Introduction

The phenomena of the "glass ceiling" and "sticky floor" persist for women in academic medicine, despite ongoing efforts to address gender disparities. The lack of gender diversity in scientific conferences can lead to unconscious bias and discourage women from pursuing careers in gastroenterology. No data exists on this issue in Pakistan, making it crucial to assess gender representation in the field. This study aims to investigate gender dynamics in invited faculty and conference committee leadership in three major gastroenterology, and hepatology societies in Pakistan over the last 5 years.

Aims & Methods

In this cross-sectional study, the annual scientific programs from 2018-2022 of three major gastroenterology, and hepatology societies in Pakistan were reviewed. The gender makeup of the faculty invited as speakers, chairs, moderators, leadership (president), and program committee (chair organizing/scientific committee) was recorded and compared. Regression analysis was used to evaluate the trends for female representation over time for each role.

Results

The proportion of women faculty invited to all conferences was extremely low ranging between 7-20%. A subtle increase in women speakers and moderators was observed in PSSLD and PSG however, there was considerable variability in PSH. There was no significant difference in the proportion of women in various roles. The trend of women's representation across all three societies remained almost unchanged over time (slope=0.08, R2=-0.078, p-value=0.875). All program committee leadership roles were held by men, except in PSSLD (2021,2022) where a woman held a committee leadership position and more women were invited as speakers.
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Conclusion

There was considerable variability in the representation of women across different roles in the conferences held by all three societies. While there was some improvement observed in the number of female speakers in certain conferences, there was no significant difference in the overall representation of women across all conferences and roles. Moreover, leadership positions were predominantly held by men.

References

1) Khan Z, Rukhshan R, Bhatt A, Guha S, Ramireddy S, Patil P, et al. (# WomeninDDW) Persistent Speaker Gender Gap at the Premier Digestive Disease Event. Digestive Diseases and Sciences [Internet]. 2022; 67(2):[390-6 pp.].
2) Rahal HK, Tabibian JH, Issaka RB, Quezada S, Gray II DM, Balzora S, et al. Diversity, equity, and inclusion in gastroenterology and hepatology: A survey of where we stand. Gastrointestinal Endoscopy [Internet]. 2022; 96(6):[887-97 pp.]

Disclosure

None

Introduction

Women have been historically underrepresented in gastrointestinal endoscopy research. Understanding the current patterns of female authorship is essential to assess progress and identify persistent gaps within this field.

Aims & Methods

This study aimed to evaluate the representation of women as first and senior (last) authors the three highest-impact journals in gastrointestinal endoscopy (Endoscopy, Gastrointestinal Endoscopy and Digestive Endoscopy) from 2015 to 2024. For each publication, we extracted bibliometric data of original articles, review articles and editorials, including the names of the first and senior authors, their primary country of affiliation, and the year of publication. Countries and territories were categorized by geographic region. Author gender was predicted using Genderize.io software (https://genderize.io), and only authors with ≥80% gender prediction accuracy were included.

Results

We analyzed 4,414 publications. Among first authors, 885 (20.15%) were women from 36 countries and 3,507 (79.85%) were men from 49 countries. Most female first authors were affiliated with institutions in North America (36.61%), while most male first authors were based in Asia (40.82%). The greatest gender disparity among first authors was observed in Asia (male-to-female ratio = 6.8), and the lowest in Europe (male-to-female ratio = 2.5). Among senior authors, 433 (11.51%) were women from 32 countries and 3,328 (88.49%) were men from 47 countries. Female senior authors were most frequently from Europe (38.57%), whereas male senior authors were again predominantly from Asia (41.12%). The largest disparity in senior authorship was in Oceania (male-to-female ratio = 44), and the lowest in Latin America (male-to-female ratio = 4.1). Notably, the odds of a woman being the first author nearly doubled when the senior author was also a woman. Overall, over the 10-year period, the male-to-female ratio among first authors improved from 4.46 (2015–2016) to 3.25 (2023–2024), and among senior authors from 9.10 to 6.43.

Conclusion

Women remain underrepresented in first and senior authorship positions in gastrointestinal endoscopy research. These disparities may be influenced by limited female representation and mentorship in the field. Although gender gaps have narrowed over the past decade, sustained and coordinated efforts are needed to promote equity in academic publishing.

Introduction

Career trajectories in gastroenterology can be influenced by parenthood, with potential disparities between genders in academic progression and workload management. This abstract presents findings from a survey by the Young Gastroenterology section of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), exploring the impact of parenthood on academic achievements and training within the field.

Aims & Methods

This study was conducted through an anonymous online survey distributed via email to DGVS members. The survey was accessible from April 4, 2023, to June 19, 2023, and was conducted exclusively in German. It employed a combination of single and multiple-choice questions, with all questions being skippable to ensure participant comfort and engagement. Depending on respondents' answers, query logic branched to gather comprehensive data on various aspects of parenthood and career progression in gastroenterology. The survey aimed to identify differences between male and female gastroenterologists with children in terms of academic positions, training delays, and work hours.

Results

The survey garnered 811 responses, distributed among 173 women without children, 206 mothers, 179 men without children, and 251 fathers. Significant gender disparities were found: Most notably, female physicians reported that childbearing often postponed their specialist training (p < 0.001), whereas men indicated that their training was seldom delayed. Employment data revealed that women with children typically worked fewer hours, whereas the majority of men, regardless of parental status, worked over 50 hours per week. Fatherhood predominantly led to full-time employment of at least 40 hours per week, suggesting that parenthood induces part-time work mainly among women. No childless men reported work hour reduction as a cause for delayed specialist status, in stark contrast to over half of the mothers citing this as a significant reason for their postponed completion of training. Post-childbirth work adaptations were markedly different: while men's work hours generally remained unchanged across all specialties, women were particularly less active in endoscopy after the birth of their first child (58%). Women with children held professorships less frequently than their childless or male counterparts (p < 0.001). Men with children were less likely to lack an academic degree.

Conclusion

The survey indicates that parenthood has a differential impact on the professional development of male and female gastroenterologists. Mothers are more likely to experience delays in training and are less represented in high academic positions. In contrast, fatherhood correlates with sustained or increased work hours, reflecting a gendered divide in work-life balance within gastroenterology. These findings highlight the need for structural changes in the medical profession to support equitable career progression for gastroenterologists, regardless of gender and parental status.

Introduction

Contemporary studies suggest there are racial disparities in the outcomes of acute presentations. This study aimed to investigate the impact of sex and race on the management and outcomes of patients presenting with upper gastrointestinal bleeding (UGIB).

Aims & Methods

Using International Classification of Diseases 10th Revision Codes, all adults >18 admitted from 2016–2020 with a discharge diagnosis of UGIB were extracted from the National Inpatient Sample.

Results

In over 900,000 hospitalisations for UGIB, 69.4%, 14.1%, 9.6%, 3.6%, 0.9% and 2.4% were for admissions in white, black, Hispanic, Asian/pacific islander, native American and ‘other’ patients respectively. Comorbidity burden varied between racial groups (p<0.001). White patients had higher crude rates of endoscopy, and comparable rates of surgery or interventional radiology to control blood loss, in comparison to other racial groups. Adjusted analysis revealed that black and Asian/pacific islander racial group patients had lower odds of in-hospital all cause mortality compared to white patients, but ‘other’ racial group patients had higher odds of mortality (p<0.001). There was no difference for Hispanic or native American patients. For non-variceal bleeding, these outcomes persisted. However, for variceal bleeds, there were no significant differences in outcomes between each racial group.

Conclusion

There are racial disparities in the management and outcomes of admissions for UGIB. These difference persist despite the aetiology of bleeding. Underlying reasons for differences in outcomes must be investigated to ensure improved outcomes across high-risk patient groups.

Introduction

Gender diversity in scientific authorship is a progress indicator in various medical fields, including gastrointestinal (GI) endoscopy. The representation of women in academia reflects broader changes in professional roles and leadership. This study aims at analyzing trends in gender representation among authors of randomised controlled trials (RCTs) in GI endoscopy from the 1960s to the present, providing insights into the progression of gender equity in academic gastroenterology.

Aims & Methods

A PubMed search using the terms "digestive endoscopy" and "gastrointestinal endoscopy" was conducted on April 1st, 2024, yielding 5,944 studies filtered for RCTs. After excluding non-English articles, those unrelated to endoscopy, and studies without identifiable first authors, 4,357 RCTs were included. First and last authors' genders were identified using Genderize.io with ≥90% certainty. Descriptive and inferential statistics, including chi-squared tests, were used to analyze trends in gender representation over time.

Results

In total, there were 967 female first authors (21.7%), 3,415 male first authors (77.0%), and 57 unclassified first authors (1.3%). Out of 4173 last authors, 637 were female (15.3%), 3,203 were male (76.7%), and 333 were unclassified (8.0%) (p < 0.001). Female representation among last authors increased from 0% to approximately 20%, while first authors rose from 0% in the 1970s to about 30% by 2024 (p<0.05 for both trends). Multivariate regression confirmed that the increase in female first authorship was more significant compared to last authorship (p<0.001, R-square 0.90).Regarding specific topics, “non-IBD-related diagnostic lower GI endoscopy” showed the highest representation for female first authors at 25.5%, while “Obesity” and “Artificial Intelligence” had the lowest at 1.4% and 1.7%, respectively. For the last authorship, “non-IBD-related diagnostic lower GI endoscopy” led at 22.1%, followed by “Diagnostic upper GI endoscopy” at 14.0%. The lowest percentages among the last authors were “Obesity” at 1.4% and “Artificial Intelligence” at 0.6%. Statistical analysis revealed significant differences in gender representation across topics (p < 0.0001).Regional differences were noted, with female first authors more prevalent in Europe (36.2%) and Asia (31.0%), while female last authors were more common in Europe (34.2%) and North America (30.8%, p = 0.032), highlighting variations in gender dynamics within endoscopy research.

Conclusion

This study demonstrates a progressive increase in female representation in digestive endoscopy RCTs, particularly among first authors. However, gender disparities persist in senior roles, underscoring the need for continued efforts to support gender equity, especially in leadership positions within academic gastroenterology.

References

Liu CS et al. Am J Gastroenterol. 2024 Oct 1;119(10):2103-2106.
Genderize Data Roskilde, Denmark. Genderize.io (last access Nov 1st, 2024