Even in an era of growing female empowerment in the workplace, ophthalmology, a male-dominated domain, remains riddled with gender inequity: In Canada, only 27% of ophthalmologists identify as women.1 Collaborating with a team of researchers and ophthalmologists from various Canadian universities, one of us (M.P.) recently examined female representation within the field in an analytical retrospective study.2 This investigation focused primarily on the gender compositions of executive leadership teams for various Canadian ophthalmology societies, coupled with an examination of the criteria necessary to obtain a leadership position, including academic rank, research productivity, and society leadership. The main objective of the study was to investigate gender relations in ophthalmology and determine the true factors that affect the allocation of leadership positions within the field.
Hoping to gather a wide range of evidence, we accessed publicly available data from 12 ophthalmology societies that detailed their executive membership from 2021. Additionally, to investigate the change in gender composition over time, we accessed the executive leadership teams for the Canadian Ophthalmology Society, the only institution with these data available over an extended period (2016–2021). By analyzing their pronouns, names, and photos, the executive leadership members were categorized as male or female. Executive positions were divided into two categories: presidential leadership, encompassing society president, vice president, chair, cochair, and vice chair; and other leadership, comprising members at large, planning committee members, digital technology committee members, and other subcommittee leaders. Subsequently, we compiled research metrics using the SCOPUS database, including the number of citations, publications, years of active research, and the h-index and m-index. The h-index and m-index are measures used to evaluate the research impact of scholars and institutions, with the h-index reflecting the number of papers and their citations and the m-index considering both productivity and citation impact.
We found that, despite progress toward greater gender equity in ophthalmology, females are still underrepresented in leadership positions. From 2016 to 2021, the percentage of women in executive leadership within the Canadian Ophthalmology Society increased from 19.2% to 42.3%; however, in 2021, of 277 total executive members across Canadian ophthalmology societies, only 81 (29.1%) were female. These data demonstrate that representation is generally increasing within executive leadership; however, ongoing efforts such as mentorship and female role modeling still have not bridged ophthalmology’s significant gender gap. Similar trends can be seen in the United States, where, from 1969 to 2019, the composition of female ophthalmologists increased from 4% to 27%.3
Through categorical executive leadership analyses, we determined that males were significantly more prevalent within presidential leadership roles than females, with 39 males compared to 23 females (P = .02). In the other leadership category, females were significantly more represented than males, with 77 females as opposed to 61 males (P = .03). The imbalance of both leadership categories suggests biases in the perception of optimal leadership qualities. For example, due to gender stereotypes, assertive males may be appreciated in leadership positions, whereas the same characteristic in females can make them seem brash, unapproachable, and aggressive. Without equitable gender-specific support systems, role modeling, and mentorship compared to their male counterparts, females may feel they cannot succeed in presidential leadership roles, disincentivizing them from even applying.
The m-index and h-index for males and females correlate with society executive leadership rank, with a positive correlation between faculty position and society executive position. We found that h-index, number of citations, number of publications, and duration of active research showed no significant differences between male and female executive members, demonstrating their equality in research productivity; however, there was a noteworthy difference in the m-index, with males having a significantly lower m-index than women (0.58 ±0.03 vs 0.67 ±0.05; P = .03). If leadership positions were based solely on research capacity and productivity, males and females should be represented equitably; the underlying discrepancies in representation are, therefore, associated more with gender dynamics than with research output.
CONCLUSION
Considering the significance of greater gender diversity in ophthalmology, our study highlighted a few methods to overcome the disparities in female leadership representation, including mentorship, gender-neutral recruitment policies, and family-friendly workplace practices. Ultimately, although great strides have been made for gender representation in Canada, there is still much to be done to optimize equity, diversity, and inclusion within the nation.
1. Buys YM, Bellan L. Updated inventory and projections for Canada’s ophthalmology workforce. Can J Ophthalmol. 2023;58(6):523-531.
2. Parvand M, Eslami M, Doughty N, Yeung SN, Kherani F. Closing the gender gap among Canadian ophthalmology societies. Semin Ophthalmol. 2024;39(2):150-157.
3. Gill HK, Niederer RL, Shriver EM, Gordon LK, Coleman AL, Danesh-Meyer HV. An eye on gender equality: a review of the evolving role and representation of women in Ophthalmology. Am J Ophthalmol. 2022;236:232-240.
