Gender equity in emergency medicine: Five years on, where are we headed?

The challenge of addressing gender inequality was highlighted in the 2016 Trainee Focus of Emergency Medicine Australasia. Despite increasing numbers of female medical graduates, including increasing female trainees in emergency medicine (EM), this has not yet translated to equal representation in formal leadership roles. Five years later, as the Australasian College for Emergency Medicine (ACEM) welcomes the second female college president, this article explores the gendered leadership gap in EM from an organisational and intersectional feminist perspective and recommends high-level strategies for change. Notably, ACEM has demonstrated committed engagement with gender equity, such as the establishment of the Advancing Women in Emergency Section. It has also achieved gender parity in provisional trainees and improved women's representation on the ACEM Board. However, broader organisational processes that ensure work-life integration, transparent leadership development pathways and equitable recruitment, promotion, retention and evaluation remain critical. Creating a local evidence-base to support diversity in leadership development remains a priority.

Leadership challenges of directors of emergency medicine: An Australasian Delphi study.

OBJECTIVE: Emergency medicine (EM) is an emerging profession with complex clinical and leadership demands. However, studies of leadership in EM are in their infancy. The present study makes a novel contribution to empirical research in this area by examining the leadership challenges faced by Australasian directors of emergency medicine (DEMs). METHODS: An online Delphi study was conducted with 87 Australasian DEMs. To structure the process, participants were sorted into four panels reflecting their leadership experience and geographical location. Using a three-phase Delphi process, participants were guided through the process of brainstorming leadership challenges, narrowing down these challenges, and ranking these challenges from most to least important. RESULTS: Four leadership challenges were shared across all panels, regardless of experience and location; namely, administrative overload, overcrowding and access block, managing challenging colleagues and engaging with hospital executive. However, the low consensus achieved within and across panels highlights the complexity of leadership in EM and cautions against simplistic approaches to addressing leadership challenges. CONCLUSION: The recommendation for DEMs is that they need to engage in programmes which will support the development of the leadership and non-clinical skills required to enable them to cope with responsibilities of hybrid role of physician-leader. The development and delivery of specialised leadership programmes attuned to the hybridity of the director role and the complexity of hospitals is vital for ensuring high-quality patient care and successful running of EDs.