Women Emergency Physicians and Gender Disparities from Entry to Advancement

We sought to summarize the last 20 years of published research on gender experience and disparities in the emergency medicine workforce.

We conducted a scoping review by searching MEDLINE ALL, Embase, Cochrane Central Register of Controlled Trials, and Scopus from 2003 to 2024, to identify original research investigating gender experience and disparities among physicians in emergency medicine in North America. We abstracted study design, sample characteristics, and outcomes. We analyzed data using an ad hoc iterative thematic analysis of the content areas as well as a synthesis of the key findings and research limitations.

We identified 5,740 candidate publications and, after exclusions, included 191 (99% observational studies). We identified 15 themes: (1) workforce, (2) childbearing, (3) attrition, (4) evaluations, (5) bias and discrimination, (6) wellness, (7) professional development groups and mentorship, (8) authorship, (9) editorial board membership, (10) research grants, (11) national speakers, (12) awards, (13) leadership roles, (14) academic rank and promotion, (15) financial compensation and one subtheme (pediatric emergency medicine). We mapped these themes to 5 domains: (1) Recruitment and Retention, (2) Culture and Environment, (3) Academic Scholarship, (4) Recognition and Promotion, and (5) Clinical Care and Decisionmaking. There were 3 to 33 publications per theme. The quality of evidence was variable. We found fewer disparities, and improvement over time in the percentage of women academic faculty, women authorship, national speaking, and educational awards. We found consistent evidence of gender disparities disadvantaging women emergency physicians in financial compensation, editorial board membership, executive leadership roles, academic rank, and experiences of gender bias, with little change over time.

Although some areas remain understudied, our central findings confirm that gender-based disparities continue to exist among emergency physicians. Future efforts should be redirected toward the development and assessment of interventions that combat these disparities.