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Toward Gender Equity in Critical Care Medicine

A Qualitative Study of Perceived Drivers, Implications, and Strategies*

Leigh, Jeanna Parsons, PhD1,2,3,4; Grood, Chloe de, BSc3; Ahmed, Sofia B., MD, MSc4,5,6,7; Ulrich, Ania C., PhD8; Fiest, Kirsten M., PhD2,3,4,9,10; Straus, Sharon E., MD, MSc11; Stelfox, Henry T., MD, PhD2,3,4,12

doi: 10.1097/CCM.0000000000003625
Online Clinical Investigations

Objectives: Critical care medicine is a medical specialty where women remain underrepresented relative to men. The purpose of this study was to explore perceived drivers (i.e., influencing factors) and implications (i.e., associated consequences) of gender inequity in critical care medicine and determine strategies to attract and retain women.

Design: Qualitative interview-based study.

Setting: We recruited participants from the 13 Canadian Universities with adult critical care medicine training programs.

Participants: We invited all faculty members (clinical and academic) and trainees to participate in a semistructured telephone interview and purposely aimed to recruit two faculty members (one woman and one man) and one trainee from each site. Interviews were transcribed verbatim, and two investigators conducted thematic analysis.

Interventions: Not applicable.

Measurements and Main Results: Three-hundred seventy-one faculty members (20% women, 80% men) and 105 trainees (28% women, 72% men) were invited to participate, 48 participants were required to achieve saturation. Participants unanimously described critical care medicine as a specialty practiced predominantly by men. Most women described experiences of being personally or professionally impacted by gender inequity in their group. Postulated drivers of the gender gap included institutional and interpersonal factors. Mentorship programs that span institutions, targeted policies to support family planning, and opportunities for modified role descriptions were common strategies suggested to attract and retain women.

Conclusions: Participants identified a gender gap in critical care medicine and provided important insight into the impact for personal, professional, and group dynamics. Recommended improvement strategies are feasible, map broadly onto reported drivers and implications, and are applicable to critical care medicine and more broadly throughout medical specialties.

1Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

2Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

3Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

4O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.

5Department of Medicine, University of Calgary, Calgary, AB, Canada.

6Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.

7Alberta Kidney Disease Network, AB, Canada.

8Faculty of Engineering, University of Alberta, Edmonton, AB, Canada.

9Department of Psychiatry, University of Calgary, Calgary, AB, Canada.

10Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

11Department of Medicine, Saint Michael’s Hospital, University of Toronto, Toronto, ON, Canada.

12Alberta Health Services, Calgary, AB, Canada.

*See also p. 615.

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Dr. Straus disclosed that she is funded by a Tier 1 Canada Research Chair. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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