Gender Inequality in the Medical Profession: the Women Doctors in Spain (Womeds) Study

Abstract

Abstract Background The WOmen in MEDicine in Spain (WOMEDS) project (https://womeds.es) aims to detect and measure possible gender bias in different settings of the medical profession in Spain, monitor its evolution over time, and propose measures to reduce it. Methods We collected primary data for the calendar year 2019-2021, retrieved from several sources, and selected surveys. We built four groups of leadership position indicators: i) health care according to specialty and region, ii) scientific and professional bodies (presidents and board members of scientific societies, guest speakers at medical congresses according to specialty, medical councils by region) iii) academic career (dean, department head, full and associated professors); and iv) research career (application/concession/financial amount of national projects with public funding). We analyze data using female ratios, calculated as the percentage of women in specific top positions divided by the percentage of women in the relevant population. Results We found a gender bias in all four settings. Disparities emerged both in medical staff and head positions. During the observed period, 76.6% of the presidents of FACME member medical societies were men and only 3 annual congresses had ratios of women speakers higher than 1. Women were over-represented in the lower groups and under-represented in the top academic positions. Only 26% and 27% respectively of the heads of departments and deans were women. The applications for public funding for research projects are led by women in 45% of the cases, with a strikingly low percentage in some modalities of research calls. The budget granted to women in public calls was 24.3% lower than that of men. Conclusion In all the areas analyzed, the leadership positions are still mostly occupied by men despite the feminization of medicine. The severe gender bias found calls for urgent interventions within a defined time horizon. Such measures must concern all levels, from national or regional regulation to changes in organizational culture or incentives in specific organizations. We hope that the WOMEDS project will contribute to making the problem visible for organizations to react proactively.