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RANZCOG sets gender equity targets

Melissa Sweet
Wednesday, October 16, 2019

Women's health, Workforce matters, #RANZCOG19

(This post has been updated with tweets and commentary from the report’s launch)

The medical specialty dedicated to women’s health is taking steps to tackle male dominance in leadership positions within its professional body, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).

Amy Coopes, who is covering the College’s annual scientific meeting in Melbourne for the Croakey Conference News Service, reports below.

Amy Coopes writes:

A series of targets designed to boost female representation at the highest levels of the Royal Australian and Zealand College of Obstetricians and Gynaecologists (RANZCOG) will be announced today, with the launch of a landmark report acknowledging bias and stereotypes have locked out women and minority groups.

Dr Vijay Roach, President of the RANZCOG, will launch the Gender Equity and Diversity Working Group’s inaugural report in an address at the College’s annual scientific meeting in Melbourne, where more than 1,000 delegates have gathered from across the two countries.

RANZCOG was put on notice about its poor gender equity record at last year’s meeting, when obstetrician Dr Kirsten Connan delivered a forensic, impassioned analysis and call to arms, urging affirmative action to correct a startling imbalance in College leadership.

While an interim quota targeting two additional women to the RANZCOG board is among recommendations contained within the Working Group’s report, targets are largely preferred as the mechanism to drive change.

These include:

Women should account for at least 40 percent of the RANZCOG Board, with a matched target of 40 percent males to safeguard balance over the longer term (no timeframe specified)
Thirty percent of College examiners should be female by 2021, reaching 40 percent in 2022
Women should be at least 30 percent of speakers at College-affiliated events by 2021, rising to 40 percent in 2022 and 50 percent in 2023.

Signalling intention

Ahead of the report’s launch, Roach told Croakey: “Rather than quotas, which are either difficult or impossible to meet, by setting a target – something that’s aspirational – we are signalling very strongly what our intention is and what our thought process is.”

Connan, who as Working Group deputy chair co-authored the report, said it was a “forward step and I am pleased that RANZCOG is having this conversation”.

“The question now is whether the report will result in authentic action,” Connan told Croakey.

“I believe for that to happen we now need the broader membership to keep the Board accountable with the [Working Group] recommendations.”

While the Working Group was genuinely committed to advancing equity in the College, Connan said this sentiment was not shared by all RANZCOG members.

“Now is the time for all of our membership to acknowledge the issue, embrace the data, recognise the benefits, and be a part of the change that will shape our College and women’s health, benefiting all,” she said.

In producing the report, RANZCOG become the first medical college in Australia to engage with the government’s Workplace Gender Equity Agency.

Despite 83 percent of College trainees being female and gender parity existing at many other levels of the organisation, there is just one woman on the Board, and this has historically always been the case.

In the history of O&G in Australia, just two women have held the office of president – one since the inception of RANZCOG in 1998, and another in the 40 years preceding conglomeration with New Zealand, when RANZCOG was known as RACOG.

“RANZCOG has the highest percentage of female members in comparison to other Australian and New Zealand medical colleges, yet one of the lowest percentages of women in top-level leadership,” the report states.

As recently as 1978, the College was overwhelmingly dominated by men, with 95 percent male membership, prompting a concerted drive to address the imbalance.

RACOG was the first medical college in Australia to introduce part-time training, and by the turn of the millennium 60 percent of O&G trainees were female. Male trainees hit 40 percent that year, and have steadily declined ever since, reaching 20 percent in 2018. The reasons for this are unknown, and warrant further investigation, according to the report.

Systemic issues

It is clear that systemic issues are at play, impacting not only women but also minority groups, including Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, international medical graduates and the LGBTQIA community.

The report states:

RANZCOG acknowledges that barriers, including implicit bias and current stereotyped leadership styles, may have impeded leadership opportunities for women and other minority groups.

These barriers have restricted training opportunities for some members of RANZCOG, reduced opportunities for some members to participate in RANZCOG events and participate in their workplace, and affected participation for some RANZCOG employees.”

While gender equity is the first priority of the Working Group, focus in the longer-term will be on increasing representation of minorities, and addressing their needs.

The report notes that, to achieve population parity, Australia needs to have 3,000 Indigenous doctors, a vast increase on the current level of 200, of whom only two fellows and six trainees are in O&G.

In Aotearoa/New Zealand, just four percent of doctors are Maori and two percent are Pacific Islander, compared to 15 percent and seven percent respectively as a proportion of the population, and RANZCOG has just six Maori fellows or trainees.

Number of Aboriginal, Torres Strait Islander and Māori FRANZCOG trainees 2019

Naming bias

The roadmap suggests RANZCOG consider using blinded resumes in trainee selection and expand and formalise flexible work, job sharing and parental leave arrangements in partnership with employers.

It also calls on hospitals and other medical workplaces to address gender imbalances in leadership and actively educate doctors on implicit bias.

It makes a number of recommendations around the transparent and consistent measurement of performance, the guarantee of paid parental leave without detriment to employment, and equal pay.

Citing work by Dr Helena Teede, the report notes that gender equity is a systemic issue in medical leadership, with women comprising just 30 percent of deans, chief medical officers and college board or committee members, and just 12.5 percent of tertiary hospital CEOs.

It highlights capacity bias (women are seen as less capable due to family and domestic responsibilities), perceived capability bias (women’s confidence in their ability to lead) and credibility bias (linking of leadership credentials to traditionally male values) as some of the issues at play.

It highlights some of the work done in recent years at other specialist Colleges on this issue, set out in the table below. This includes the adoption of a 40 percent quota for female leadership in the Victorian branch of the Australian Medical Association, and a 40 percent target for the federal leadership of the AMA.

Weighing up the evidence for quotas versus targets, the report notes that the latter have been adopted as the Workplace Gender Equity Agency’s preferred approach, and while they take longer to show results, offer more discretion and flexibility.

Quotas work quickly and can be transformative, but invite the perception of tokenism and may be seen as conflicting with merit-based appointments, the report says.