Perception and Improvisation of Gender Climate in Oncology and Role of International and National Societies
Women constitute nearly half of the world's population and are making great strides in all professions, including medicine. Unfortunately, despite the apparent progress made by women, many women still have to face the elephant in the room, often ignored and unmentioned gender bias, at all stages of their careers.  Oncology is a rapidly expanding specialty with multiple newer advances and research developments. Integration of women oncologists into mainstream oncology, including leadership positions, is vital in developing a gender-diverse oncology workplace. Combining the assets and skills of men and women oncologists to create a harmonious working environment will go a long way toward an inclusive gender climate in oncology.
Women face several challenges in professional development. The last few decades have seen women striving to come out from their traditional “homemaker” and “mother” roles to professional “career women” roles. However, pregnancy and related ramifications are still primarily womens' concerns in some cultures and continue to slow down the growth of many women professionals, in addition to the other societal perceptions. Constant attempts by women have steadily improved the gender climate in several aspects, like the increasing number of medical graduates and senior author publications.   However, the positions of power and leadership are still dominated by males as evidenced by the predominant male senior academic positions, senior/first author publications, leadership and managerial positions, professional society chairpersons, and editorial board leaders.  
This is an unmet need, and fortunately, some global professional organizations are making significant efforts to improve gender parity at all levels. There is a focused interest from international organizations especially from the European Society for Medical Oncology (ESMO), which has a dedicated Women for Oncology (W4O) initiative, exclusively meant to uplift women oncologists. Other organizations like the American Society of Clinical Oncology (ASCO), the Society for Immunotherapy of Cancer (SITC), the Indian Society of Medical and Pediatric Oncology (ISMPO), and the Immuno-Oncology Society of India (I-OSI) are also committed to improving the gender balance. We are at the helm of exciting changes and accelerated progress, with different local networks like the W4O Indian initiative, under the auspices of ESMO W4O.
ESMO has over 250,000 members from 160 countries and has a dedicated support program for all oncologists to support and improve their professional careers. For effective human resource development, the fair inclusion of women into career support programs is essential. Visionary presidents such as Dr. Martine Piccart and Dr. Solange Peters promoted a committee to focus on under-representation of women in leadership roles in oncology. The ESMO W4O committee, initially chaired by Dr. Peters and then by Dr. Garrido, further refined the ideas and continued to work under the ESMO wing.
When she joined Dr. Solange Peters, the second ESMO woman president, noticed that she was one of the very few women on the ESMO Executive Board. There was an overall expectation that there would be spontaneous resolution of the gender gap with more women oncologists. She presented the facts to the ESMO board that women constituted only less than 15% of ESMO board members, 25% of invited speakers at ESMO meetings, and 30% of ESMO committee members, with no significant changes in the past 10 years. The ESMO board took rapid action and initiated conscious attempts to maintain the gender balance in all the ESMO endeavors. Dr. Solange continued her efforts to increase awareness about the gender gap with keynote presentations, national and international networks, and group discussions. When she was the chair of the W4O committee, there was a focus on power-sharing between male and women oncologists to foster gender equality in the workplace. She highlighted the need to overcome conditioned societal beliefs about the professional roles of women and men oncologists. She was pivotal in increasing the participation of women oncologists from other continents like Asia in core committees as an effort to increase workforce diversity and as an ESMO mission to provide equal opportunities to all. Women oncologists themselves may have entrenched bias and subconsciously hold back from taking on leadership positions; ESMO provides the facility for mentorship programs and programs to build confidence and change negative perceptions about women oncologists and enhance the learning to navigate the obstacles in carrier path. There is an opportunity for distant mentorship as well. With the recognition of the significant barriers to the career advancement of women oncologists, ESMO has worked toward better child-care facilities and modification of the age restrictions for women that may block career progression.
Currently, headed by Dr. Pilar Garrido, W4O continues to be committed to alerting the oncology community to the current gender gap, championing women leaders and fostering their careers by collaborating with national societies. Currently, the W4O committee includes representative members from Asia/India and involves male oncologists also, thereby evolving a good network for improving gender parity. W4O, thus, becomes a “hub” for facilitating the local initiatives. In addition to mentorship sessions and a specific W4O fora at ESMO congresses, there are ongoing and completed studies to measure and monitor the gender disparity in the oncology world.     Collaborative work with the national women oncology networks helps bridge the gap between women and men. Tackling gender inequality further, W4O addresses the women issues from the grassroot level by mentorship and roundtable social media discussions that will bring to light the gender gaps at all career levels. W4O tries to encourage female oncologists' good participation in all ESMO academic activities. It appraises the ESMO board about the challenges women face in their careers and works toward the advocacy of women-friendly policies. There is also an annual ESMO Women for Oncology award to recognize the services of people who have significantly worked toward improving gender parity in oncology. ESMO W4O also works toward sensitizing the oncology industry colleagues regarding increasing the number of female principal investigators for funded research projects, an index for the promotion or career progression in most academic institutes.
Oncologists from different countries have started W4O initiatives in their own countries, all working toward collaborative efforts to improve the gender balance in oncology. W4O-Hellas is a distinct non-profit organization working since 2014 in Greece to support women oncologists, help women cancer patients, and encourage cancer prevention activities. W4O-Italy (2018) aims to pave the way for Italian women oncologists to take up leadership positions and overcome gender disparity with special managerial training programs. W4O Italy also collaborates with the other associations supporting women. Spanish Society of Medical Oncology W4O (2019) works to create opportunities for professional development and raises awareness regarding the need for a gender vision before the launch of any scientific initiative. Established in 2020, the Hong Kong W4O (HKW4O) improves communication and networking among women clinical oncologists and medical oncologists. In addition to career support, HKW4O also takes an active interest in women's health, cancer prevention, and care, helping disadvantaged women in the community. W4O-Ireland (W4OIE) aims to improve on the national resources for training and enhancement of women oncologists, and utilise the W4O platform for improving research opportunities.
Under the aegis of ESMO, ISMPO also started an official woman for oncology India initiative (W4O-I) in June 2020, though informal activities were also happening before this time. This initiative attempts to identify and address the challenges women oncologists face in India and support them in career advancement with focused mentorship and training opportunities. By collaborating with other national and international societies, the W4O-I envisages better future oncology gender parity, both at workplaces and in leadership positions in oncology. There are ongoing discussions about policy changes for gender-neutral workplaces and include gender awareness into the curricula/syllabus for Attitude Ethics and Communication modules during primary medical education.
W4O-I encourages gender-balanced participation in ISMPO activities, with dedicated sessions at conferences/meetings and monitors, and reports gender disparity among the oncology community to increase awareness on this issue. W4O-I also provides networking opportunities for women oncologists to collaborate and access better career development opportunities. By becoming more visible, the women oncologists in a leadership role can identify and mentor younger oncologists, grooming them for a leadership role. Similarly, working and networking with senior oncologists provide the younger oncologists a clearer perspective to improving their careers. Societies with women presidents and board members are more likely to have more women members, thus increasing participation, as evidenced by the I-OSI, the only oncology society in India with women as president and secretary.
The ASCO also provides networking opportunities for women oncologists. It has a dedicated “Women in Oncology” blog site to share insights on navigating careers with personal development challenges. ASCO circulated the best blogs later at the ASCO annual conference. Similarly, SITC has started Women in Oncology Network. The networking prospects are essential, especially for young women oncologists at the beginning of their careers.
Artikel online veröffentlicht:
17. Februar 2022
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