A recent cross-sectional study sought to quantify the frequency, nature, and outcomes of workplace gender, racial, and LGBTQIA+ discrimination among US ophthalmologists and trainees.
From May 5 to July 22, 2022, online survey responses were collected from 463 participants across 10 US-based ophthalmology organizations. Respondents—249 women (53.8%), 204 men (44.1%), and 10 who declined to state their gender—were ophthalmologists and trainees, with diverse racial and ethnic backgrounds. Their responses were analyzed for discrimination frequency based on gender, race and ethnicity, and LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, and asexual) status; as well as the consequences, bases, and sources of discrimination; and how discrimination was associated with job satisfaction and progress toward career goals. Results were recently published in JAMA Ophthalmology.
Overall, 41.9% of respondents reported experiencing workplace discrimination, and women were significantly more likely to report discrimination (61.8% of women vs. 19.6% of men). Specifically, pregnancy and maternity-related discrimination were frequently reported (25% and 11.1% of women, respectively). The study included quotes from respondents in this area:
“When I took maternity leave, male and female colleagues said that was ‘naive and selfish,’” one respondent said.
From another, “I was told that it was ‘my own fault for getting pregnant’ and therefore I would be charged overhead during the time I am on maternity leave.”
Men who reported discrimination identified racial or ethnic bias more frequently (61.9% of male cases vs. 17.6% of female cases). Black respondents experienced the highest rates of discrimination (92.9%), followed by Asian respondents (50%).
Common consequences of discrimination included disrespect or passive aggression (34.1%), loss of employment opportunities (18.6%), and misrepresentation (e.g., being mistaken for non-physician roles; 14%). Women exclusively reported income-related discrimination: 23.1% cited reduced pay or benefits. One respondent noted: “When I asked a boss once about salary equality I was told, ‘why worry about it, why does it matter?…your husband also works, so you’re the second income.’” Discrimination was associated with lower job satisfaction (3.9 vs. 4.3 on a 5-point scale) and reduced achievement of career goals (3.9 vs. 4.3).
Younger professionals and trainees reported higher rates of discrimination: 57.5% of trainees and 54.9% of those 6 to 10 years post-training reported discrimination, compared to 28.8% of those 20+ years post-training, while senior faculty were the most frequent source of discrimination (38%), followed by hospital administration (29.5%) and patients (22.5%).
The findings from this study corroborated the results from analyses in Australia and New Zealand, which found that “42.4% of ophthalmologists reported being subject to discrimination on more than three occasions,” that was most commonly perpetrated by other ophthalmologists. Additional “studies have shown an association of female gender with burnout and career outcomes, such as research funding, leadership positions, or conference presentations.”
Targeted interventions are needed to address discrimination in ophthalmology, the researchers concluded. “With increased recognition of the prevalence and outcomes of discrimination in the workplace, ophthalmologists can advocate for policy changes and model appropriate behavior to improve the working environment and promote diversity, equity, and inclusion goals.”
A full list of author disclosures can be found in the published research
