Membership in medical societies is associated with a number of benefits to members that may include professional education, opportunities to present research, scientific and/or leadership training, networking, and others. In this perspective article, the authors address the value that medical specialty society membership and inclusion have in the development of an academic physician's career and how underrepresentation of women may pose barriers to their career advancement. Because society membership itself is not likely sufficient to support the advancement of academic physicians, this report focuses on one key component of advancement that also can be used as a measure of inclusion in society activities-the representation of women physicians among recipients of recognition awards. Previous reports demonstrated underrepresentation of women physicians among recognition award recipients from 2 physical medicine and rehabilitation specialty organizations, including examples of zero or near-zero results. This report investigated whether zero or near-zero representation of women physicians among recognition award recipients from medical specialty societies extended beyond the field of physical medicine and rehabilitation. Examples of the underrepresentation of women physicians, as compared with their presence in the respective field, was found across a range of additional specialties, including dermatology, neurology, anesthesiology, orthopedic surgery, head and neck surgery, and plastic surgery. The authors propose a call for action across the entire spectrum of medical specialty societies to: (1) examine gender diversity and inclusion data through the lens of the organization's mission, values, and culture; (2) transparently report the results to members and other stakeholders including medical schools and academic medical centers; (3) investigate potential causes of less than proportionate representation of women; (4) implement strategies designed to improve inclusion; (5) track outcomes as a means to measure progress and inform future strategies; and (6) publish the results to engage community members in conversation about the equitable representation of women.

Background: Ensuring the strength of the physician workforce is essential to optimizing patient care. Challenges that undermine the profession include inequities in advancement, high levels of burnout, reduced career duration, and elevated risk for mental health problems, including suicide. This narrative review explores whether physicians within four subpopulations represented in the workforce at levels lower than predicted from their numbers in the general population-women, racial and ethnic minorities in medicine, sexual and gender minorities, and people with disabilities-are at elevated risk for these problems, and if present, how these problems might be addressed to support patient care. In essence, the underlying question this narrative review explores is as follows: Do physician workforce disparities affect patient care? While numerous articles and high-profile reports have examined the relationship between workforce diversity and patient care, to our knowledge, this is the first review to examine the important relationship between diversity-related workforce disparities and patient care. Methods: Five databases (PubMed, the Cochrane Library of Systematic Reviews, EMBASE, Web of Knowledge, and EBSCO Discovery Service) were searched by a librarian. Additional resources were included by authors, as deemed relevant to the investigation. Results: The initial database searches identified 440 potentially relevant articles. Articles were categorized according to subtopics, including (1) underrepresented physicians and support for vulnerable patient populations; (2) factors that could exacerbate the projected physician deficit; (3) methods of addressing disparities among underrepresented physicians to support patient care; or (4) excluded (n = 155). The authors identified another 220 potentially relevant articles. Of 505 potentially relevant articles, 199 (39.4%) were included in this review. Conclusions: This report demonstrates an important gap in the literature regarding the impact of physician workforce disparities and their effect on patient care. This is a critical public health issue and should be urgently addressed in future research and considered in clinical practice and policy decision-making.

Key Points Question Are women, who in 2015 made up 61.9% of pediatricians and 53.0% of full-time physician pediatric faculty, underrepresented among physician first authors of perspective-type articles published in the 4 highest-impact general pediatric journals? Findings In this cross-sectional study, women were underrepresented among physician first authors (140 of 336 [41.7%]). Underrepresentation was more pronounced in article categories described as more scholarly (range, 15.4%-44.1%) vs narrative (range, 52.9%-65.6%). Meaning Because women are underrepresented among physician first authors of perspective-type articles, they are less likely to have opportunities to express their opinions and provide insights that may influence the field.

Gender bias and discrimination have profound and far-reaching effects on the health care workforce, delivery of patient care, and advancement of science and are antithetical to the principles of professionalism. In the quest for gender equity, medicine, with its abundance of highly educated and qualified women, should be leading the way. The sheer number of women who comprise the majority of pediatricians in the United States suggests this specialty has a unique opportunity to stand out as progressively equitable. Indeed, there has been much progress to celebrate for women in medicine and pediatrics. However, many challenges remain, and there are areas in which progress is too slow, stalled, or even regressing. The fair treatment of women pediatricians will require enhanced and simultaneous commitment from leaders in 4 key gatekeeper groups: academic medical centers, hospitals, health care organizations, and practices; medical societies; journals; and funding agencies. In this report, we describe the 6-step equity, diversity, and inclusion cycle, which provides a strategic methodology to (1) examine equity, diversity, and inclusion data; (2) share results with stakeholders; (3) investigate causality; (4) implement strategic interventions; (5) track outcomes and adjust strategies; and (6) disseminate results. Next steps include the enforcement of a climate of transparency and accountability, with leaders prioritizing and financially supporting workforce gender equity. This scientific and data-driven approach will accelerate progress and help pave a pathway to better health care and science. Gender bias and discrimination have profound and far-reaching effects on the health care workforce, delivery of patient care, and advancement of science and are antithetical to the principles of professionalism. In the quest for gender equity, medicine, with its abundance of highly educated and qualified women, should be leading the way. Because women comprise the majority of pediatricians in the United States, pediatrics has a unique opportunity to stand out as progressively equitable. Indeed, there has been much progress to celebrate for women in medicine 1-7 and pediatrics. 3,4,7 However, many challenges remain, and there are areas in which progress is too slow, stalled, or regressing. 8-14 Moreover, women with intersectional identities (ie, simultaneously belonging to multiple underrepresented groups, including gender, race, sexual orientation, ability, age, or socioeconomic status 15) may experience heightened levels of bias and discrimination, sometimes called a "double bind." 16 Therefore, this report focuses on persistent disparities and highlights key a Executive Leadership in Academic Medicine Program,

The long-standing underrepresentation of women among medical academic leaders (deans, chairs, and professors) is well documented. However, little is known about trends in medical society leadership. Because tenure in society leadership positions contributes to academic advancement and provides opportunities to influence both the organization and the medical specialty, it is crucial to begin examining the demographics of society leadership.Methods | In this cross-sectional study, we identified 1 major physician-focused medical society for each of the 43 spe-cialty groupings listed in the 2016 Physician Specialty Data Report (Table ). 1 We generally selected the largest and/or most influential society in the field. Groupings for internal medicine/ pediatrics, neonatal-perinatal medicine, pediatric cardiology, and pediatric hematology/oncology (4 of 43 groupings) were then excluded because physicians in these specialties generally belong to the American Academy of Pediatrics (AAP). The primary outcome measures were years of presidential leadership attributed to men and women. To minimize some lack of independence across years, which is even greater for societies using 2-year presidential terms (4 of 39 societies; Table ), data were collected for a 10-year period (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017), allowing for a minimum of 5 election cycles. For 38 societies, presidents' names were assigned to the year of election. For the AAP, which changed the start of its presidential term from fall to January in 2014, presidents elected before 2014 were assigned to the year following election. Gender was determined and verified via publicly available online profiles. Onesample tests of proportions comparing the percentage of women among association presidents with the percentage of women in active practice (Figure ) were used to determine the significance (2-sided P values) of underrepresentation or overrepresentation.

Although the reasons why are not clear, women were often underrepresented among individual physician recognition award recipient lists, particularly for highly prestigious awards.

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had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.