Gender equity in academic rheumatology Save

I write from Aotearoa/New Zealand in my office at the Waipapa Taumata Rau/The University of Auckland. I am a Professor of Medicine and a Specialist Rheumatologist. Recently, I was promoted to Head of the Department of Medicine within my faculty. I write from a place of privilege, as a cisgender Pākehā (New Zealand European) woman, living in a country that was the first to give women the vote and is now ranked 4th in the world for gender equity. My career as a woman in academia has been supported by a spouse who took primary responsibilities for childcare and many household activities. I have had many women academic role models who showed me a path to career progression. 

What do we know about gender equity in academic rheumatology?

Although almost half of our specialist rheumatology physician workforce is now women, gender inequity in career progression within academic rheumatology is a persistent problem. A recent analysis of the US rheumatology workforce showed that although women were well represented in rheumatology program director and division director leadership roles, women academics were less likely to be full or associate professors, had fewer publications, and received fewer NIH grants. Gender differences were observed even in the most recent series of graduates with sufficient follow-up time to consider academic promotion. While rheumatology-specific data are not available, additional inequities in academic promotion exist for Black women, Hispanic women, and Indigenous women, compared to White women. 

These inequities reflect greater opportunities afforded to men, particularly those from Europe and the US, in endeavours that contribute substantially to academic promotion. We have shown that gender inequity is reflected in authorship of rheumatology academic papers, particularly highly cited industry-funded clinical trials. Although there have been some improvements in representation, men are more likely to have key authorship positions in rheumatology management guidelines. Men are also more likely to be invited speakers at major international rheumatology conferences and recipients of prestigious academic rheumatology prizes. 

While societal and institutional changes are needed to address barriers to academic career progression, there are actions that can be accomplished by rheumatology organisations to promote gender equity in academic rheumatology. For example, the New Zealand Rheumatology Association has developed a gender equity statement for our annual scientific meeting, which recommends that the organising committee invites equal numbers of men and women speakers, and ensures equal gender representation as session chairs, on discussion panels and as award judges. The NZRA also sponsors 'parental grants' for members attending the ASM who have had a child in the last two years, which cover the cost of travel expenses and accommodation for a caregiver and child/ren. It is very exciting to see other rheumatology organisations developing a focus on gender equity, including the EULAR taskforce on gender equity and the Lancet Rheumatology initiatives. 

Individual responses to gender inequity are also needed from rheumatologists of all genders.

Professor Tuhina Neogi and I did this recently after we observed that 14 of the 15 ‘Heroes and Pillars of Rheumatology’ profiled in Ann Rheum Dis were men. This provided us with an opportunity to celebrate the many academics who have contributed to the fundamental understanding of rheumatic disease and its treatment, and who are not men. We also need to advocate, both ‘behind the scenes’ and publicly, for equitable opportunity both in clinical and academic settings. I reflect on several recent invitations to contribute a chapter to an eminent textbook that was co-edited by an all-man editorial group. Although this was a career opportunity, I indicated that I would not contribute to work that did not have gender representation in the editorial team. I encourage other academic rheumatologists, particularly those of us in senior positions, to make similar challenges when we view inequity within academic spaces.