Women in Medicine: Are career development opportunities the same?
According to the National Institute of Statistics, there were 283,811 licensed physicians in Spain in 2021: 149,984 women (52.8%) and 133,827 men (47.2%). The predominance of women will grow in the near future given that at present, 70% of medical students are women. However, despite the progressive increase in the number of women in our pro- fession, there are still marked differences in leadership positions in the healthcare, teaching, and research settings that are not justiﬁed by age.
The Ministry of Science and Innovation’s Cientíﬁcas en Cifras 2021 [Female Scientists in Numbers 2021] report has identiﬁed some positive trends, such as the gradual increase in female researchers, who represented 41% of research per- sonnel in Spain. On the other hand, although the proportion of female researchers who apply for funding in R&D calls is increasing, women have lower rates of success (43% of women and 48% of men were successfully funded in 2019) and they receive proportionally less funding. Curiously, this occurred in a country in which the number of women with a doctoral degree increased more than 70% between 2013 and 2018, compared to 4% in the European Union as a whole. V
arious articles have indicated that the effects of less funding lead to women publishing fewer articles and/or those articles being referenced less. 1 As a consequence, women are less visible as scientiﬁc researchers or authors and they have fewer probabilities of being invited to be reviewers or editors of prestigious journals. This situation, in turn, reduces success in funding, as reﬂected in an edito- rial by the Lancet, which represented this vicious circle in a highly visual manner.
The European Society for Medical Oncology’s Women for Oncology (W4O) group also recently published an arti- cle entitled ‘‘Female leadership in oncology-has progress stalled?’’ which described the slow rate of change and the potential reasons for it. 3 In addition to all of this is the impact of the COVID-19 pandemic, which has led to profound organizational and social changes. A 2021 report from the United States of America’s National Academies of Sciences, Engineering, and Medicine alerted that the disrup- tions caused by the COVID-19 pandemic not only threatened the commitment, experience, and retention of women in the academic ﬁelds of science, technology, engineering, mathe- matics, and medicine (STEMM), but could also roll back some of the achievements made by women in recent years.
In Spain, a recent article reﬂected that while male researchers participated in a greater number of scientiﬁc activities for career development, female researchers per- formed more invisible scientiﬁc tasks, such as peer review or outreach activities. 5 Along these lines, an editorial related to another publication by the W4O group with similar conclu- sions indicated the risk of this phenomenon increasing the gender gap in the medium and long term and that it has particular repercussions on the careers of younger women. It also noted the crucial role scientiﬁc societies must play to mitigate it.
The article on female leadership and the gender gap in clinical research by Villamañán et al., included in this issue of the Revista Clínica Española, is a retrospective, obser- vational study conducted in a Spanish university hospital over two decades. 8 The results show that women led 39.7% of all studies, with the gender gap being most marked in non-interventional clinical studies, and that this occurred despite the trend of a growing number of female physicians, who represented nearly 60% of research personnel at the end of the study period.
The economic impact analysis indicated that when grants come from private organizations—-mostly pharmaceu- tical companies or scientiﬁc societies—-the difference was greater and clearly unfavorable for women. All of this reinforces the message that there is much to be done. Many times, gender bias is unconscious and it is fundamental to bring it to light in order to promote active policies for its eradication. Things as simple as using a dif- ferent degree of formality when introducing a woman or a man at a conference could inﬂuence the perception of expe- rience and competence. 9 For this reason, it is so important to quantify and publish data on this issue.
Articles such as the one published today help us size up the problem and press us to work on searching for solutions. Scientiﬁc societies—-and the Federation of Span- ish Scientiﬁc-Medical Associations (FACME, for its initials in Spanish) as their member organization—-can and must be drivers of change that empower a gender perspective in order to make talent visible and promote proactive poli- cies aimed at ensuring women having the same professional development opportunities as men in all ﬁelds of medicine.
Dra. Pilar Garrido.