Survey highlights gender and racial disparities in ophthalmology

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Investigators from The Vision Center at the Children’s Hospital Los Angeles, and the Roski Eye Institute, Keck School of Medicine, University of Southern California, both in Los Angeles, reported that, based on their recent study, discrimination is prevalent among US ophthalmologists, with gender-based discrimination being reported most frequently.

The study was led by first author Shreya Sirivolu, BA, who is affiliated with both institutions.

The authors conducted a cross-sectional study to determine the frequency, nature, and outcomes of discrimination experienced by ophthalmologists and trainees in the US, because they pointed out that little is known about discrimination among ophthalmologists in the US in contrast to other countries.

To conduct their investigation, the researchers collected anonymous online survey responses from ophthalmologists and ophthalmologists in training from 10 US-based ophthalmology organizations between May 5 and July 22, 2022.

The main outcome measures were the frequency of discrimination based on gender; race and ethnicity; lesbian, gay, bisexual, transgender, queer, intersex, and asexual status; the bases, negative consequences, and sources of discrimination; and the association of discrimination with job satisfaction and achieving career goals, they explained.

Survey findings

A total of 463 participants responded to the survey, of whom 53.8% were women; 41.9% of respondents reported having experienced discrimination.

The investigators reported, “Women more commonly encountered discrimination based on gender than men (73 of 108 [67.6%] versus 2 of 21 [9.5%], for a difference of 58.1 percentage points (95% confidence interval [CI], 42.7-73.4 percentage points] (P < 0.001).

Over and above gender, pregnancy (27 of 108; 25.0%] and maternity (12; 11.1%) were the most frequently cited bases of discrimination among women.

Other sources of discrimination were race or ethnicity, which was reported more frequently by men, 61.9% versus 17.6% by women, a difference of. −44.3 percentage points (95% CI, −66.3 to −22.3 percentage points; P < 0.001).

The negative consequences of discrimination reported by the survey participants were disrespect or passive aggression (44 of 129; 34.1%), loss of employment opportunities (24 of 129; 18.6%), and misrepresentation, for example, for a nurse, janitor, or other profession (18 of 129; 14.0%). Another negative consequence, loss of income, was reported only by women (25 of 108; 23.1%).

Participants who reported at least 1 episode of discrimination described significantly lower job satisfaction than those who did not (3.9 [1.0] versus 4.3 [0.8] on a scale of 1-5, where 1 indicated very dissatisfied and 5 indicated very satisfied. This represented a difference of −0.4 (95% CI, −0.7 to −0.2); P < 0.001). These participants also experienced lower achievement of current career goals (3.9 [1.1] vs 4.3 [0.8] on a scale of 1-5; difference, −0.4 [95% CI, −0.6 to −0.2]; P < 0.001).

The investigators concluded, “This study suggests that discrimination remains prevalent among ophthalmologists in the US, with gender-based discrimination being reported most frequently. Discrimination was negatively associated with income, employment opportunities, job satisfaction, and achievement of career goals for respondents.”

The researchers also pointed out that as a result of the increased recognition of the prevalence and outcomes of discrimination in the workplace, ophthalmologists are in a position to advocate for policy changes and model appropriate behavior to improve the working environment and promote diversity, equity, and inclusion goals.

Reference:

1. Sirivolu S, Pike S, Reid MW, et al. Discrimination within the US Ophthalmology workforce. JAMA Ophthalmol. Published online December 5, 2024; doi:10.1001/jamaophthalmol.2024.5139