The Influence of Gender on a Career in Advanced Endoscopy: An International Perspective

Aims Females remain underrepresented in advanced endoscopy (AE). A number of studies have previously reported family planning, perception of gender bias and lack of female mentors as barriers to undertaking AE. No published study to date has surveyed at an international level. The authors are part of the Women in Endoscopy Mentorship Programme,which aims to promote leadership and diversity within endoscopy. To assess factors which may contribute to poor uptake of AE training among female endoscopists.

Methods A cross-sectional survey was designed which included questions on demographics, the centre in which the endoscopist worked, experience in endoscopy, time away from endoscopy, burnout, mentorship and leadership. This was shared via social media platforms and among multiple national societies, as well the Women in Endoscopy network. Statistical analysis (primarily descriptive and chi square testing) was performed using SPSS v30 software [1] [2].

Results There were 220 responses, n=135 female (61.3%),n=131 from Europe (59.5%). 20% of respondents stated that<10% of all endoscopists in their unit are female; only 18.5% of respondents worked in a unit with>50% female endoscopists. Females were significantly more likely to have taken time away from endoscopy (51% vs 12%,p<0.01). and more likely than males to have a partner who worked full time (64.4% vs 35.6% p<0.01).They were more likely to feel that having a family delayed their career (45.9% vs 27.1% p=0.04)-but 60.7% also felt that their career had led to them delaying having a family (vs 32% males p<0.001). 68.9% of women felt their gender held them back in their career versus 10.6% of men (p<0.001).Over half (52%) felt that they were not offered the same opportunities as men, while 44% felt they were offered the same opportunities, just not at the same time (p<0.001). Whether they had a mentor or not did not impact on these perceptions. They were less likely to have ever been in a leadership role (56.4% vs 45.2% ns); this became significant specifically for those who had taken a career break (55% vs 41.8% p=0.037). There was no difference in hours worked over all, and they were as likely to be working in a tertiary, high volume endoscopy centre. There was no difference in results between females in different countries/continents. Of all advanced endoscopy procedures, they were most likely to perform diagnostic EUS; less likely than male colleagues to perform basic ERCP (61.2% vs 46.7% p=0.025), complex ERCP (43.5% vs 28.1% p=0.025) or therapeutic EUS (61.4% vs 48.2% p=0.011). There was no difference when it came to third space endoscopy involvement, but numbers here were small.Despite the above findings,women were as likely as men to recommend a career in GI.

Conclusions This international survey identified that we still have a long way to go to change perceptions and reduce differences between the male and female experience in the endoscopy unit. Females in advanced endoscopy are still struggling to attain parity with their male colleagues when it comes to leadership,performing complex procedures and equal opportunities.

• References

• 1 Yu JX, Berzin TM, Enestvedt B, Anderson MA, Popov VB, Thompson CC, Schulman AR.. Gender disparities in advanced endoscopy fellowship. Endosc Int Open 2021; 9 (03): E338-E342
• 2 Siddiqui UD, van Hooft JE, Sethi A.. Gender disparities in advanced endoscopy fellowship: Women in Endoscopy (WIE) perspective. Endosc Int Open 2021; 9 (04): E505-E506