Strategies to Overcome Gender Disparity in Anesthesiology

Cameron Bosinski, MD, MS

Although women comprise the majority of medical school graduates, they are underrepresented in the field of anesthesiology. This disparity continues through the ranks of academia with only 10% of women as chairs of departments in the United States. Dr. Vesna Jevtovic-Todorovic shared insights, drew from research and offered solutions for this important topic during her presentation, “Women in Anesthesiology,” held Saturday, April 2 during the IARS, AUA, SOCCA and eSAS Scholars’ Day. This comprised just one of the three forward-thinking and inspiring discussions during the session, “Expanding the Footprint of Academic Anesthesiology.”

This session was moderated by Kimberly Rengel, MD, Assistant Professor, Anesthesiology and Critical Care Medicine at Vanderbilt University Medical Center and Co-Chair of the IARS Meetings Committee and Co-Vice President of the Early-Stage Anesthesiology Scholars (eSAS).

An accomplished anesthesiologist and clinician scientist with more than 25 years of experience, Vesna Jevtovic-Todorovic, MD, PhD, MBA, FASA, Professor and Chair of the Department of Anesthesiology at the University of Colorado School of Medicine, delved into the challenges that women face in anesthesiology and offered constructive advice for overcoming these hurdles and advancing as a woman in this specialty. She shared insights from her own experience as well as her role as Chair. As a chair, she focuses on mentorship and growth of junior faculty, expanding the clinical programs and increasing collaboration with the School of Medicine and the surrounding community. All were actions that supported some of the tips she provided for enhancing the experience for women in anesthesiology during her presentation.

To frame her talk, she began by reviewing data from published papers over the past 10 years, focused on the disparities of women in anesthesiology. Studies have examined the factors that lead to gender disparity in leadership positions, which include unsupportive work environments, lack of mentorship, personal choice, childcare responsibilities and active discrimination against women.

With fewer women in leadership positions in anesthesiology and fewer who are funded, early-career women often find it difficult to find a woman mentor to guide them in their academic career advancement. Although extremely supportive of her career growth over the years, Dr. Jevtovic-Todorovic shared that over the past 25 years all of her mentors were men.

Women have more childcare responsibilities and make personal choices that may differ from men, all of which affect specific decisions that a woman in the field will make.

Dr. Jevtovic-Todorovic revealed results from one study (Anesthesiology, 2015) in which American Society of Anesthesiologists members were surveyed in 2007 and then again in 2013. This demographic encompassed more than 80% of all practicing anesthesiologists in the United States. Based on 6,783 responses, the authors reported that women anesthesiologists on average earn 29% less than men. Even after accounting for experience, hours worked, compensation plan and employer characteristics, women still earned 7% less than men.

Forty percent of women cited active discrimination as a factor when applying for funding. Women need to publish three more papers in high-impact journals or 20 papers in top journals to earn the same application score on National Institutes of Health grants as men. Women who display desirable leadership characteristics, such as competitiveness, ambition and confidence, are more likely to be judged as hostile by others. Women are less likely to receive distinguished awards than men. Since 1945, 25 out of 211 Distinguished Science Awards were given to women. As of 2019, no women had won an award from the American Society of Anesthesiologists, Society of Anesthetic Pharmacology or the Society of Cardiovascular Anesthesiologists in the past 10 years. However, the Society of Ambulatory Anesthesia and the Society for Education in Anesthesia have given 40% of their awards to women.

Dr. Jevtovic-Todorovic recommended strategies to overcome these disparities and help advance the careers of women. She encouraged academic institutions to develop programs to recruit, promote and retain women faculty. In order to increase representation of women in leadership roles, search committees need to be in tune with the recruitment of women as well as be diversely composed to allow for different perspectives. More women should be considered for awards and asked to be keynote speakers. In addition, journals and funding agencies should track gender data and be aware of potential bias. She emphasized that research funding allocation needs to be redesigned to focus more on the content of the proposal and less on previous publications.

Overall, Dr. Jevtovic-Todorovic has found that women are more concerned about failing than men. She stressed that it is OK to fail and much can be learned from these moments to help you excel and grow in the future. In her leadership role, she has found that several women have hesitated to take on leadership positions. However, she has never had a man turn down a leadership opportunity. When faced with this situation, she encourages women not to be afraid of failure and to treat each experience as a learning opportunity.