Women in gastroenterology: the UK trainee experience

Abstract

IntroductionCompared with other medical specialties, there are lower numbers of female trainees and lower rates of flexible working in gastroenterology. This study aims to examine the experience of male and female trainees to understand specialty demographics and the experience of training.MethodsGastroenterology training data were obtained from the British Society of Gastroenterology (BSG) trainee surveys from 2014, 2018 and 2020, and from the Royal College of Physicians Medical Workforce unit between 2011 and 2019. Data on endoscopy measures from 2011 to 2021 were obtained from the Joint Advisory Group (JAG) on gastrointestinal endoscopy, including the JAG Endoscopy training system and the National Endoscopy Database. Data were segregated and compared by gender.ResultsThe percentage of female gastroenterology trainees remains at around 40%, largely unchanged over the previous decade. From the BSG trainee survey, 29.5% of women have flexible working patterns compared with 2.6% of men (p<0.001), which is lower than other medical specialties. Less than half of female trainees felt confident about their job prospects once they qualify. A greater proportion of male than female trainees achieved provisional colonoscopy certification during training (55% vs 45%, p=0.005) and female trainees took longer to certify than male trainees (63 months vs 56 months, p=0.004). The total length of training time from primary medical qualification to consultancy was the same for men and women.ConclusionChanges must be addressed from a national and institutional level to address equitable access to national training programmes and equality of outcome for male and female trainees.

UK ERCP sedation practices, patient comfort and endoscopist characteristics: National Endoscopy Database (NED) analysis on behalf of the JAG and BSG

“…The proportion of female endoscopists performing ERCPs is low, with only 6% of practitioners being female. The low proportion of female specialist trainees (7%) suggests the gender discrepancy is not improving despite the increased proportion of female gastroenterology trainees (40%) 23…”

Regional survey of foundation trainee doctors’ views on a career in gastroenterology: implications for diversity and inclusion

“…Most respondents agreed that increased acceptability of less than full time work and greater flexibility would help improve female recruitment, however, of particular interest, men selected greater flexibility more than women. Given that flexibility was selected as the most important factor for specialty choice, a greater discussion may be required to improve flexibility for all trainees, with only 2.6% of male gastroenterology trainees opting for flexible working compared with 29.5% of women 5. Schemes such as ‘Flexible Portfolio Training’ in which 20% of contracted time is protected for personal development may provide an opportunity for greater flexibility 13–15.…”

“…Based on recent publications and workforce reports, we hypothesise there are significant differences in the perception of gastroenterology as a career between genders 5. We further hypothesise that identifying these differences will allow organisations to implement schemes to increase diversity in recruitment.…”

“…Understanding the perception of female doctors towards gastroenterology is of particular importance given that they comprise >50% of all medical students. Further issues face the specialty, with it being the second most male dominated specialty at consultant level with only 22% of consultants female, with only 17.8% of consultants being female in the Northwest of England 4–6. This is especially concerning as, despite an increase in total number of female consultants, this has not kept pace with female recruitment in other medical specialties.…”

Editorial: Women in gastrointestinal and hepatic pharmacology 2022

“…Until 1990, fewer than 5% of gastroenterologists were women ( Feliu-Dominguez et al, 2017 ). Women representation has increased, but recent reports still show gender disparity favoring men in numbers (gastroenterology remains within the top 10 for male-dominated physician specialties; AMMC, 2021 ), salary, and leadership positions in both clinical and academic settings, irrespective of geographic area ( Chua et al, 2021 ; Sethi et al, 2022 ; Kedia et al, 2023 ). Despite an early similar degree of interest as males, females perceive greater gender-based barriers to full development of a gastroenterology career as early as during their internal medicine residency ( Advani et al, 2022 ).…”