, the Feminem Idea eXchange, it seems like there is no better time like the present to discuss female presenters at paediatric conferences.

Authors:  Tessa Davis, Ben Lawton, Grace Leo, Henry Goldstein, Andrew Tagg, Natalie May

Aim: To determine the gender balance of keynote and concurrent speakers at contemporary international paediatric conferences.

Methods: We reviewed the published programs of eight major paediatric conferences, which took place in 2016/2017. We compared both session numbers and minutes of speaking time allocated in keynote and concurrent sessions to speakers of male and female gender. This was compared to the proportion of females working in paediatrics.

Results: Of 1259 presentations given at eight conferences, 536 (42%) were delivered by women. Women delivered keynote addresses in 33% of cases. Presentations delivered by women were 174 seconds shorter than those delivered by men (27 minutes 18 seconds vs 30 minutes 12 seconds), leaving women with 40% of total speaking time across the conferences we studied. One of the eight conferences studied had a majority female speaker cohort.

Conclusion: Women remain under-represented in the speaking programs of major paediatric conferences, particularly in the US, European, and International conferences. This under-representation is particularly marked at the keynote level.

What is already known on this topic

In Emergency Medicine and Critical Care, females are under-represented as conference speakers.

By comparison to Emergency Medicine, Paediatrics has a more equitable gender balance of practitioners ranging from 47% – 72% females

What this study adds

This is the first study looking at gender representation at paediatric conferences

The most internationally diverse conferences have less than 35% female speakers

All but one conference has the vast majority of keynote speakers being male.

COI: All authors have been on the organising committees of a number of conferences in the field of paediatrics or critical care.

With increased scrutiny of the role of women in the workplace heralded by the #everydaysexism hashtag, attention has been focused on gender representation at medical conferences. Work has already been done in this area, looking at emergency medicine and critical care. We sought to identify if there was a gender gap in conferences attended by our craft group, paediatrics, given that it is traditionally considered a female-friendly speciality. It has previously been suggested that, despite increased awareness of the issue, keynote presentations were still the male purview.

The aim of our study was to examine the published programmes of a series of key international paediatric conferences and determine the number of female and male speakers, both in plenary and concurrent sessions and the proportion of speaking time allotted to both sexes.

Conferences included in this study were major English-speaking paediatric conferences running in 2016/2017. Eight conferences were included: The American Academy of Pediatrics National Conference (AAP), the Royal College of Paediatrics and Child Health Conference (RCPCH), the Royal Australasian College of Physicians – Paediatric and Child Health Division Congress (RACP), The International Paediatric Summit (IPS), Canadian Paediatric Society Conference (CPS), Europaediatrics Congress (Europediatrics), Excellence in Paediatrics Conference (EIP) and the European Academy of Paediatric Societies Congress (EAPS).  

The Paediatric Academic Societies 2017 Meeting was considered but not able to be included in this study due to the lack of an accessible program detailing talk timings.

Conference programs were collected from conference websites or from their respective organising committees. Each conference program was analysed by one author for the gender of keynote and general conference speakers and the length of their individual presentation times.

Genders were determined through local knowledge or Google search. Introductory and closing speeches by chairs, poster presentations and industry-sponsored sessions were not included in the analysis.

For conferences with a mixed audience (such as RACP), the general keynotes were included, but in the concurrent streams, only speakers from the Paediatric and Child Health divisions were included. Results were tabulated in an Excel spreadsheet and cross-checked by a second author. Any discrepancies between the two sets of results were resolved by a third author.

The authors analysed the programmes across eight paediatric conferences in 2016/2017.

There were 1259 presentations in total, and of them, 42% (536) were given by women. This ranged from 25% (European Academy of Paediatric Societies Conference) to 65% (Canadian Paediatric Society Conference). See Table 1.

Table 1: Proportion of speakers by gender

Keynote speakers were overwhelmingly male with only 33% in total being female. Only one conference had more female than male keynote speakers (American Academy of Pediatrics). Two conferences had no female keynote speakers at all, and a further two conferences had only 16% female keynote speakers. See Table 2.

Table 2: Proportion of keynote speakers by gender

The authors considered 36519 minutes of presentations, 40% of which were delivered by women. Presentations delivered by women were, on average, 174 seconds shorter than those delivered by men (27 mins 18 secs v 30 min 12 secs). The proportion of time allocated to female speakers ranges from 23.4% (EAPS) to 63.6% (CPS). See Table 3.

Table 3: Proportion of presentation minutes by gender

These results have to be taken in the context of the overall representation of women in paediatrics. Statistics on gender distribution of paediatricians were obtained from reports by the General Medical Council (UK), the Australian Institute of Health and Welfare (Australia), the American Board of Pediatrics (USA), and the Canadian Medical Association (Canada).

Table 4: Comparison of the percentage of females in paediatrics v the percentage of female speakers at national conferences

Table 4 shows the gender breakdown in paediatrics across the UK, Australia, the USA, and Canada in comparison with the representation of speakers at these national conferences.

We have examined the gender balance across a section of international paediatric conferences, including the speaking group, keynote speakers, and speaking time. Although similar studies have been performed in Critical Care and Emergency medicine conferences, this is the first study of this kind in the field of Paediatrics.

By comparison to Emergency Medicine, Paediatrics has a more equitable gender balance of practitioners ranging from 47%-72% females; in this frame we can examine more incisively the gender balances within the conferences themselves.

With respect to overall speakers, the authors found a range of 24% to 66% female speakers. Of note, the three conferences based in Commonwealth countries (Australia/New Zealand, Canada and Great Britain) all had greater than 55% female speakers. The most internationally diverse conferences, EIP, EAPS and IPA, all had less than 35% female speakers.

Australian, UK and Canadian conferences had a greater proportion of female speakers than there are females represented in their speciality. However, this was not reflected in the USA. 72% of US paediatricians are female, but only 39% of speakers at the AAP conference were female. At European/International conferences (EIP, EAPS, IPA, and Europaediatrics), the average percentage of female speakers was 36.6%. Based on the workforce statistics from other countries, this is likely to be a large under-representation of women in paediatrics.

When considering only keynote speakers, all but one conference had the vast majority of keynotes as male. Women are underrepresented within the keynote cohort of these conferences.

Additionally, we calculated the actual time apportioned to female speakers, ranging from 23% to 64% of the overall speaking time; with some minor variations, this distribution mirrored the aforementioned breakdown with respect to overall speakers.

We have adopted a similar methodology to Carley et al.’s 2016 paper; by comparison to Emergency Medicine conferences, Paediatrics has a more equitable distribution of speakers, both overall and what we postulate as a more representative sample of the population of clinicians from which it is drawn.

One potential limitation of our study is the assumptions of binary gender. As the speakers themselves were not polled, we have made assumptions based on photographs, names and third-party advice. Whilst relatively accurate, there remains a likely small but significant set of speakers who identify as intersex or transgender and are not captured by this style of classification.

Another potential limitation of our study is the definition of what constitutes a major paediatric conference. When formulating this study, the criteria for a major meeting was agreed as being “international”, “general” with organisation and governance associate with a peak body for paediatricians in the associated geographic area.

With respect to the disparity between genders speaking as keynotes, a number of factors may influence the results. There remains a small sample size given the small number of keynote speakers. Additionally, we postulate that keynote speakers – particularly at well-established national and international conferences – tend to be more senior clinicians and researchers. Hence, well established generational, sociocultural and systemic biases against women in the workplace may be contributory in the overall disparity between genders at the keynote level.

A further limitation of this study is the limited window of data collection; longitudinal data would provide additional insights regarding any evolving trends in both speaker and keynote balance. This would be particularly relevant given the changing balance of gender balance for doctors.

References

Carley S, Carden R, Riley R, May N, Hruska K, Beardsell I, et al. Are there too few women presenting at emergency medicine conferences? Emerg Med J. 2016 Oct;33(10):681–3.

Mehta S, Rose L, Cook D, Herridge M, Owais S, Metaxa V. The Speaker Gender Gap at Critical Care Conferences. Crit Care Med. 2018 Jun;46(6):991–6.

Bindal T, Wall D, Goodyear HM. Medical students’ views on selecting paediatrics as a career choice. Eur J Pediatr. 2011 Sep;170(9):1193–9.

Kass D, Choo EK. When will we have enough women speakers in emergency medicine? Vol. 33, Emergency medicine journal : EMJ. England; 2016. p. 680.

The state of medical education and practice in the UK [Internet]. 2016. Available from: https://www.gmc-uk.org/-/media/documents/SOMEP_2016_Full_Report_Lo_Res.pdf_68139324.pdf

AIHW. Medical practitioners workforce 2015 [Internet]. 2015. Available from: https://www.aihw.gov.au/reports/workforce/medical-practitioners-workforce-2015/contents/what-types-of-medical-practitioners-are-there

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