St Luke's Medical Center - Bonifacio Global City; University of the Philippines - Manila Paranaque, Manila, Philippines, Philippines
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Lisa Traboco1, Pavel Ovseiko2, Sarah Dyball3, Tayyeba Khursheed4, ALEJANDRA BABINI5, Asgar Ali Kalla6, Catherine Hill7, Debashish Danda8, Dzifa Dey9, Elena Nikiphorou10, Ghita Harifi11, Ho SO12, Humeira Badshah13, Ihsane Hmamouchi14, Joan Marie Von Feldt15, Júlia Boechat Farani16, Mariana Peixoto Guimarães17, Kanon Jatuworapruk18, Laura Andreoli19, Nelly Ziade20, PENELOPE PALOMINOS21, Qian Wang22, Ran Nakashima23, Syed Haq24, Wilson Bautista-Molano25, Yoshiya Tanaka26, Grace Wright27, Vikas Agarwal28, Laura Coates29 and Latika Gupta30, 1University of the Philippines - Manila, St Luke's Medical Center - Bonifacio Global City, Paranaque, Manila, Philippines, 2Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom, 3University of Manchester, Stockport, United Kingdom, 4Pakistan institute of Medical Sciences, Islamabad, Pakistan, 5Hospital Italiano Cordoba, Cordoba, Argentina, 6Department of Medicine, University of Cape Town, Cape Town, South Africa, 7The Queen Elizabeth Hospital, Woodville, Australia, 8Christian Medical College & Hospital, Vellore, India, 9University of Ghana Medical School, Rheumatology Unit Department of Medicine and Therapeutics, Korle bu Teaching Hospital, Accra, Ghana, 10King's College London, London, United Kingdom, 11HBMC, Dubai, United Arab Emirates, 12The Chinese University of Hong Kong, Hong Kong, China, 13Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates, Dubai, United Arab Emirates, 14Rheumatology Unit, Lalla Aicha Temara Hospital, Temara, Morocco, 15University of Pennsylvania, Pennsylvania, PA, 16Division of Rheumatology, Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, Brazil, 17Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, MG, Brazil, 18Thammasat University, Pathumthani, Thailand, 19University of Brescia, Brescia, Italy, 20Saint-Joseph University, Beirut, Lebanon, 21Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil, 22Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College Hospital, The Ministry of Education Key Laboratory, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China, 23Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 24BSM Medical University, Dhaka, Bangladesh, 25University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia, 26University of Occupational and Environmental Health, Kitakyushu, Japan, 27Grace C Wright MD PC, New York, NY, 28Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India, 29University of Oxford, Oxford, United Kingdom, 30Royal Wolverhampton Trust, Wolverhampton/University of Manchester, United Kingdom
Background/Purpose: There is growing attention to gender inequity within rheumatology with persistent challenges in achieving pay parity, career progression, & access to leadership roles. In order to promote rheumatology as a career & improve job satisfaction, we need to understand the current gender climate & develop potential solutions.
Methods: The CHANGE e-survey is a cross-sectional self-reported survey, adapted from the GEAR taskforce. It was available in 6 languages, & distributed to rheumatology organizations & social media, until April 2023. Descriptive statistics were used, & survey responses were compared by gender.
Results: Of 782 respondents, 682 had complete data & were analyzed. There were 205 male & 479 females (M:F 1:2.5), of age 35 (37-55) years from 83 countries (Figure 1) Two-thirds were rheumatologists (65%) the rest were allied healthcare professionals. Half were academics (59%) & 73% worked full time. 49% of respondents worked within the public sector & median career duration was 18 (11-29) years
Women were working in the public sector (52%) while men were distributed in the public (42%) & private sectors (43%). Both male and female respondents reported working >40 hours per week & having active leadership (55%) and academic roles (58%). Internationally, there was no difference between participation by men vs women, but at national & local levels there was more participation by women. (national: 514 vs 1043, p=0.04; local: 498 vs 962 , p=0.02) 30% of women, and 57% of men reported equal division of roles, whereas 50% of women reported these roles to be carried out predominately by women, compared with 30% of men. The most common family caretaking responsibilities were caring for children (F=57%, M=36%, p=0.41). 14% of women reported more than two responsibilities compared with 10% of men (p=0.001). 62% of women report taking previous parental leave compared with to 22% of men
Notably, both genders report a negative impact of having children on their career (10% vs. 2%); women were more likely to report a lack of career advancement opportunities due to family commitments (49 % vs. 35%). Bullying was reported by both genders, with 84% experiencing ongoing bullying. Perceived gender discrimination is described in figure 3; women reported feeling that they were 'less likely to receive a promotion' (p=0.04), to not be 'groomed for leadership positions' (p=0.05), receive less remuneration (p=0.012), assigned 'below expertise' tasks (p=0.05) & deal with an intimidating work environment (p=0.007). Women reported discrimination more common from older colleagues (p=0.03), nurses (p=0.04), patients (p=0.03) & administrators (p=0.019).
The most common recommendations were conference related, including no 'male-only panels' and family-friendly rheumatology conferences. Other suggestions include country specific support, writing & presentation skills training. 13% of women reported a desire to increase visibility of female role models
Conclusion: This e-survey is the first in rheumatology to highlight challenges faced by female rheumatologists globally. The results of the e-survey will be used to investigate the drivers of these inequities, as well as develop strategies and interventions to promote gender equity.
Method and Global Distribution
Mean percieved discrimination
Intervention Recommendations
L. Traboco: None; P. Ovseiko: None; S. Dyball: Eli Lilly, 5, Novartis, 5, UCB, 5; T. Khursheed: None; A. BABINI: None; A. Kalla: None; C. Hill: None; D. Danda: None; D. Dey: None; E. Nikiphorou: AbbVie/Abbott, 6, Celltrion, 6, Eli Lilly, 6, fresenius, 6, Galapagos, 6, Gilead, 1, 6, Pfizer, 6, Sanofi, 6; G. Harifi: None; H. SO: None; H. Badshah: None; I. Hmamouchi: None; J. Von Feldt: None; J. Farani: None; M. Peixoto Guimarães: None; K. Jatuworapruk: None; L. Andreoli: None; N. Ziade: Abbvie, 6, Boehringer-Ingelheim, 6, Eli Lilly, 6, Janssen, 6, Newbridge, 6, Novartis, 6, Pfizer, 6, Pierre Fabre, 6, Roche, 6, sanofi, 6; P. PALOMINOS: None; Q. Wang: None; R. Nakashima: None; S. Haq: None; W. Bautista-Molano: None; Y. Tanaka: AbbVie, 6, AstraZeneca, 6, BMS, 6, Boehringer-Ingelheim, 6, Chugai, 5, 6, Eisai, 5, 6, Eli Lilly, 6, Gilead, 6, GSK, 6, Mitsubishi-Tanabe, 5, Pfizer, 6, Taiho, 6, Taisho, 5, 6; G. Wright: AbbVie, 2, 6, Amgen, 2, 6, Association of Women in Rheumatology, 4, AstraZeneca, 2, 6, Bristol Myers Squibb, 5, Eli Lilly, 2, 6, Gilead Sciences, 5, GSK, 2, 6, Janssen, 2, 5, 6, Novartis, 2, 6, Pfizer Inc, 2, 5, 6, UCB, 2, 6; V. Agarwal: None; L. Coates: AbbVie, 2, 5, 6, Amgen, 2, 5, 6, Biogen, 6, Bristol Myers Squibb, 2, Celgene, 2, 5, 6, Eli Lilly, 2, 5, 6, Galapagos, 2, 6, Gilead Sciences, 2, 6, GSK, 6, Janssen, 2, 5, 6, Medac, 6, MoonLake, 2, Novartis, 2, 5, 6, Pfizer Inc, 2, 5, 6, UCB, 2, 5, 6; L. Gupta: None.