Using the American Board of Ophthalmology (ABO) Diplomate database, a recent study from researchers at Yale University and the University of Washington analyzed gender trends in ophthalmology subspecialties.
Give me some background.
Similar to other healthcare fields, there is currently an underrepresentation of women in ophthalmology, especially in leadership positions.
According to the research, “as of 2021, women represented 37% of active physicians, 40.6% of residents, and 28% of program directors.”
Talk about the study.
In this trend and cross-sectional study, researchers used de-identified records of all (12,844) ABO-certified ophthalmologists between 1992 and 2020.
They noted the year of certification, gender, and self-reported primary practice area for each ophthalmologist.
Findings?
The majority of the ABO-certified diplomates were male (8,459, 65.9%); out of all the diplomats, 6,042 (47.0%) reported a primary practice area other than “comprehensive” or “cataract.”
These two were combined into one group to indicate a non-subspecialty practice.
Of the ophthalmologists who reported a subspecialty practice area, 3,940 (65.2%) were men, and 2,102 (34.8%) were women.
Tell me more about these proportions.
A significantly greater proportion of women than men reported a subspecialty in pediatrics (20.6% vs. 7.9%, p < 0.0001) and glaucoma (21.8% vs. 16.0%, p < 0.0001).
Conversely, a significantly greater proportion of men reported a subspecialty in vitreoretinal surgery (47.2% vs. 22.0%, p < 0.0001).
What about certification?
Additionally, in terms of the overall number of diplomates certified per year, the percentage of men certifying in 1992 (79%) has decreased over time (56% in 2020) as more women have undergone certification.
To note, the ratio of men to women who certify per year is slowly approaching 1:1.
And specialty practices?
While both men and women have increasingly reported a subspecialty practice, the number of women in subspecialty practice areas is rising faster compared to male diplomates.
For example, in 1992, 27% of female ophthalmologists reported oculoplastics as their subspecialty, but by 2020, this increased to 49%.
Go on …
Similarly, the representation of women in glaucoma and cornea subspecialties increased from 21% and 25% in 1992, respectively, to almost 56% in 2020 for both.
Interestingly, women have remained the majority in pediatric ophthalmology since 2000 and continue to outnumber men, making up 76% of newly-certified ophthalmologists focused on pediatrics in 2020.
Significance?
The study authors outlined that the gender-based disparities in ophthalmology are “primarily a residency recruitment issue.”
While ophthalmology residency numbers are approaching an even gender split (40.6% female residents), not all subspecialties have reached parity, though progress has been noted in increasing female representation across all subspecialties.
Next steps?
Further efforts to ascertain the underlying causes of gender-based differences, ensure uniform surgical residency experiences, and access to female mentorship and role models are key approaches for addressing this problem.