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Perceptions of gender equity in emergency medicine in Canada

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Abstract

Introduction

Women-identifying emergency physicians face gender-based discrimination throughout their careers. The purpose of this study was to explore emergency physician’s perceptions and experiences of gender equity in emergency medicine.

Methods

We conducted a secondary analysis of data from a previously conducted survey of Canadian emergency physicians on barriers to gender equity in emergency medicine. Survey responses were analyzed using logistic regression to determine the impact that gender, practice setting, years since graduation, race, equity-seeking status, and parental status had on agreement about gender equity in emergency medicine and five of the problem statements.

Results

A total of 710 participants completed the survey. Most identified as women (58.8%), white (77.4%), graduated between 2010 and 2019 (40%), had CCFP (Emergency Medicine) designation (47.9%), an urban practice (84.4%), were parents (62.4%) and did not identify as equity-seeking (79.9%). Women-identifying physicians were less likely to perceive gender equity in emergency medicine, OR 0.52, CI [0.38, 0.73]. Women-identifying physicians were more likely to agree with statements about microaggressions, OR 4.39, CI [2.66, 7.23]; barriers to leadership, OR 3.51, CI [2.25, 5.50]; gender wage gap, OR 13.46, CI [8.27, 21.91]; lack of support for parental leave, OR 2.85, CI [1.82, 4.44]; and education on allyship, OR 2.23 CI [1.44, 3.45] than men-identifying physicians.

Conclusion

In this study, women-identifying physicians were less likely to perceive that there was gender equity in emergency medicine than men-identifying physicians. Women-identifying physicians agreed that there are greater barriers for career advancement including fewer opportunities for leadership, a gender wage gap, a lack of parental leave policies to support a return to work and a lack of education for men to become allies. Men-identifying physicians were less aware of these inequities. Health systems must work to improve gender equity in emergency medicine and this will require education and allyship from men-identifying physicians.

Résumé

Introduction

Les femmes médecins urgentistes sont confrontées à une discrimination fondée sur le sexe tout au long de leur carrière. L'objectif de cette étude était d'explorer les perceptions et les expériences des médecins urgentistes en matière d'équité entre les sexes en médecine d'urgence.

Méthodes

Nous avons procédé à une analyse secondaire des données d'une enquête menée précédemment auprès des médecins urgentistes canadiens sur les obstacles à l'équité entre les sexes en médecine d'urgence. Les réponses au sondage ont été analysées à l’aide d’une régression logistique pour déterminer l’incidence que le sexe, le milieu de pratique, les années écoulées depuis l’obtention du diplôme, la race, le statut de demandeur d’équité et le statut parental avaient sur l’accord sur l’équité entre les sexes en médecine d’urgence et cinq des énoncés de problème.

Résultats

Au total, 710 participants ont répondu à l'enquête. La plupart d'entre eux sont des femmes (58.8 %), de race blanche (77.4 %), ont obtenu leur diplôme entre 2010 et 2019 (40 %), ont le titre de CCMF (médecine d'urgence) (47.9 %), exercent en milieu urbain (84.4 %), sont parents (62.4 %) et ne se déclarent pas en quête d'équité (79.9 %). Les médecins s'identifiant à des femmes étaient moins susceptibles de percevoir l'équité entre les sexes en médecine d'urgence, OR 0.52, IC [0.38,0.73]. Les médecins s'identifiant comme femmes étaient plus susceptibles d'être d'accord avec les déclarations sur les microagressions, OR 4.39, IC [2.66, 7.23] ; obstacles au leadership, OR 3.51, IC [2.25, 5.50] ; écart salarial entre les hommes et les femmes, OR 13.46, IC [8.27, 21.91] ; le manque de soutien pour le congé parental, OR 2.85, IC [1.82, 4.44]; et l’éducation sur l’alliance, OR 2.23 IC [1.44, 3.45] que les médecins s'identifiant comme hommes.

Conclusion

Dans cette étude, les médecins s'identifiant à des femmes étaient moins susceptibles de percevoir qu'il y avait une équité entre les sexes en médecine d'urgence que les médecins s'identifiant à des hommes. Les femmes médecins s'accordent à dire qu'il existe davantage d'obstacles à l'avancement professionnel, notamment moins d'opportunités de leadership, un écart salarial entre les hommes et les femmes, un manque de politiques de congé parental pour favoriser le retour au travail et un manque d'éducation des hommes pour qu'ils deviennent des alliés. Les médecins s'identifiant à des hommes étaient moins conscients de ces inégalités. Les systèmes de santé doivent s'efforcer d'améliorer l'équité entre les sexes dans la médecine d'urgence, ce qui nécessitera une formation et un allié de la part des médecins qui s'identifient aux hommes.

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Abbreviations

CAEP:

Canadian Association of Emergency Physicians

CCFP(EM):

Certificate of the College of Family Physicians with a Certificate of Added Competence in Emergency Medicine.

CI:

Confidence Interval

ED:

Emergency Department

OR:

Odds ratio

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Acknowledgements

We would like to thank CAEP for their support and the many individuals who took the time to complete the survey.

Author information

Authors and Affiliations

  1. Discipline of Emergency Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada

    Gillian Sheppard & Emma McIlveen-Brown

  2. Division of Population Health and Applied Health Sciences, Memorial University of Newfoundland, St. John’s, NL, Canada

    Queen Jacques & Yanqing Yi

  3. Faculty of Business Administration, Memorial University of Newfoundland, St. John’s, NL, Canada

    Nicole Barry & Alyson Byrne

  4. Department of Family and Emergency Medicine, University of Montreal, Montreal, QC, Canada

    Judy Morris

  5. Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada

    Taylor Bischoff

  6. Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada

    Chau Pham

  7. Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada

    Isabella Menchetti

  8. Department of Pediatrics, Western University, London, ON, Canada

    Rodrick Lim

  9. Division of Emergency Medicine, Department of Medicine and Pediatrics, McMaster University, Hamilton, ON, Canada

    Alim Pardhan

  10. Department of Emergency Medicine, Huron Perth Healthcare Alliance, Stratford, ON, Canada

    Miriam Mann

  11. Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada

    Katrina F. Hurley

  12. Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada

    Ayesha Zia

  13. School of Medicine, Toronto Metropolitan University, Toronto, ON, Canada

    Teresa M. Chan

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  1. Gillian Sheppard
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Contributions

All authors contributed to the study concept and design. Authors TMC, EB, JM, and GS were responsible for ethics approval for the study, developing the research question, analyzing the results and writing the manuscript. Authors YY, QJ, and NB were responsible for developing the study protocol, preparing the statistical analysis for the study and manuscript preparation. Authors TB, CP, IM, RL, AP, MM, AZ, KH, and AB were each involved in developing the research question, study protocol, analyzing the results and reviewing the manuscript. The first draft of the manuscript was written by GS and all authors commented on previous versions of the manuscript. All authors have reviewed the final manuscript and have given their permission for publication.

Corresponding author

Correspondence to Gillian Sheppard.

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Conflict of interest

Author NB, MM, QJ, AP, IM, EB, RL, CP, TB, YY, AB, and KH have nothing to declare. Author TMC has received funding from a PSI Foundation Grant, AAMC Honoraria, and has received Honoraria from Harvard University, Toronto Metropolitan University and McMaster University, and has received funds for travel from CAEP, AAMC, Toronto Metropolitan University, and McMaster University. Author GS is the former Chair of the CAEP Women in Emergency Medicine Committee and has received travel support and speaking honoraria from CAEP and Memorial University. Author JM is a board member at CAEP and L’Association des médecins d’urgence de Quebec and is the Vice-Chair of the CAEP Leadership committee.

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Sheppard, G., McIlveen-Brown, E., Jacques, Q. et al. Perceptions of gender equity in emergency medicine in Canada. Can J Emerg Med 26, 271–279 (2024). https://doi.org/10.1007/s43678-024-00665-9

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