Focus on Diversity Boosts Number of Women Speakers at ISC

LOS ANGELES, CA—A concerted effort by the American Heart Association/American Stroke Association (AHA/ASA) and the program planning committee of the International Stroke Conference (ISC) successfully increased the number of women who were invited as speakers at the 2019 meeting, a new study shows.

Between 2014 and 2018, only 28% of invited speakers at the annual stroke meeting were women, but that number jumped to 47% in 2019, Anjail Sharrief, MD (McGovern Medical School at UTHealth, Houston, TX), reported at the ISC here last week.

A particularly large gain in the proportion of women was seen among physician speakers—increasing from 17.7% in 2014-2018 to 37.9% in 2019.

“It’s important for . . . the [meeting] committees to acknowledge the disparities and enhance focus on diversity among speakers, and this influences change,” Sharrief, director of stroke prevention for the UTHealth Institute of Stroke and Cerebrovascular Disease, said during her presentation. “Increased opportunities to speak at major scientific conferences for women may help to address factors that contribute to gender differences in academic advancement and promotion.”

She noted, however, “that more work must be done to increase speaker diversity by race and country, and across different presentation categories.”

Women Underrepresented in Multiple Areas

It’s known that at the faculty level in neurology, men exceed women in terms of academic positions, rank, and number of publications. The proportion of women is highest among assistant professors (47%), falling to 38% among associate professors and 21% among full professors, according to Sharrief.

Speaker lineups at meetings are also male-dominated, she pointed out. As reported at ISC 2019 by Sharrief’s colleague Lauren Fournier, MD (McGovern Medical School at UTHealth), women made up only about one-quarter of invited speakers in the prior 5 years of the meeting despite representing 37.7% of all attendees, with no changes over that span. Representation was particularly problematic when it came to physician speakers and women from racial/ethnic minority groups.

It’s important to have different perspectives and different lenses through which we look. Anjail Sharrief

The ISC program planning committee encouraged Sharrief’s team to look into the issue, and between 2018 and 2019, put a focus on increasing diversity among speakers and recruiting more qualified women to present. At the 2019 meeting, ISC included a mentoring lunch for women and a special event around women’s issues in stroke, and at this year’s meeting, there were even more programming activities around women’s issues, Sharrief said.

To find out if those efforts had an impact, Sharrief and her colleagues obtained data from the American Heart Association/American Stroke Association on invited speakers who presented at the 2019 meeting.

The gains in the proportion of women speakers from 2014-2018 to 2019 seemed to be evident across various academic-degree categories, although numbers were small for certain categories.

Women were more likely to be invited for debate in 2019 than in the prior 5 years (37.5% vs 13.1%) and to be invited to speak in the acute, in-hospital care category (39.8% vs 19.0%). Of the speakers who presented more than once in 2019, 46% were women, an improvement over the 21.3% rate seen in prior years.

Increases in the proportion of women were also seen across racial/ethnic categories, with substantial jumps among whites (32.7% to 48.2%) and Asians (20.0% to 41.2%). There were apparent improvements among Hispanic and African-American women as well, although overall numbers of speakers from these groups remained small.

Geographically, female representation was improved among speakers from North America and Europe, but speakers from other parts of the world remained less common. There were no female speakers from Africa.

“I think there’s still work to do in terms of further diversity,” Sharrief told TCTMD.

Importance of More-Diverse Speakers

Sharrief said that having a more diverse lineup of speakers at major medical meetings is important for a number of reasons. For one, it makes for better science, because there are issues in stroke that differentially affect women and people from racial/ethnic minority groups. “It’s important to have different perspectives and different lenses through which we look,” Sharrief said. “So by having a diversity of speakers presenting you really are looking things from different perspectives.”

Then, on a professional level, data presented by Sharrief’s colleague, Pamela Zelnick, MD (McGovern Medical School at UTHealth), showed that even women account for half of medical students, they remain less likely than men to go into neurology or vascular neurology. “If we want to continue to attract the brightest and the best students and residents, then we have to show that there are opportunities for them in leadership, and having opportunities to speak at conferences gives people opportunities for leadership within the organization but also for academic advancement,” Sharrief said.

To that last point, she noted that contributions to science and recognitions of achievement are important when it comes to being promoted. “Being invited to conferences [is something] that you can list there as being evidence of peer esteem, evidence that you have had an impact on a national/international level,” Sharrief said.

Thus, it’s important to continue to track diversity among speakers and report the findings, and ensure that the leaders of the AHA/ASA and ISC maintain their focus on the issue every year so the gains are not lost, Sharrief said, adding that it seems they are committed to doing so.

Bruce Ovbiagele, MD (University of California, San Francisco), a co-author on Sharrief’s study and ISC program committee chair in 2017 and 2018, told TCTMD that it’s “gratifying to see that in such a short period of time things seem to have improved—maybe because we’re highlighting it more—but it would be nice to have a systematic way of making sure that is always the case and a way of obviously measuring later on to see if the effect is actually sustained.”

The key to ensuring a lasting effect is the “attention factor,” he said, noting that Louise McCullough, MD, PhD (McGovern Medical School at UTHealth), who was vice chair of ISC 2019 and 2020 and will be chair of the meeting for the next 2 years, has a number of strategies she wants to incorporate. One, for example, is making sure each invited speaker panel has at least one woman. He noted that inviting more women is one thing, but ensuring that the speakers who actually attend the meeting are more diverse is another. McCullough, he said, has promised to intensify efforts to replace women who decline invitations with other women whenever possible.

“The ASA is definitely doing a lot to make sure that there are more ‘womanels’ and not ‘manels,’” Ovbiagele said.

What Sharrief takes away from this look into representation of women at the ISC is that “change can happen if we think to look and see where the differences are. Diversity is important for many reasons.”