Abstract
Background and study aims
There are far fewer female, independent endoscopic retrograde cholangiopancreatography
(ERCP) practitioners than men in the UK. This study aimed to explore what lies behind
the disparity by examining the current state of training, attitudes, and other factors
that may influence trainees’ decision to pursue ERCP training, with a view to identifying
modifiable factors.
Methods
Anonymized responses to an electronic survey distributed to gastroenterology trainees
and independent ERCP practitioners in the UK were collected and analyzed.
Results
Of 214 respondents 45% were female. Whereas gender distribution in non-hepatobiliary
therapeutic endoscopy was balanced, only 29% of ERCP trainees were female. Eighty
percent of those who worked less than full time (LTFT) were female, but 32% felt that
LTFT was incompatible with ERCP training. Concerningly, one-quarter of female respondents
reported that they had been discouraged. It was noted that females are often treated
differently within endoscopy units, including by patients. Fifty percent of females
indicated that radiation exposure affected their decision to train in ERCP, compared
with 22% of males. A question specific to trainers revealed that 95% felt that male
gender was associated with increased confidence. In free-text responses, valuable
insights into trainees’ personal experiences were provided, and a selection is presented.
Finally, strategies to redress the gender imbalance are proposed.
Conclusions
Gender disparity in HPB endoscopy exists and is stark. Underlying this are attitudes,
assumptions, and environmental factors that will require systemic and sustained correction.
Ideas about how to address this challenge need to be explored.
Keywords Pancreatobiliary (ERCP) - Quality and logistical aspects - Training - Quality management
Bibliographical Record
