Gender, conferences and careers in EM. St.Emlyn’s

Gender, ConfereCareers& EM

This is the first of two blog posts from Ashley Voss-Liebig and Natalie May on a paper we recently published in the EMJ1. These two posts tell the story behind that paper, why we think it’s important and why we believe the best way to change the world is to do something that shares a message and explains the rationale. We hope these help you understand why we at St.Emlyn’s believe that there is work to do to examine gender in the worlds of emergency medicine, critical care and prehospital care.

Over to you, Ashley.

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In December of last year, a Twitter conversation sparked fervent debate about the low number of female speakers at Emergency Medicine conferences.  Scott Weingart (EmCrit.org), Simon Carley (Stemlynsblog.org), Dara Kass & Jenny Esmay (FemInEM.org) hosted a Google Hangout event to discuss why women are not represented in emergency medicine conferences around the globe.  This was a direct result of the line up for the annual ResuscitateNYC16 event that is a free conference for EM residents. If you want to recap that converation then click on the YouTube link below.

Immediately, I was intrigued. If I am honest, I was annoyed.  I thought this was an attack on my friend (Scott) who, I am quite certain, doesn’t have a biased bone in his body.  Additionally, I am a woman who has always pushed her way to the front.  Women aren’t allowed in combat?  We’ll see.  Woman are not great rescue specialists? We’ll see. I’m here to prove you wrong, by working hard, committing the time and by doing the work.

I want women to work.  I want them to be more and better and prove that beyond a shadow of a doubt that they deserve to be there, wherever “there” may be.  I penned the article “What are you waiting for?” for FemInEM2.  Those points, made almost a year ago remain valid; work ethic is paramount, volunteering and respecting your value is critical, avoiding excuses because of family and gender role is essential.

moe-570520_960_720

Imagine my surprise when I learned last week that I was all wrong.  Women are doing the work.  Women are taking the stage. Not only are they taking the stage, they are doing so in numbers, higher than their male counterparts.  An observational study published last week in EMJ, Carley et al1, found that the proportion of female speakers was actually slightly higher than the proportion of female EM specialists.  My joy in the fact that women are actually speaking in larger numbers than I anticipated, is only overshadowed by the fact that, though women have taken the stage, they tend to talk for less duration.  Is this because they think they have less to offer? Do they lack confidence in their expertise? Or maybe we could conclude that women are more precise, effective communicators. Either way, the evidence is clear on one thing: I was focused on the wrong problem!

We are now required to change the scope of concern, and further, our scope of action. As pointed out by Dara Kass and Esther Choo in their EMJ Editorial3 , perhaps we should be looking at why women do not pursue EM as a specialty.

Why is it that women; brilliant, talented, powerful, women leave this specialty to the wayside?  And because we, as a community, appreciate and respect the perspective that women bring to field, why are we not pushing harder to attract and include them?

“Equity”, as pointed out by Dr. Nikki Stamp, “is not the same a equality.”

We could use this research as evidence for equity, and be satisfied. Conference organizers around the world could choose to righteously pat themselves on the back.  Private debates could be won with “I told you so”.

Or.

We could act the like the professionals we profess to be and recognize our responsibility to mentor.  We could empower and encourage, rather than compete.  We could set standards and innovate, taking notes from conferences like Social Media and Critical Care (SMACC), where 40% of the speakers are women.  We could do the work; the hard work of inclusion, the hard work of assessing our own personal bias, the hard work of eliminating barriers.

Attracting women to EM will require a multifocal approach, which must include women in prominent positions, be that in leadership, academia, or in the limelight.  Little girls want dolls that look like them. Women want career mentors that represent them.

Dr. Natalie May put it best “we should applaud the progress in our specialty but keep on pushing forward until we are surprised we ever had to have this conversation”.

It seems that we, in emergency medicine, still have a great deal of work to do.

vb

Ashley

If you are inspired to consider more female speakers at your conference, try the FemInEM Speakers Bureau.

Before you go please don’t forget to…

1.
Carley S, Carden R, Riley R, et al. Are there too few women presenting at emergency medicine conferences? Emergency Medicine Journal. August 2016:emermed-2015-205581. doi:10.1136/emermed-2015-205581.
2.
Kass D. FeminEM. FeminEM. https://feminem.org/. Published January 2016. Accessed August 2016.
3.
Kass D, Choo EK. When will we have enough women speakers in emergency medicine?: Table 1. Emergency Medicine Journal. August 2016:emermed-2016-206088. doi:10.1136/emermed-2016-206088.

9 Comments

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  3. drkirstyc

    Yes, yes, yes and yes some more Ashley! I have always subscribed to the philosophy of being publicly stunned if anyone suggested my lack of Y chromosome meant I couldn’t do something (a few have tried).

    I would pick you up on one thing – I don’t think that women necessarily need female mentors; role models yes, but my long-term mentors and strongest advocates have all been male (Steve, Darren, Jon – thank you).

    Keep up the XX factor 🙂

    Kirsty

    Reply
    1. Simon Carley

      Yes…..but.

      Kirsty – you are an exceptional clinician, researcher and presenter. People like you will always get there through sheer determination and ability. That’s not the case for everyone: Male or Female.

      Think of it as two pyramids. The peak of both will always succeed, but a greater chunk of one pyramid may get the opportunity and encouragement.

      In other words we can’t judge from the exceptionally fabulous (you and many others I know). It’s to the common (wo)man that we might have to turn our attention to.

      What do you think?

      S

      Reply
      1. drkirstyc

        Agreed (and thank you for not using “bloody-mindedness”).

        I just don’t think we should make equalising the chunks an issue for female mentors only. In some ways that perpetuates the problem (“developing good women is only the responsibility of women already in post”). Female trainees/researchers should also expect & benefit from good male mentorship of the kind that has helped me.

        A different but related issue is providing strong female role models; a middle-aged man in a tweed jacket said to me when I was about 30 “ploughing your own furrow is hard work” – this is where those of us already in post have scope to improve the lot of our successors. I will stand up and say you can be a woman and have babies and finish training and get a PhD – because you can!

        K

  4. Victoria Brazil

    Hey Ashley
    Thanks for your thoughtful post. I am definitely a proponent of getting on and doing it.

    This shouldn’t prevent a hard look at the fragile, flawed concept of ‘merit’.
    Like Dara in the hangout – i can’t accept there aren’t excellent women ‘qualified’ to speak on resuscitation in New York.
    And ‘just try harder’ can’t be our only advice to them.

    Simon’s excellent article showed up Australian EM well in term of women speakers, but if we look at keynotes at those ACEM conferences, I’m not as reassured as you were by the article.

    speakers women
    2016 5 1
    2015 4 0
    2014 5 2
    2013 4 1

    We all have biased bones in our bodies – including Scott, me, conference organisers. What a shame we can’t do ‘blind auditions’ 🙂 https://www.theguardian.com/women-in-leadership/2013/oct/14/blind-auditions-orchestras-gender-bias

    Maybe we would get the kind of female numbers that would give Scott the dinner companions he prefers.
    Or maybe we wouldn’t?

    Thanks again to St Emlyns and all others tor promoting a complex and nuanced discussion. And not relegating it to Twitter !

    Reply
    1. Simon Carley

      Thanks Vic,

      I think if we were to do this again we might delve into the data more. The problem with keynotes is that not all conferences identify them as such. It was tricky to determine who was a keynote for all. In my non-published data it was pretty clear that.

      1. Keynotes (or big talks) were almost exclusively men.
      2. The proportion of women was not the same across all topics. Paeds for example had far more women speakers than say ‘airway management’ or anything involving the use of a scalpel or sunglasses (!).

      Where can we take this next? Maybe some qual work to explain the reasons rather than just document it.

      vb

      S

      Reply
      1. Victoria Brazil

        Yes Simon. Its amazing how complex the study question(s) got before you delved very far.

        Maybe qualitative next step ? perhaps conference organizers and ‘typical’ audience members thoughts

        or maybe experimental? crazy ideas like give exactly same script and slides to different speakers – and ask for impressions from their audience (so many variables than just gender, but……)

        vb

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