If All the World’s a Stage, Then Where’s Our Microphone?

Abstract

LIFE’S parallels are endless—and the presence of women on stage is no exception. Consider this: in Shakespeare’s London, men and adolescent boys played the role of female characters for literally decades. Paradoxically, they might even have found occasion to play the part of a woman pretending to be a man. Now there’s talent! It was not until 1642, at the start of the English Civil War when the Puritans gained control, that stage plays were banned, and theaters and playhouses were shuttered.1Manktelow H. Discovering literature: Shakespeare and renaissance. Available at: https://www.bl.uk/shakespeare/articles/women-playing-shakespeare-the-first-female-desdemona. Accessed February 21, 2020.Google Scholar With the restoration of the English monarchy (or should we call it “manarchy”?) in 1660, King Charles II, after having spent years in exile at the court of Louis XIV of France, had developed an appreciation for the theater arts. In addition to reinstituting the theater in England, Charles II allowed women to act professionally for the first time, having developed great enthusiasm for their talents on the French stage.2Thorpe V. Secret lives of women who broke taboo to act in Shakespeare. Available at: https://www.theguardian.com/culture/2016/apr/10/secret-lives-of-women-shakespeare. Accessed February 21, 2020.Google Scholar Most notably, Anne Marshall is credited with likely having been the first woman to play Desdemona in Othello in 1660, 44 years after Shakespeare’s death.1Manktelow H. Discovering literature: Shakespeare and renaissance. Available at: https://www.bl.uk/shakespeare/articles/women-playing-shakespeare-the-first-female-desdemona. Accessed February 21, 2020.Google Scholar Now, here we are in the 21st century’s modern scientific world where presumably we have made great strides and yet men continue to grace the podium in far greater numbers than women, paralleling history on multiple levels. In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Shilcutt et al. examined the representation of women as speakers at the Society of Cardiovascular Anesthesiologists (SCA) annual meetings’ scientific sessions over a 4-year period (2015-2018).3Shilcutt L. Lorenzen K.A. Whose voices are heard? Speaker gender representation at the Society of Cardiovascular Anesthesiologists Annual Meeting.J Cardiothorac Vasc Anesth. 2020; 34: 1805-1809Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar These sessions included the main program, problem-based learning discussions (PBLDs), workshops, and moderation of fellow sessions. SCA membership by gender was estimated using the recent 2019 SCA Diversity Survey, which yielded a female representation of 29.1%. The authors found that for all combined sessions, there was an overall significant difference in the expected versus observed proportion of women speakers, who accounted for 22% to 25% of all speakers. However, further breakdown demonstrated that these differences remained significant for the main sessions but not the PBLDs, workshops, and fellow sessions. So, is this good news that women are being equitably represented at PBLDs, workshops, and fellow sessions? When you begin to think about it, not really. The prestige lies with the main program, including keynote addresses, plenary sessions, etc. It then should come as no surprise that women are underrepresented in the more coveted and esteemed portions of the program. As will be discussed further in the following, this problem is not unique to the SCA and has been described repeatedly in various medical and surgical specialties, technology, business, and other unrelated professions. Each year new words enter the lexicon of the English language. Words such as “selfie,” “Googling,” “woke,” and “boomer” have become commonplace in today’s modern dialogue. So, too, has the term “manel,” which appeared in the Cambridge Dictionary as a newly coined word on October 30, 2017, and is cited as follows: manel noun [C]–/ˈmæn.əl/–a panel made up only of men.4cambridge Dictionary. About words: New words – 30 October 2017. Available at: https://dictionaryblog.cambridge.org/2017/10/30/new-words-30-october-2017/. Accessed February 25, 2020.Google Scholar The point of panels, as we all know, is to create a platform that brings a variety of divergent experiences, opinions, and perspectives to a topic of interest. The issue of “manels” has been raised in numerous contexts, yet the surplus of all-male panels at scientific conferences still exists despite efforts to curb the problem. The upward climb to professional success is steeper for women. Unfortunately, hard work and excellent credentials cannot always overcome some of the existing biases within the system, including unbalanced opportunities for advancement and promotion and less access to resources.5Nonemaker L Women physicians in academic medicine: New insights from cohort studies.N Engl J Med. 2000; 342: 399-405Crossref PubMed Scopus (371) Google Scholar Promotion is dependent on recognized achievements that open increasing numbers of doors. A key event in one’s academic career is the invitation to serve as a speaker at a professional society meeting. These speaking engagements offer numerous advantages, including public recognition of one’s achievements, networking opportunities, serving as an aid to academic advancement, potential for future collaboration, and external recognition as an expert in the field. Networking is a major means of expanding professional opportunities and can lead to future speaking engagements. Having women at the podium also has a positive effect on younger female peers who are seeking role models. To date, metrics used for academic promotion have been unfavorable toward women.5Nonemaker L Women physicians in academic medicine: New insights from cohort studies.N Engl J Med. 2000; 342: 399-405Crossref PubMed Scopus (371) Google Scholar These include first and senior author publications,6Jagsi R Guancial EA Worobey CC et al.The “gender gap” in authorship of academic medical literature—a 35-year perspective.N Engl J Med. 2006; 355: 281-287Crossref PubMed Scopus (531) Google Scholar grants and awards,7Pagel PS Hudetz JA Scholarly productivity and National Institutes of Health funding for Foundation for Anesthesia Education and Research grant recipients: Insights from a bibliometric analysis.Anesthesiology. 2015; 123: 683-691Crossref PubMed Scopus (36) Google Scholar membership on editorial boards,8Amrein K Langmann A Fahrleitner-Pammer A et al.Women underrepresented on editorial boards of 60 major medical journals.Gender Med. 2011; 8: 378-387Abstract Full Text Full Text PDF PubMed Scopus (152) Google Scholar department leadership positions,9Bissing MA Lange EMS Davila WF et al.Status of women in academic anesthesiology: A 10-year update.Anesth Analg. 2019; 128: 137-143Crossref PubMed Scopus (38) Google Scholar speaking engagements at regional and national conferences, professional society leadership positions,10Toledo P Duce L Adams J et al.Diversity in the American Society of Anesthesiologists leadership.Anesth Analg. 2017; 124: 1611-1616Crossref PubMed Scopus (38) Google Scholar and serving as an oral board examiner.11Fahy BG Culley DJ Sun H et al.Gender distribution of the American Board of Anesthesiology diplomates, examiners, and directors (1985-2015).Anesth Analg. 2018; 127: 564-568Crossref PubMed Scopus (15) Google Scholar It should come as no surprise then that women also are scarce at the podium, particularly as headliners and keynote speakers. Numerous reports have found that diversity improves decision making, quality, and financial performance and leads to improved outcomes by bringing new perspectives, experience, and ideas to the table.12Gomez LE Bernet P Diversity improves performance and outcomes.J Nat Med Assoc. 2019; 111: 383-392Crossref PubMed Scopus (81) Google Scholar This holds true for medicine and other professions, including business and technology.13Jayne MEA Dipboye RL Leveraging diversity to improve business performance: Research findings and recommendations for organizations.Human Resource Manage. 2004; 43: 409-424Crossref Scopus (273) Google Scholar,14National Center for Women and Information Technology. What is the impact of gender diversity on technology business performance: Research summary. Available at: https://www.ncwit.org/sites/default/files/resources/impactgenderdiversitytechbusinessperformance_print.pdf. Accessed February 26, 2020.Google Scholar Diversity also has had a positive effect at scientific meetings. At the American Society for Radiation Oncology Annual Meeting, for instance, panels with >50% female gender composition were associated with individual measures of audience satisfaction.15Rahimy E Jagsi R Park HS et al.Quality at the American Society for Radiation Oncology Annual Meeting: Gender balance among invited speakers and associations with panel success.Int J Rad Onc Biol Phys. 2019; 104: 987-996Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar Grand rounds are another speaking venue where gender representation has been unbalanced relative to audience demographic. Boiko et al. surveyed grand rounds speaker series among 9 specialties, including anesthesiology, in 2014.16Boiko JR Anderson AJM Gordon RA Representation of women among academic grand rounds speakers.JAMA Intern Med. 2017; 177: 722-724Crossref PubMed Scopus (68) Google Scholar They compared female speaker percentages with workforce demographics and found that, with the exception of obstetrics/gynecology and surgery, the percentages of nontrainee female speakers were significantly lower than the female composition of faculty workforces. For anesthesiology, there were 26.2% female nontrainee speakers relative to 34% faculty members who were women. There also was more intramural versus extramural participation by women. Another troubling observation that has been described frequently is that when women present at conferences, they are addressed less frequently by their professional title than are their male counterparts when introduced by a male colleague. The converse has not been the case.17Files JA Mayer AP Ko MG et al.Speaker introductions at internal medicine grand rounds: Forms of address reveal gender bias.J Womens Health (Larchmt). 2017; 26: 413-419Crossref PubMed Scopus (119) Google Scholar,18Davids JS Lyu HG Hoang CM et al.Female representation and implicit gender bias at the 2017 American Society of Colon and Rectal Surgeons’ Annual Scientific and Tripartite Meeting.Dis Colon Rectum. 2019; 62: 357-362Crossref PubMed Scopus (36) Google Scholar This unfortunate practice, even if unintentional, undermines the status of women within the society. A study that examined the gender makeup of speakers relative to the expected composition based on membership profiles at the American Society of Anesthesiologists (ASA) annual meetings from 2011 to 2016, found that gender breakdown was fairly consistent over the period under study, ranging from 22.3% to 27.7% female participation.19Moeschler SM Gali B Goyal S et al.Speaker gender representation at the American Society of Anesthesiology Annual Meeting.Anesth Analg. 2019; 129: 301-305Crossref PubMed Scopus (24) Google Scholar Although the overall number of women speakers was similar to what would be expected relative to ASA membership (25.0% v 25.9%; p = 0.153), the proportion of single speakers (as opposed to panelists) was more unfavorable toward women (20.2% v 25.9%; p < 0.001). In fact, among single speakers, women made up only 7% of plenary lectures (3/41). Furthermore, single- gender panels (2-5 participants) showed a significant predominance of all-male constituents. A retrospective analysis of the representation of women speakers at the Canadian Anesthesiologists’ Society annual meeting from 2007 to 2019 found that 28.5% of speaker slots included women, closely approximating their representation in Canadian clinical anesthesiology, with increasing trends over the study period.20Lorello GR Parmar A Flexman AM Representation of women amongst speakers at the Canadian Anesthesiologists’ Society annual meeting: A retrospective analysis from 2007 to 2019.Can J Anesth. 2020; 67: 430-436Crossref PubMed Scopus (7) Google Scholar A breakdown of anesthesiology subspecialties, however, found that women had the greatest representation in obstetric anesthesia, as opposed to cardiothoracic anesthesia, transplantation anesthesia, and critical care symposia. This is in alignment with trends in authorship in anesthesiology journals.21Miller J Chuba E Deiner S et al.Trends in authorship in anesthesiology journals.Anesth Analg. 2019; 129: 306-310Crossref PubMed Scopus (42) Google Scholar Furthermore, among the 311 symposia (defined as consisting of 2 or more speakers), 46% consisted of all-male speakers. Unlike the study by Shilcutt et al., this analysis excluded PBLDs and workshops.3Shilcutt L. Lorenzen K.A. Whose voices are heard? Speaker gender representation at the Society of Cardiovascular Anesthesiologists Annual Meeting.J Cardiothorac Vasc Anesth. 2020; 34: 1805-1809Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar A retrospective audit of annual scientific meetings (2012-2014) that included 6 Australasian specialty colleges, including anesthesiology, found that male speakers not only outnumbered women at every conference, but that they also were allocated greater speaking time in 7 of 17 of the annual scientific meetings.22Modra LJ Austin DE Young SA et al.Female representation at Australasian specialty conferences.Med J Aust. 2016; 204: 385-386Crossref PubMed Scopus (14) Google Scholar Clearly, we have a problem. A cross-sectional analysis of speaker gender at 181 US and Canadian medical conferences found that although the proportion of female speakers increased from 24.6% in 2007 to 34.1% in 2017, women still remained underrepresented as a whole.23Ruzycki SM Fletcher S Earp M et al.Trends in the proportion of female speakers at medical conferences un the United States and in Canada, 2007 to 2017.JAMA Netw Open. 2019; 2: e192103Crossref PubMed Scopus (67) Google Scholar A review of women’s participation as speakers at 5 critical care conferences from 2010 to 2016 found that men outnumbered women at all conferences over the 7-year period, with female physicians representing 5% to 26% of speakers.24Mehta S Rose L Cook D et al.The speaker gender gap at critical care conferences.Crit Care Med. 2018; 46: 991-996Crossref PubMed Scopus (56) Google Scholar Similar trends also have been noted in general surgery,25Wilcox AR Trooboff SW Lai CS et al.Trends in gender representation at the American College of Surgeons Clinical Congress and the Academic Surgical Congress: A mixed picture of progress.J Am Coll Surg. 2019; 229: 397-403Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar neurosurgery,26Silva N Cerasiello S Semonche A et al.Gender representation at neurological surgery conferences.World Neurosurg. 2019; 129: 453-459Abstract Full Text PDF PubMed Scopus (19) Google Scholar plastic surgery,27Santosa KB Larson EL Vannucci B et al.Gender imbalance at academic plastic surgery meetings.Plast Reconstr Surg. 2019; 143: 1798-1806Crossref PubMed Scopus (16) Google Scholar and dermatologic surgery,28Flaten HK, Goodman L, Wong E, et al. Analysis of speaking opportunities by gender at national dermatologic surgery conferences [e-pub ahead of print]. Dermatol Surg. doi: 10.1097/DSS.0000000000002275, AccessedGoogle Scholar among others. Subcategories of speaking topics considered “female friendly” tend to be where women predominate. These include obstetrics and gynecology, breast, pediatrics, and sessions geared specifically at women. For instance, greater female representation at the American Society for Radiation Oncology Annual Meeting was noted in the “female subspecialties” of breast, gynecology, and pediatrics,15Rahimy E Jagsi R Park HS et al.Quality at the American Society for Radiation Oncology Annual Meeting: Gender balance among invited speakers and associations with panel success.Int J Rad Onc Biol Phys. 2019; 104: 987-996Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar whereas at the American College of Surgeons Clinical Congress and Academic Surgical Congress, women-only panels predominated on the topics of breast surgery and women in surgery.25Wilcox AR Trooboff SW Lai CS et al.Trends in gender representation at the American College of Surgeons Clinical Congress and the Academic Surgical Congress: A mixed picture of progress.J Am Coll Surg. 2019; 229: 397-403Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar A number of reasons (or excuses) have been postulated for the lack of participation of women as invited speakers.29Nittrouer CL Hebl MR Ashburn-Nardo L et al.Gender disparities in colloquium speakers at top universities.Proc Natl Acad Sci USA. 2018; 115: 104-108Crossref PubMed Scopus (85) Google Scholar, 30Wennerås C Wold A Nepotism and sexism in peer review.Nature. 1997; 387: 341-343Crossref PubMed Scopus (797) Google Scholar, 31Guzman-Reyes S Pivalizza EG Gender distribution in professional anesthesiology activities.Anesth Analg. 2019; 129: e179-80Crossref PubMed Scopus (3) Google Scholar, 32Penfold R Knight K Al-Hadithy N et al.Women speakers in healthcare: Speaking up for balanced gender representation.Future Healthc J. 2019; 6: 167-171Crossref PubMed Google Scholar These include the following:•Women are offered invitations to speak but decline more often than men because of personal or professional obligations (this notion has been debunked)•Women are less career-oriented than men•Women are less assertive in their search for opportunities•Women are less productive than men, so their efforts have less merit•Personal choices•Greater part-time status•Need for patience with gaining appropriate experience necessary to become a speaker•Event organizers wanted more women to speak but could not find anyone suitable or invitees were unavailable The important question is whether the gender gap at the podium results from bias or is simply the result of gender differences within academic medicine itself. Trying to rationalize the facts will continue to prove fruitless unless real solutions with measurable outcomes are implemented. The bête noire that nobody speaks of—nepotism—unfortunately and unwittingly can result in a lack of change in the regular lineup of speakers at scientific conferences. Many qualified individuals have felt shut out of public speaking opportunities because they were not part of a well-connected network of peers. The concept of a “friendship bonus”30Wennerås C Wold A Nepotism and sexism in peer review.Nature. 1997; 387: 341-343Crossref PubMed Scopus (797) Google Scholar has been argued both ways, and despite ongoing efforts at the organizational level to promote qualified women, this element should not be dismissed. This notion has been suggested as a possible explanation for the over-representation of “all-male” panels and the lack of an open nomination process for ASA plenary speakers (as opposed to selection by committee alone).33Chandraprose RK, Hopf HW. Gender representation in speakers at ASA: It’s not a patience, part-time, or pipeline issue [e-pub ahead of print]. Anesth Analg doi: 10.1213/ANE.0000000000004645, AccessedGoogle Scholar Along parallel lines, a study by Wennerås et al. strongly suggested that peer reviewers for the Swedish Medical Research Council, a main funding agency for biomedical research in Sweden, were unable to judge scientific merit independent of gender.30Wennerås C Wold A Nepotism and sexism in peer review.Nature. 1997; 387: 341-343Crossref PubMed Scopus (797) Google Scholar Using multiple regression analyses of the relationship between defined parameters of scientific productivity and competence scores, the authors found that peer reviewers either overestimated the achievements of men or underestimated those of women. They found unequivocally that men and women with equal scientific productivity did not receive the same competence rating by the Medical Research Council reviewers. These authors also coined the term “friendship bonus” previously mentioned, supporting the observation that applicants who were affiliated with a committee member received higher competence scores than applicants of the same gender and productivity without such connections. The proportion of women invited to speak at conferences has been correlated to the number of women among event organizers and committees and a reduction in the number of infamous “manels” in a number of reports.24Mehta S Rose L Cook D et al.The speaker gender gap at critical care conferences.Crit Care Med. 2018; 46: 991-996Crossref PubMed Scopus (56) Google Scholar,34Débarre F Rode NO Ugelvig LV Gender equity at scientific events.Evol Lett. 2018; 2: 148-158Crossref PubMed Scopus (29) Google Scholar, 35Dumitra TC, Trepanier M, Lee L, et al. Gender distribution of speakers on panels at the Society of American Gastrointestinal and Endoscopic Surgeons annual meeting [e-pub ahead of print]. Surg Endosc. doi: 10.1007/s00464-019-07182-2, AccessedGoogle Scholar, 36Al-Lami H, Bingener J. Faculty diversity at academic surgical meetings—Opportunity for action [e-pub ahead of print]? J Gastrointest Surg. doi: 10.1007/s11605-019-04394-8, AccessedGoogle Scholar, 37Gerull KM, Wahba BM, Goldin LM, et al. Representation of women in speaking roles at surgical conferences [e-pub ahead of print]. Am J Surg. doi: 10.1016/j.amjsurg.2019.09.004, AccessedGoogle Scholar, 38Ghatan CE Altamirano J Fassiotto M et al.Achieving speaker gender equity at the SIR Annual Scientific Meeting: The effect of female session coordinators.J Vasc Interv Radiol. 2019; 30: 1870-1875Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar An often-cited study examined the relationship of women on a convening team with the proportion of female speakers at scientific symposia. In an analysis of 460 symposia involving 1,845 speakers at 2 large meetings sponsored by the American Society of Microbiology, the presence of at least 1 female member on the convening team was directly correlated to a greater proportion of invited female speakers and the decreased likelihood of an all-male symposium roster.39Casadevall A Handelsman J The presence of female conveners correlates with a higher proportion of female speakers at scientific symposia.Bio. 2014; 5: e00846-13Google Scholar These findings suggested that women make conscious efforts to be more inclusive of other women, although direct causation can only be inferred from the correlation. For each year under study, Shilcutt et al reported a female representation on the SCA scientific program committee of 29.6% (n = 8), 39.0% (n = 9), 30.7% (n = 8), and 29.6% (n = 8), respectively.3Shilcutt L. Lorenzen K.A. Whose voices are heard? Speaker gender representation at the Society of Cardiovascular Anesthesiologists Annual Meeting.J Cardiothorac Vasc Anesth. 2020; 34: 1805-1809Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar This breakdown mirrors SCA membership based on survey results with the exception of 2016 and is much higher than the proportion of women participating in the main sessions in each of the years (16.0%, 17.4%, 16.9%, and 16.9%, respectively). Fortunately, several organizations have taken a proactive stance to create a more balanced and inclusive speaker profile at conferences. These include the following:•On June 12, 2019, Dr. Francis Collins, Director of the National Institutes of Health, announced that he would no longer participate in scientific and medical forums that do not include women, stating: “Starting now, when I consider speaking invitations, I will expect a level playing field, where scientists of all backgrounds are evaluated fairly for speaking opportunities. If that attention to inclusiveness is not evident in the agenda, I will decline to take part. I challenge other scientific leaders across the biomedical enterprise to do the same.”4040. Collins FS. Time to end the manel tradition. Available at: https://www.nih.gov/about-nih/who-we-are/nih-director/statements/time-end-manel-tradition. Accessed February 25, 2020.Google Scholar•The Lancet has made a diversity pledge, posted on its web site (https://www.thelancet.com/diversity) and is committed to ending all-male panels; ending participation of its editors on public conference panels that do not include women; and for hosted events, setting a goal for the inclusion of at least 50% female speakers.41The Editors of the Lancet Group The Lancet Group’s commitments to gender equity and diversity.Lancet. 2019; 394: 452-453Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar•The National Academy of Sciences, National Academy of Engineering, and Institute of Medicine have published guidelines with the goal of maximizing opportunities for and the potential of women in science and engineering.42National Academy of Sciences, National Academy of Engineering, and Institute of Medicine Beyond bias and barriers: Fulfilling the potential of women in academic science and engineering. National Academies Press, Washington, DC2007Google Scholar•Springer’s Nature formalized its efforts to make conferences more inclusive by introducing a code of conduct and diversity policy applicable not only to Nature conferences, but to all Springer Nature scholarly events. This commitment includes putting an end to all-male organizing committees for all new Nature conferences; inviting equal percentages of men and women speakers, including keynote presentations; eliminating “manels”; and monitoring and reporting progress annually.43Skipper M, Inchcoombe S. Announcing a new diversity commitment for Springer Nature’s research publishing. Available at: https://www.springernature.com/gp/advancing-discovery/blog/blogposts/new-diversity-commitment/17485502. Accessed February 25, 2020.Google Scholar Determining the optimal proportion of female speakers without having to resort to quotas or tokenism will be a challenge, but not an insurmountable one. Most of us can agree that gender equity should be based on merit. Still, there is no consensus on whether the representation of women should mirror the proportion of practicing physicians, that of professional society members, or even that of trainees.35Dumitra TC, Trepanier M, Lee L, et al. Gender distribution of speakers on panels at the Society of American Gastrointestinal and Endoscopic Surgeons annual meeting [e-pub ahead of print]. Surg Endosc. doi: 10.1007/s00464-019-07182-2, AccessedGoogle Scholar The latter might actually help to accelerate a narrowing of the gender gap. Nevertheless, we will need to do a better job gathering critical data. The makeup of our professional societies will need to be better tracked for starters. Perhaps including stated gender as a voluntary part of membership renewal and creation of a database would be a way of improving accuracy over incomplete survey data. It also would be important to know more about speaking invitations, how often they are declined, and the number of individual orators versus those giving multiple talks (which often are counted individually, bloating the actual number of women). Finally, just as King Charles II opened the doors for women to perform on the stage in England, so, too, must male colleagues, who outnumber women in key decision-making positions, be agents of change by taking an active role in encouraging diversity.32Penfold R Knight K Al-Hadithy N et al.Women speakers in healthcare: Speaking up for balanced gender representation.Future Healthc J. 2019; 6: 167-171Crossref PubMed Google Scholar As previously stated, many organizations have taken pledges, and perhaps it is time we all did the same. There are no conflicts of interest to report. Whose Voices Are Heard? Speaker Gender Representation at the Society of Cardiovascular Anesthesiologists Annual MeetingJournal of Cardiothoracic and Vascular AnesthesiaVol. 34Issue 7PreviewGender disparities in academic medicine continue to be prevalent despite significant advances in the number of women entering medicine over the last decades. The purpose of the present study was to investigate gender representation of speakers at Society of Cardiovascular Anesthesiologists (SCA) Annual Scientific Sessions meetings from 2015 to 2018. Full-Text PDF