Gender Representation in Speakers at ASA: It's Not a Patience, Part-Time, or Pipeline Issue.

Abstract

To the Editor In Speaker Gender Representation at the American Society of Anesthesiology Annual Meeting: 2011–2016, Moeschler et al1 highlight the significant underrepresentation of women as speakers at the American Society of Anesthesiologists (ASA) annual meeting compared to the percentage of female ASA members. Specifically, all-male panels are more common, and women are underrepresented as single speakers (168 out of 831, or 20.2%), particularly in the narrower category of plenary speaker (3 out of 41, or 7.3%). In response, Guzman-Reyes and Pivalizza2 propose 3 possible explanations for these findings, and encourage women to be more proactive in submitting proposals and “urge patience” in waiting for women to gain “experience commensurate with speaking engagements at national meetings.” While we agree there has been progress in the representation of women at ASA meetings, we strongly disagree with explanations by Guzman-Reyes and Pivalizza2 of the notable disparities, as well as their recommendation of “patience.” Guzman-Reyes and Pivalizza2 suggest that the current percentage of women entering anesthesiology is too recent for enough women to have the relevant experience. In 2007, approximately 26% of practicing anesthesiologists ranging from 36 to 45 years of age were women.3 Thus, the “pipeline” of women should have been sufficient by the 2010s. A better explanation for the comparative lack of female single, and especially plenary, speakers is that individual hard work and merit, while required, do not reliably overcome the well-documented negative impact of gender bias on opportunity. Guzman-Reyes and Pivalizza2 note that most panel presentations at the ASA meeting result from “voluntary submissions with a limited acceptance rate.” We agree that information on acceptance rates by gender would be valuable, but we strongly disagree that the discussion of the possible influence of a “friendship bonus” “diminishes the voluntary effort and commitment of ASA colleagues in the peer review process.” There is extensive evidence of gender bias in reviews of journal articles and grant proposals, so a differential acceptance rate is possible.4 Even if the difference is explained by fewer women submitting panel proposals, the preponderance of all-male panels suggests a tendency for all-male panels to be disproportionately formed and/or accepted. Such a concentration of all-male panels might indeed result from a “friendship bonus.” The phrase “friendship bonus” does not imply intentionality; rather, men are a “known quantity,” and are therefore more likely to be selected. ASA plenary speakers are chosen by a committee. Lack of an open nomination process amplifies existing gender bias and facilitates the friendship bonus. Selection committees with <35% women are less likely to select a woman. Thus, increasing the representation of women on selection committees and implementing a wider nomination process is more likely to result in increased representation of women as plenary speakers than “a call to action to academic women faculty to increase panel submissions.”5 Guzman-Reyes and Pivalizza2 suggest that the disparity may be due to the “personal choice” of part-time work. According to a 2015 Rand Corporation survey commissioned by ASA, only 15% of all female anesthesiologists work part time. Even in studies comparing only men and women who work full time, men have more rapid professional advancement than women.6 Many women with part-time academic appointments present on panels at ASA (personal experience), suggesting that it does not preclude successful contributions to advancing the specialty. We agree with Moeschler et al1 that their data “illuminate an opportunity to improve gender representation and enrich professional networks at the ASA Annual Meeting.” We look forward to the day when women are fairly and equitably represented in the speaker rosters of ASA and other medical societies. Rekha K. Chandrabose, MDDepartment of AnesthesiologyUniversity of California San DiegoSan Diego, California[email protected]Harriet W. Hopf, MDDepartment of AnesthesiologyUniversity of UtahSalt Lake City, Utah