Gender equity

In March 2019, through the work of the Gender Equity Working Group, we released the Gender Equity Position Statement which states our commitment to advocate for gender equity.

To support the Gender Equity Position Statement, we have developed a task-oriented action plan to be delivered over the coming five years.

The action plan aligns with the five key focus areas identified in the resource toolkit, and the ANZCA Strategic Plan (2018-2022). Regular updates on the progress of the plan will be communicated to our members, and tracked via our Professional Affairs Executive Committee.

The Gender Equity Resource Kit contains useful tools and strategies that may be used by trainees, specialist international medical graduates (SIMGs) and fellows, to contribute to gender equity within hospitals or workplaces.

The resource kit may provide guidance and support in these vital areas, which are outside the direct remit of the college. It is structured into five key areas of focus:

• Inclusive and equitable culture.
• Diverse and representative workforce.
• Flexible and empowering workplace.
• Attention to closing gaps.
• Strategic and accountable leadership.

 

We encourage you to download and share the toolkit, and use the gender equity self-assessment quiz to challenge the gender balance and equity practices in your health services, departments and teams. The results might surprise you!

The Gender Equity Sub-Committee has identified aspects of the recruitment process that can be negatively influenced by unconscious bias, particularly gender bias. This includes but is not limited to when fellows participate on panels. Unconscious biases are social stereotypes about certain groups of people that individuals form outside their own conscious awareness relating to gender, ethnicity, age and other parameters. The Unconscious bias and interview panels toolkit provides an introduction to unconscious bias and how this might impact decision making in the context of participation in an interview panel. The toolkit offers practical guidance on best practice for facilitating an interview and includes a range of resources and links to training and further education.

Top ten tips for avoiding bias on interview panels:

1. Develop an understanding of unconscious bias.  The Unconscious bias and interview panels toolkit’s resources are an excellent starting point for this.
2. Everyone holds some sort of biases. Familiarise yourself with what your own biases might be by taking some of the free online test referred to in the toolkit.
3. Create a diverse interview panel who are involved in all stages of recruitment.
4. Develop a position description and selection criteria that welcome a diverse range of applicants.
5. Be consistent and mark applicants against the panel’s pre-defined selection criteria.
6. Have a pre-interview planning meeting for the panel. Encourage all panel members to speak up if they are worried about biased behaviour.
7. Ask all candidates the same questions, based on the selection criteria. 
8. Practice using substitution to avoid biased decision-making.  For example, “would I have developed the same concerns about this candidates family commitments, if they were of a different gender?”.
9. Have a post-interview meeting for the panel to debrief and reach a consensus together.
10. Be conscious of situations which potentiate bias: tiredness, rushing and groupthink or the desire to not to upset the balance of a group of people.

The Gender Equity Sub-Committee (GESC), like all college committees advertises and promotes positions on the committee through an expression of interest process.  Applications are sought, welcomed and encouraged from all members of the college.  This process has been followed from the early days as a working group through to the current sub-committee status.  
 
If you are interested in learning more about the work of the GESC, would like to talk though how to be involved in some of our initiatives or are considering joining the sub-committee, please email us at membership@anzca.edu.au 

The college has made a commitment to regularly report on gender metrics, as part of the Gender Equity Action Plan (2018 – 2022). The following figures were collated in 2020 and provide an overarching view of gender metrics across the college for 2019. These will be updated biennially.

Please note, that historical gender data has been collected under the terms “female” and “male” with the college updating its terminology to include non-binary options in 2020. For the purpose of these statistics “male”, “female” and “other” will be utilised until which time the college can obtain updated data to more accurately reflect our members gender.  

Historical gender imbalances in the specialities of anaesthesia and pain medicine are decreasing as more women continue to enter the training program annually and those retiring are predominately male. In 2019 females made up forty eight percent of those accepted into ANZCA’s training program while only eighteen percent of ANZCA’S retirees for that year were female.

With the current gender equity movement at a societal level and the college’s commitment to gender equity, the results are evident and far-reaching. Nevertheless it could still be many years for the imbalance to reach near parity, with the bulk of mid-career fellows being men.

Leadership

With leadership being one of the focus areas of the Gender Equity Action Plan, we are pleased to report a significant rise of representation of females in this area in recent years. Not only is this helping close the gender gap, it is giving women more of a voice in anaesthesia. Four of the seven Directors of Professional Affairs in the college are currently women along with the Executive Director of Professional Affairs.

Since 2008, five of seven ANZCA presidents have been women, while comparatively, FPM have had two women deans in this time, demonstrating the necessity for the college to continue its work in advocating for gender equity.
 
Leadership behaviours typically adopted by women are critical to create diverse leadership teams. Representation of women on ANZCA Council and FPM Board showed a favourable improvement from 2018 to 2019 with an increase on council of nine per cent (from 29 per cent to 38 per cent) and on the bard of seven per cent (from 31 per cent to 38 per cent). Pleasingly, these figures bring us to parity or higher in a previously male dominated area and accordingly brings diversity of skills, experiences and opinions that is not achievable without significant representation of both genders.
 


An increase in the presence of female supervisors of training (SOT) over the past two years has been recorded. Currently the percentage of female SOTs is slightly greater than the percentage of female FANZCAs overall. In other words, roughly a third of ANZCA fellows are female but half of supervisors of training are female.




Women are occupying 24 per cent of the heads of department positions for ANZCA and 21% for pain medicine. This figure has remained relatively consistent over the last few years as women strive to obtain this type of role.



Despite so many wins, issues of concern still persist regarding disparities between the sexes. Parental leave makes up 40 per cent of the applications for interrupted training (up from 29 per cent in 2018), yet for both years only 1 per cent of these applications were from males. As women are continuing to take the majority of the parental leave, their career progression is significantly impacted which leaves them at risk of being left behind in regards to achievement and merit. (For information around interrupted training, including the application form, please contact the college’s interrupted training officer at training@anzca.edu.au.)
 
The college is committed to supporting women in this area by advocating for both a flexible and empowering workplace. Our action plan states our commitment to workplace policies and management practices that enable gender equity in part-time work, primary and secondary parental leave and other flexible work practices to support fellows at this stage of their career.

Committee positions
 ANZCA has made significant inroads with increased representation of women on committees. Females now hold 51 per cent of ANZCA committee positions as opposed to 37 per cent in 2018 and a considerable increase from 28 per cent in 2018 to 46 per cent in 2019 for FPM. This is an outstanding achievement, and one which we are very proud of.
 
Female representation on regional committees has increased slightly from 37 per cent to 41 per cent however female regional committee chairs have decreased by four percent from 29 per cent to 25 per cent in 2019. As a whole, female committee chairs have increased from 23 per cent to 29 per cent.

   

   

CPD
The CPD activity that demonstrates the largest difference by gender, is visible in the Workplace-Based Assessment (WBAs) of trainees at 12.11 per cent from 2018 and 12.25 per cent in 2019 weighted to females. This appears to indicate the WBA responsibilities are more likely to be undertaken by females as opposed to males. The reasons for this is likely to be multifactorial. There are differences in type of location of employment (teaching hospital/ non-teaching public/ private). It may also be a reflection of total hours worked (full-time/part time). In general it suggests that CPD activities may be weighted towards hospital department type of work versus a weighting towards private/VMO practice for males.
 
Research
​The number of women leading research grant projects has risen by nine per cent since 2017. This is a pleasing result that we hope to see continue to rise as women are supported in this area and other leadership roles.



Specialist International Medical Gradates
Females make up 44 per cent of active SIMGs for ANZCA and there are currently no female SIMGs for FPM.



New fellows
​In 2019, 45 per cent of new ANZCA fellows admitted to the college were female (and 39 per cent for FPM). These figures give us hope that parity is in sight, yet we must not rest on our laurels just yet, there is still much work to be done for gender equity to be embedded as part of business as usual in the selection and training of future anaesthetists



We will continue to collect statistics to create an understanding of where inequities lie. Please continue to use the resources available such as the Gender Equity Resource Kit and Gender Equity Self-Assessment Quiz. The college and members of the Gender Equity Sub-committee are constantly working on projects to help this cause such as promoting awareness of unconscious bias, undertaking a gender related survey and promotion of International Women’s Day.
 
Let’s work together to choose to challenge inequity and continue the journey to improve gender equity in our speciality and our broader society.

For further information please contact Membership Services.

You may have some questions about what gender equity really means in the context of anaesthesia and pain medicine; how this impacts you as a member; or how you go about creating change in your hospital. Or you may want to know more about what we are doing and how. We’ve compiled a list of frequently asked questions to help explain our gender equity work in more detail or alternatively view the video complication of fellows answering these questions here.
 
What is gender equity?
The Gender Equity Sub-committee defines ‘equity’ in terms of its goal of providing everyone with the full range of opportunities and benefits to achieve equity, that is ‘the same finish line’. Equality is the effect of treating everyone fairly without difference; each individual is considered the same without measuring or comparing their attributes to others.
 
What is intersectionality?
Intersectionality is the complex, cumulative manner in which the effects of different forms of discrimination combine, overlap, or intersect (Merriam Webster dictionary). Intersectionality is the sum of its parts, meaning that the inequality resulting from one area of discrimination is compounded when other areas of discrimination overlap. This results in greater inequity. For example, Indigenous women are grossly under-represented in professional roles in Australia and Aotearoa New Zealand.
 
Is a merit based approach an appropriate way to ensure equity?
The Cambridge English Dictionary defines meritocracy as “a social system, society, or organisation in which people get success or power because of their abilities, not because of their money or social position.” Whilst this approach appears unbiased on first glance, it does not take into account inequities which affect merit – for example, taking time for parental leave increases the time it takes to achieve a designated level of merit. Determination of merit must take into account the inequities to which the individual has been exposed.
 
How does gender equity inform workplace practices in relation to part time and flexible work practices?
Gender equity seeks to develop empowering workplaces for all staff to allow maximum flexibility in workplace roles without causing detriment to career opportunities. Gender equity provides this by encouraging part time rostering, flexible work hours and leave conditions. Gender equity seeks to improve outcomes for all genders by making these conditions available to all staff and particularly by encouraging and supporting its uptake by all.
 
How can I promote gender equity?
The first step toward promotion of gender equity is to recognise the value of diversity within the workplace and encourage discussion and open communication to raise awareness. Being open to viewing your workplace through the lens of diversity is a crucial first step, along with empowering staff to consider diversity within their departments, hospitals and networks. Learn more about how to enact change in our resource toolkit.

Are women supported to return to work while breastfeeding?
ANZCA and FPM fully support the rights and needs of women who return to work while breast-feeding a position that reflects the law ^{1, 2} and contemporary thinking and research on gender equity and inclusion and diversity, more broadly ^3..

Breastfeeding is a physiological process and pumping of breast milk may be essential for the health and wellbeing of breastfeeding women and their infants. The college's expectation is that workplaces will provide support for breastfeeding and pumping, which would reasonably include dedicated space (separate to bathrooms), reasonable break time, and recognition by colleagues that needs vary between women. This also includes the use of wearable breast pumps in theatre, as human breast milk is not recognised as a bodily fluid requiring universal precautions.⁴  

The provision of safe anaesthesia and pain medicine procedures is paramount, and requires close clinical observation and assessment by a vigilant anaesthetist a standard that assumes their continuous presence ⁵. Consequently, provisions should be made to schedule pumping breaks at times when they do not have clinical responsibilities for patients, which may involve scheduling appropriate arrangements for breaks and handover.

Workplaces need to ensure adequate provision of resources to facilitate continuous direct clinical monitoring of anaesthetised patients. However, ANZCA recognises that in exceptional circumstances brief absences from the operating theatre are unavoidable. Hospitals and theatre staff should recognise and support clinicians who may face such circumstances. The anaesthesist may leave if they determine it necessary, taking into account all relevant factors such as the risks and benefits to the anaesthetised patient at that particular point in time, the availability (or otherwise) of another specialist, suitably trained and competent nurse or technician to stay with the patient, and their capacity to commit to an appropriately brief absence and to remain close by in order to return immediately, if required.

References and further reading

1. Australian Government Fair Work Ombudsman, Returning to Work from Parental Leave, Breastfeeding in the Workplace.  Accessed February 2023 
2. Employment New Zealand, Breastfeeding at Work. Accessed February 2023.
3. ANZCA, Gender Equity Position Statement. Accessed February 2023.
4. Centre for Disease Control and Prevention Breastfeeding FAQ. Accessed February 2023.  
5. ANZCA,PS18 Guidelines on Monitoring during Anaesthesia. Accessed February 2023
6. American Academy of Family Physicians Foundation. Breastfeeding and Lactation for Medical Trainees. Accessed February 2023  

Browse our Gender Equity Libguide for an extensive range of journal articles, books, links and other resources on all things gender equity.

Women are underrepresented at conferences and meetings. Particularly as invited speakers, panellists, and convenors but also, in some cases, as delegates.

At the 2019 ANZCA Annual Scientific Meeting (ASM), 32 per cent of speakers were female and the 2020 ASM was due to be even more promising with 44 per cent of speakers being female, however the ASM was cancelled due to COVID-19. 

We have been pro-active with this issue by promoting, mentoring and actively advocating for gender balance at conferences and in leadership opportunities. We encourage conference convenors to review their speaker lists with gender balance in mind.

We also provide family/carer-friendly facilities where possible, to support speakers and delegates who are caring for children.

The ANZCA panel pledge is based on an initiative of Male Champions of Change and Chief Executive Women, national groups which work with influential leaders to redefine men’s role in taking action on gender inequality. 

Too many panel appearances and speaking engagements are offered to men, too few to women. This imbalance means that audiences are getting a narrow perspective and the quality and diversity of conversations and experiences are limited. We ask that willing participants take the following pledge. 

I stand for gender diversity at every forum.

When you're invited to speak at or participate in a professional forum:

• Request confirmation of who the other panellists/speakers/participants are, and how gender balance will be achieved.
• Request that as a condition of acceptance, you expect women to participate in a meaningful way.
• Reserve the right to withdraw from the event should this not be the case when the speaker list is finalised.
• Offer names of women from within your organisation or network and, if helpful, point them to resources for support in finding women.

 

Panel pledgers at the STEMM Breakfast, 2019 Annual Scientific meeting in Kuala Lumpur.

If you'd like to add your name to the growing list below by formally taking the pledge, please email us with you name, college ID, and the pledge “I stand for gender diversity at every forum”.

Dr Anisa Abu Baker Dr Leinani Aiono-Le Tagaloa Dr Salam Al-Khoury Dr Vanessa Beavis Dr Andrea Binks Dr Julia Birch Dr Dane Blackford Dr Kimberley Browne Dr Roger Browning Dr Kerryn Bunbury Dr Neroli Chadderton Dr Elaine Chilcott Dr Charles Chilvers Dr Alan Ch'ng Dr Chui Chong Ms Majella Coco Dr Simon Collins Dr Clara Cotaru Dr Meredith Craigie Ms Monica Cronin Dr Lucky De Silva Dr Edward Debenham Dr Monica Diczbalis Dr Bridget Effeney Dr Nigel Fidgeon Dr Clare Fisher Mr Adam Fitzgerald Ms Laura Foley Dr Dean Fulford Ms Kate Galloway Dr Ian Graham Dr Genevieve Goulding Dr Neil Hauser Mr Maurice Hennessy Dr Charles (Yan) Ho Prof Harriet Hopf Dr Sofia Huddart Mr John Ilott Dr James Jarman Dr Simon Jones Dr Micheal Jones Ms Nadja Kaye Dr Alison Kearsley Assoc Prof Ross Kerridge Dr Emma Lansbury Dr Brian Lee Dr Ken Lee Dr Min-Qi Lee

Prof Kate Leslie Dr Jenny Liddell Dr Susie Lord Dr Angus Loraine Dr Scott Ma Dr Adele MacMillan Dr Jack Madden Dr Stuart Marshall Dr Timothy Marshall Assoc Prof Nolan McDonnell Dr Sean McManus Dr Rebecca McNamara Ms Heather Ann Moddie Dr Bruce Newman Dr Ann Ngui Dr Michelle O'Brien Prof Philip Peyton Assoc Prof Nicole Phillips Dr Georgina Prassas Dr John Prentice Dr Natalie Purcell Dr Lindy Roberts Dr Nigel Robertson Dr Sancha Robinson Dr Peter Roessler Dr David Rowe Dr Matt Rucklidge Dr Allanah Scott Dr Aylin Seven Dr Prani Shrivastava Ms Jaspreet Sidhu Ms Hannah Sinclair Assoc Prof Marcus Skinner Ms Teri Snowdon Prof David Story Dr Cara Thomson Dr Savas Totonidis Dr Christine Vien Dr Jana Vitesnikova Dr Radha Vivekananthan Assoc Prof Leonie Watterson Ms Gabby White Dr Chris Wilde Assoc Prof Deborah Wilson Dr Maggie Wong Dr Jennifer Woods Dr Mark Young

Watterson Ms Gabby White Dr Chris Wilde Assoc Prof Deborah Wilson Dr Maggie Wong Dr Jennifer Woods Dr Mark Young

In accordance with the ANZCA’s commitment to being an equal opportunity employer and our compliance requirements under the Workplace Gender Equality Act 2012, the college lodged its annual compliance report with the Workplace Gender Equality Agency (Agency) on 16 June 2020.

A copy of this report which can be accessed here indicates what policies, strategies and work practices the college has in place to ensure our staff are able to access and enjoy the same rewards, resources and opportunities regardless of their gender.
 
For more information on the Agency and reporting requirements under the Workplace Gender Equality Act 2012, please visit the website. 

The Gender Equity Sub-committee released a third iteration of a seminal gender research survey on 11 May 2022. The survey was open for four weeks and examined the impact of gender on the professional lives of Australian and New Zealand based fellows. 
 
The first iteration of the survey was run by Dr Diana Khursandi on behalf of the Australian Society of Anaesthetists in 1993, and the second by Dr Catherine Ashes and Dr Natalie Smith in 2010.

The recent survey built upon the previous versions to further explore job satisfaction and work composition.  It was sent to approximately 15 per cent of the fellowship, selected at random, and received a response rate of 39 per cent which will provide a meaningful sample to analyse the data.

We thank all who participated, and look forward to being able to share the results of this research at the combined SIG meeting in September.

The researchers behind the three gender equity surveys mentioned spoke to us earlier in the year for International Women’s Day 2022.  Watch the videos here.