Representation by Gender of Recognition Award Recipients from Gastroenterology and Hepatology Professional Societies.

Background: Recognition awards from professional medical societies play an important role in physicians' career advancement. Our aim was to evaluate the gender representation of award recipients from gastroenterology and hepatology societies. Methods: We analyzed the lists of award recipients from the American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy and determined the gender of these award recipients. The primary outcome was the overall representation of women physician award recipients as compared with the representation of women in the specialty. Results: Between 1941 and 2019, there were 921 awards, of which 77 (8.4%) were given to women and 844 (91.6%) to men. There was a significant increase in the proportion of women recipients over time, from 0% in 1970-1984 to 22.0% in 2015-2019 (p for trend <0.0001). Compared with the concurrent representation of women in the specialty, women physician recipients were underrepresented from 1970 to 1981 and 1984 to 2015, equitably represented from 1981 to 1984, and overrepresented from 2015 to 2019. Of the total number of awards in each category, women received 13.8% of teaching/mentorship awards and 3.8% of the highest achievement awards (p = 0.002). The proportion of women recipients varied among the societies, from 6.8% to 14.5%. Conclusions: The representation of women physician recipients of gastroenterology and hepatology society recognition awards has generally been low until most recently, when it has surpassed the proportion of women in the specialty. Because award recognition is important to career development, professional societies should have transparent processes that aim to identify and reduce various forms of bias, including gender-related bias, in all phases of award recognition.

Increase in female faculty in American Society for Gastrointestinal Endoscopy-sponsored programming over time.

BACKGROUND AND AIMS: Female representation in medicine is increasing across all levels of medical training, yet women hold fewer senior leadership positions than men. National recognition, including participation as faculty in society-sponsored programs, is one component of academic advancement. The aim of this study was to characterize female representation among faculty in courses sponsored by the American Society for Gastrointestinal Endoscopy (ASGE). METHODS: We performed a retrospective review of demographic data, including faculty gender and role, year, and program type, from the ASGE database of its sponsored programs between 2009 and 2014. Female faculty rates were compared with the rate of female membership in the ASGE and by faculty role and course type over time. RESULTS: Between 2009 and 2014 there were a total of 2020 ASGE course faculty positions of which women comprised 19%. There was a significant increase in the proportion of women that served as course faculty over time (P < .0005). Female faculty participation exceeded the ASGE female domestic membership rate in all years. Women were more likely to serve as course directors than lecturers (25% vs 18%, P = .004) and to participate in smaller courses (P = .0003). CONCLUSIONS: We found an increase in female participation in ASGE programming over time, suggesting that specialty societies are making efforts to improve female representation at the national level. Future work should evaluate whether or not these opportunities translate into leadership roles for women within their own institutions or lead to promotions for women over time.

View from the Top: Perspectives on Women in Gastroenterology from Society Leaders.

Women are making great strides at all levels of medicine, including gastroenterology. The proportion of women members in gastroenterology societies has increased nearly 2-fold and the percent of women trainees is 36%. Although there continue to be challenges for women in academic and community practice, the American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and other gastroenterology societies have dedicated substantial resources to foster careers of women in gastroenterology and develop women as leaders in our societies. This article outlines ongoing challenges for women in gastroenterology and some key initiatives addressing barriers to success.

Impact of gender on requests for ASGE leadership assignments.

BACKGROUND AND AIMS: Committee membership in gastroenterology national societies is considered prestigious, opening the door for leadership roles and professional advancement. Some have hypothesized that women ask for leadership opportunities less frequently than men. Our aim was to examine the gender representation of requests for placement on an American Society for Gastrointestinal Endoscopy (ASGE) committee. METHODS: We analyzed deidentified records of all requests for assignment to ASGE committees from 2011 to 2014, including applicant's gender, prior service to ASGE, year of application, and whether the applicant was appointed. The primary outcome was the proportion of requests from women compared with the overall ASGE female membership. RESULTS: There were 513 requests for ASGE committee appointments; 101 (20%) were from women, exceeding the active ASGE female membership (15%; P = .004). Overall, the total number of committee requests increased over time from 89 to 195 (P = .08); the proportion of requests from women remained stable at 16% to 21% (P = .51). Compared with men, women were significantly less likely to have had previous ASGE service (28% vs 42%; P = .01) and more likely to have a statement of endorsement from a mentor (33% vs 24%; P = .06). The rate of appointment to a committee was 47% (95% confidence interval [CI], 41-52) overall, 42% (95% CI, 37-48) for male applicants, and 65% (95% CI, 54-76) for female applicants. Female gender (odds ratio [OR] 2.6; 1.5-4.5), endorsement from a mentor (OR 3.4; 2.1-5.6), and prior ASGE service (OR 2.3; 1.5-3.5) predicted committee appointment. CONCLUSIONS: For ASGE committee appointments, it appears that women who make requests are successful in receiving these appointments. Future work should evaluate requests and appointments by gender among other gastroenterology societies and explore whether service translates into leadership opportunities for women.

Effect of endoscopic stenting of malignant bile duct obstruction on quality of life.

BACKGROUND AND GOALS: Endoscopic stent insertion is considered the method of choice for palliation of malignant bile duct obstruction (MBDO). However, it can cause complications and requires periodic stent exchanges. Although endoscopic stenting is clearly indicated for relief of cholangitis or refractory pruritus, its role in patients with jaundice alone is less clear. Endoscopic stenting for this relative indication might be justified, if there is a significant improvement in quality of life (QOL) of such patients. The aim of our study was to determine whether endoscopic stenting for MBDO results in improved QOL. PATIENTS AND METHODS: Patients undergoing endoscopic retrograde cholangiopancreatography for MBDO and participating in a randomized trial comparing patency duration of 10 and 11.5-Fr biliary plastic stents, completed the Functional Assessment of Cancer Therapy-General questionnaire at baseline, at 1 month after stent insertion, and at 180 days after stent insertion. RESULTS: A total of 164 patients answered the QOL questionnaire at baseline, 95 patients answered the questionnaire at 30 days, and 54 patients answered the questionnaire at 180 days after stent insertion. Endoscopic biliary stenting resulted in a statistically significant improvement in overall score of QOL, and different aspects of QOL such as physical, emotional, and functional well-being. There was a statistically significant improvement in most of the symptoms specific for MBDO at 30 and 180 days after stenting. CONCLUSIONS: Endoscopic stenting significantly improves QOL in patients with MBDO, and, therefore, is an appropriate part of palliative treatment in this patient population.

Research in clinical practice.

Clinical research in the practice setting can be a rewarding experience. The atmosphere of research is changing, however, with tighter budgets, more oversight, increasing litigation risks, financial pressures, and increased competition. Sites must be increasingly careful to negotiate appropriate study budgets and contract language that is not overly burdensome or risky for the site. The focus on investigator training and use of qualifies personnel is paramount to preserve and improve the quality of clinical research in the United STates. The future may find certification examinations necessary for all research staff, including investigators. Eventually, the number of clinical research sites in the community will decrease, and academic sites, along with international sites, will once again fill the void.

Clinical research.

Opportunities for clinical research should be explored carefully. Sites should evaluate potential areas of success, and focus on developing a quality center that can provide accurate data. Although there are numerous challenges to building a successful and productive research center, the rewards are great.