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• teaching

In an observational study published in EMJ, Carley et al1 asked “Are there too few women presenting at emergency medicine conferences?” The authors analysed the apparent gender of speakers at eight major emergency medicine (EM) conferences from 2014 to 2015. They found that women presenters gave 29.9% of the talks occupying 27.6% of the total speaking time.

The group then compared these percentages to the mean percentage of the EM workforce that is female (26.2%) and concluded that the percentage of women speaking is likely representative of the gender distribution in EM, not necessarily gender bias in speaker selection.

The authors do not describe their means of identifying the women in the ED workforce, so it is difficult to know whether this estimate is accurate. But let us say, for argument's sake, that the proportion of women speaking is representative of the proportion of women in the field. Would we then have enough women speaking at EM conferences?

Roughly half of US medical school graduates are female, yet only about one-third of EM trainees in the USA are women.2 Twenty seven per cent of EM physicians in both Canada and the UK are women according to the most recent published data.3 ,4 EM is perceived as a flexible and family-friendly career, so we might expect it to attract women physicians. Yet our numbers are on par with general surgery and anaesthesiology.5 Aiming for proportionate representation means that we are satisfied with the status quo. Why use the number of women certified as the target denominator if women are under-represented to start?

Parity on stage has value for the women in the audience. Speakers at conferences do not just represent the current state of affairs; they also serve as inspiration for those listening. With podcasts and live tweets, academic conferences are now accessible to learners beyond the auditorium walls. Students, residents and physicians in other specialties look to our flagship conferences for the most current EM knowledge. We need equal representation on those stages, in those podcasts and on those video feeds.

Assumptions that women are not seen on the stage because they are unqualified, lack ambition or would not travel6 originate from the same gender-based biases that keep the proportion of women in the specialty <50%. In fact, women find the time to do high-value activities like lecturing at national conferences. Attesting to this, the website FemInEM,7 an online community of women emergency physicians, recently assembled a speakers bureau8 of over 100 women EM faculty representing a broad range of areas of expertise. The vast majority, regardless of stage of career, indicated availability to travel internationally for speaking engagements (table 1).

Perhaps the question should not be whether we have proportional gender representation; perhaps the gender imbalance in both speakers and EM specialists should raise questions about what is happening in the EM pipeline that is draining talented women away from our specialty. It may be that we need more women on stage to inspire those in the audience and listening at home.