Gastroenterology (GI) has historically been a male-dominated field. In its 2023 US Physician Workforce Data Dashboard, the Association of American Medical Colleges (AAMC) reported that, as of 2022, female gastroenterologists made up only one-fifth of the active physicians in this field. A 2022 retrospective study published in the Annals of Gastroenterology showed that female representation in GI remains significantly lower than with other specialties. Furthermore, although more women are entering and graduating medical school, between 2009 and 2019, the percentage of female GI fellows only grew by 3.3 percent.
Michelle Kang Kim, MD, PhD, who made history as the first female chair of Cleveland Clinic’s Department of Gastroenterology, Hepatology, and Nutrition, has also conducted multiple studies on the matter. In two of them, published in Gastrointestinal Endoscopy in 2020, Dr. Kim and her colleagues identified multiple inequities female gastroenterologists experience. For example, they continue to have lower income compared to their male counterparts. They are also subject to both conscious and unconscious biases that limit their professional and research opportunities, and lack representation as panelists or keynote speakers at major events and conferences.
A 2021 article in Gastroenterology, the flagship journal of the American Gastroenterological Association (AGA), presents a multi-pronged approach to promoting gender equity for women in GI. Co-written by gastroenterologists Michelle T. Long, MD, and Sharmeel K. Wasan, MD, as well as resident physician Samantha Chua, MD (all from Boston Medical Center, Boston University School of Medicine), the article recommends taking action in five directions: advocacy, gender equity in GI, mentorship and sponsorship, networking, and academic success and leadership skills development. In addition, the authors suggest all five areas be addressed on individual, institutional, and societal levels.
Long, Wasan, and Chua also emphasize the importance of continuous individual and institutional advocacy to shift the paradigm. They call for transparency and zero-tolerance policies on discrimination to overcome the challenges women in GI face. In addition to the inequities mentioned above, the authors point out the gender-based discrepancies in family-related responsibilities (particularly child care), which is partially the cause of women postponing or forgoing their academic careers. They suggest adjusting expectations for academic promotions in a way that does disadvantage women who have missed developing their academic portfolio due to fulfilling family or nonacademic obligations. Furthermore, the Boston physicians insist on implementing consistent and feasible leave policies and a transparent value system to optimize flexibility and work-life balance.
The article’s authors suggest multiple actions for advancing gender equity in GI. These include acknowledging the existence of the gender gap in the field, advocating for female gastroenterologists in leadership positions (from keynote speakers to funding committees and scientific advisory boards), promoting open discussions of their career objectives, payment negotiations, and work-life balance, and objectively assessing grant and peer-review applications.
Reiterating the pivotal role mentorship and sponsorship play in career advancement, the Boston physicians appeal to both male and female senior gastroenterologists to mentor prospective female gastroenterologists and those from underrepresented minorities. Furthermore, they suggest institutions establish mentor training programs and compile institution-specific databases, which can facilitate matching the right mentors with mentees. Similarly, Long, Wasan, and Chua encourage institutions to develop structured sponsorship programs to ensure the identification, support, and retention of talented female gastroenterologists.
Networking effectively and having a strong and supportive professional network are both key to success of female gastroenterologists. The article’s authors recommend they connect with fellow gastroenterologists and other professionals within and outside their institutions to create a cross-sectional, multi-institutional network. Long, Wasan, and Chua also appeal to professional societies to establish databases where members can search each other based on their clinical and research interests, in order to facilitate connecting individuals with shared interests.
Finally, the authors outline the development trajectory of academic success and leadership skills. They start with individual fellows, who should reflect on and identify their strengths and weaknesses, seek opportunities both inside and outside their academic institutions to sharpen their leadership and research skills, and actively build their careers. Long, Wasan, and Chua continue with institutions and employers, which should organize workshops and seminars aimed at women that cover such critical skills as conflict resolution, negotiation, resilience, and knowledge of the business aspect of GI. They finish by listing various professional development opportunities provided by national societies, including the American College of Gastroenterology (ACG), AGA, and the American Association for the Study of Liver Diseases (AASLD), including academic skills and leadership conferences, programs, and workshops.
