Women's professional development programs for emergency physicians: A scoping review

Abstract

Background

Gender disparities in emergency medicine (EM) persist, with women underrepresented in leadership positions and faced with unique challenges, such as gender discrimination and harassment. To address these issues, professional development programs for women have been recommended.

Objectives

The purpose of this scoping review was to examine current women's professional development programs for EM and develop a collection of program characteristics, meeting topics, and tips for success that can be useful to new or existing women's professional development programs.

Methods

The authors systematically searched research databases for literature detailing current women's professional development programs for EM physicians. Studies detailing professional development programs for female physicians in EM were included.

Results

After 149 unique articles were screened, 11 studies met inclusion criteria, describing 10 professional development programs for women in EM. The most commonly cited program objectives included providing mentors and role models (n = 9, 90%), offering career advice and promoting professional advancement and leadership skills (n = 5, 50%), increasing academic recognition for women (n = 4, 40%), and promoting work–life balance and integration (n = 2, 20%). The most common topics covered in program sessions included mentorship and coaching, compensation and/or negotiation, leadership skills, and career advancement and promotion. Challenges and barriers to the success of these programs included a lack of funding and support, difficulty in recruiting participants, lack of institutional recognition and support, lack of time, and difficulty in sustaining the program over time.

Conclusions

The study's findings can inform the development of programs that promote gender equity and support the advancement of women in EM.

BACKGROUND

Gender disparities in medicine have long been recognized as a significant issue. ¹ Physicians who are women are underrepresented in emergency medicine (EM), particularly in leadership positions, and face unique challenges in their careers. Even though roughly half of medical school graduates are women, women are less likely to select EM as their specialty and less quickly promoted and make less money than men in EM. ²

To overcome the issues of representation of women in EM and leadership positions within the specialty, leaders from the Academy of Women in Academic Emergency Medicine (AWAEM) and the American Association of Women Emergency Physicians (AAWEP) recommended multifaceted programs to increase representation, advocacy, and equity. They suggested that such programs may include mentorship, funded networking activities, membership in gender‐specific organizations and conference travel, and institutional advocacy. ³ Additional suggestions for program activities included bias, allyship, and microaggression response training; feedback for trainees focused on tangible actions rather than personality traits; and creation of policies that promote leadership role parity, career flexibility, salary transparency, and paid parental leave. ⁴ Using a modified Delphi approach, a team of experts identified key metrics for women's professional development groups and arranged them into four categories: gender equity, sustainability, financial, and acclaim. ⁵

Prior work demonstrates that women's professional development groups provide an organized support structure for women and can contribute to gender equity–related organizational transformation. ⁶ A range of professional development programs have been developed specifically for women in EM. These programs aim to provide support, mentorship, and networking opportunities for female physicians as well as to promote gender equity and address the systemic barriers that prevent women from advancing in their careers. ⁷

This scoping review will provide an overview of the existing literature on professional development programs for female EM physicians, including the types of programs available, the programming and topics covered, and the challenges and barriers to their implementation. Our research question is “What are the common practices of women's professional development programs for EM physicians?” The topic lends itself well to a scoping review as this is a broad question on an emerging topic, with most available literature on women's professional development programs being from the past decade. We also aimed to identify gaps in the literature and develop suggestions for future research.

METHODS

We used the Arksey and O'Malley ⁸ framework for scoping reviews as well as the PRISMA Extension for Scoping Reviews (PRISMA‐ScR) as a guide throughout the research and reporting process. ⁹ The review protocol is detailed below. Institutional review board approval was not obtained for this study, as the scoping review incorporates published articles publicly accessible through medical literature databases and does not fall under the definition of human subject research.

The research question

After a preliminary review of available literature, and discussion with several experts on gender disparities in medicine and scoping reviews, we narrowed the research question down to “What are the common practices of women's professional development programs for EM physicians?” We aimed to describe program characteristics including mission, leadership, educational content and topics covered, meeting frequency and location, evaluation, participant inclusion, and barriers to program success. We chose to keep the topic narrowed to EM because women remain underrepresented and only 39.4% of active residents in EM are female. ¹⁰ Furthermore, excelling in the field of EM requires unique leadership skills and work–life integration patterns given the clinical environment and shiftwork schedules.

Search strategy

We searched the published peer‐reviewed literature using PubMed, CINAHL, and MedEdPORTAL. We included the CINAHL database in our search as we wanted to allow for inclusion of interdisciplinary programs which included a focus on physicians as well as other health professionals. We conducted the search on September 27, 2022, with the assistance of a librarian and included all literature published in English before this date. The search terms are provided in the Supplemental File S1.

Eligibility criteria (inclusion and exclusion criteria)

Studies were included for review if they provided the details of one or more professional development groups for female physicians in EM. For the purposes of this study, we defined a professional development group as a collective of individuals within an organization or industry who come together to improve their skills, knowledge, and expertise in their respective field or industry and may also advocate for their profession. We used the terms female and women to include any person identifying as such. Exclusion criteria included meta‐analyses, systematic reviews, scoping reviews, opinion pieces, and studies in which the participants were not women physicians in EM and/or did not describe a specific professional development program.

Study screening and selection

All studies found on initial screening were uploaded in Covidence (Veritas Health Innovation, Melbourne, Australia) and duplicates were removed. Two authors (RD, SF) screened each study by title and abstract for inclusion. Discrepancies were resolved through full‐text review by the same two authors (RD, SF) to determine inclusion for final analysis. In the case of discrepancies following full‐text review, a third author (BAAW, formally trained and experienced in qualitative analysis) made the final decision. References from each included article were reviewed to ensure literature saturation but did not yield any additional studies for inclusion.

Data charting process

We developed a data extraction tool through an iterative process by first performing a pilot extraction using the results of three exemplar studies and then revised the tool through consensus. Two authors (RD, SF) independently extracted data from each study using Covidence. Attempts were made to contact the original authors in the cases of missing data. Extracted data from each study included program objectives, program leadership, funding, additional resources available for participants, meeting location and frequency, participant demographics (specialty, gender, academic rank), program evaluation methods and results, attendance, educational activities/methodologies, meeting themes, and barriers to program success.

Three authors (RD, SF, BAAW) performed an inductive content analysis via group consensus to identify themes related to meeting topics, program barriers, and suggestions to overcome those barriers. Any discrepancies within themes were evaluated by a third author (BAAW). All extracted data were organized into three charts: a program demographics table, a table of meeting topics, and a collection of barriers identified to program success and suggestions to overcome these barriers. Data were edited for concision.

RESULTS

The authors identified 149 studies after removing duplicates. After eligibility screening, 23 articles went through full‐text review. Three articles were reviewed by the third author for discrepant opinions on inclusion, and of those three articles, one was included and two were dropped. Eleven studies describing 10 programs were ultimately included in the scoping review (Table 1). Two included articles described the same program, and data from these articles were pooled. ⁷ , ¹³ A PRISMA diagram illustrating the inclusion and exclusion of studies can be found in Figure 1.

TABLE 1.

Program demographics.

Study No.	Author, year	Program objectives	Program leadership	Funding	Additional resources for participants (e.g., online repository, website)	Meeting characteristics (location, frequency)	Participants (specialty, gender, academic rank)	Program evaluation and results	Attendance	Activities/educational methodologies
1	Welch 2012 11	Provide mentors and role models for female faculty and residents. Offer career advice and networking. Promote work–life balance and integration. Provide emotional support. Address the challenges of gender bias. Facilitate nominations of qualified women for honors and awards. Offer avenues for collaboration in scholarly activities.	A group of faculty at a single institution; additional mentors were recruited from academic and community physician alumni via an established email listserv.	Besides a one‐time workshop grant, there was no designated departmental or institutional full‐time equivalent faculty support or funding.	Website and group listserv to enhance communication.	Most sessions were 2 h, scheduled in advance every other month. Sessions occurred in a relaxed environment such as a cafe or faculty member's home. Children and guests were welcomed at most meetings.	72 female faculty and residents, with a ratio as high as 1:3, at a single academic center. Female alumni were also invited.	Anonymous electronic survey of program participants: 46/72 participants completed the survey (64% response rate). 40/46 (87%) reported that the program provided mentors and role models. Program was valuable (average, 4.65 on a 5‐point Likert scale). Members created a new, paid family‐leave policy for all of the more than 800 faculty physicians in our institution's practice plan, and the policy research performed resulted in a publication. Established dedicated lactation space in the EDs at two hospitals. Actively nominating women for awards resulted in 2 departmental, 2 institutional, and 1 national award for female faculty and residents. Two women in the program were the first in their academic department to achieve promotion to associate professor.	Meeting attendance ranged from six to 35 participants.	Vertical mentoring, peer mentoring, role modeling. Small‐group discussions, workshops. Curricular topics were derived from the literature on women in medicine and rotated on a yearly cycle.
2	Bhatia 2015 12	Provide tailored educational and mentorship programs targeting residents.	Women faculty.	“Low cost”; institution's office for women's careers cosponsored an event.	Online resources including institutional resources, information about challenges women in academics encounter, and educational articles about skills including public speaking, interviewing, and teaching techniques. A list of potential female faculty advisors including alumni, external physicians from local hospitals, and physicians outside EM.	Held in the evening.	Female residents within a single academic institution.	Event evaluations (n = 24): 81.8% of senior residents said that the events provided them with mentorship and insight into life as an academician that they have not received elsewhere. 76.4% of attendees said the events provided skills and insight to better inform their practice choice and prepare them for academics	Over two‐thirds of women residents have attended each evening event.	Interactive sessions. A theme and corresponding article were used to focus discussion with faculty, who offered experiential expertise.
3, 5	Lin 2019 7 Sethuraman 2019 13	Support the recruitment, retention, advancement, and leadership of women in academic EM. Facilitate academic advancement through scholarly productivity, leadership experiences, awards, and promotions; mentorship and sponsorship; peer support and collaborations; reduced professional isolation; and initiatives to address systemic gender inequities and challenges, including strategies to navigate bias, promote pay equity, and advocate for family‐friendly workplace policies. Enable members to overcome barriers to senior rank. Propel curricular, organizational, and policy changes that improve academic EM.	Executive Committee for Academy of Women in Academic Emergency Medicine (AWAEM), a group within SAEM. This committee consists of nine faculty and one resident members.	$100 annual membership fee (some years).	Sponsorship for promotions through a letter‐writing bureau. Online modules. Formal national awards initiative. National leadership experience. Bimonthly newsletter.	Monthly virtual meetings. One 4‐h in‐person session.	350 academic EM physicians of varying career stages throughout the United States.	Annual formal survey and informal program evaluation. Bimonthly newsletter read regularly by >90% of the membership.	Virtual attendance ranges from 20 to 60 and in‐person attendance ranges from 50 to 150.	Mentorship, sponsorship, collaboration. Networking and didactic activities. Faculty development sessions.
4	Parekh 2019 14	Provide a support system, mentorship, and networking opportunities for female EM residents, fellows, and faculty Promote professional advancement and leadership skills Conduct educational programming pertinent to female EPs Community outreach Advocacy for female physician representation in department leadership and lactation space	Two faculty leaders	Funded by the department chair		Eight annual activities, including three topical dinners	Female residents and attendings at a single academic emergency department	Kirkpatrick's model was used and participants were surveyed. All scheduled events were successfully completed. 20/20 (100%) of the female faculty strongly or very strongly supported the program.	40/42 (95%) of female faculty and residents attended at least one event and 38/42 (90.5%) attended more than one event.	Topical dinners, group discussions, seminars, volunteering, holiday‐themed events, wellness week. Curriculum created via Kern's six steps of curriculum development. 21 Mentoring events.
6	Sunga 2019 15	Enhance skills and confidence in presentation abilities for women speakers Raise academic recognition for women through external speaking engagements	One organizing faculty member; one external faculty mentor (a highly regarded speaker); one dept. chair who committed to her faculty's participation	Funded by the department; books are reusable for future years; mentors were volunteers	FOAMed videos and books for self‐directed learning	Video chat sessions	4 female faculty physicians at an academic emergency dept, recruited based on leadership roles and/or research experience, from intentionally diverse career stages and presentation portfolios	Participants reported improved speaking skills, confidence, and drive to present externally		Speaker development program based on: Self‐directed book and FOAMed video learning assignments on presentation theory. Participants independently created and then individually delivered their presentations at departmental Grand Rounds, which were recorded, and video chat feedback sessions helped to review two at a time. Participants submitted and delivered lectures in any external setting.
7	Khatri 2020 16	Address challenges faced by female physicians and support the recruitment and retention of female residents. Improve awareness of and develop skills relevant to gender disparities in mentorship, speakership and conference representation, compensation, evaluations, wellness and service, and award recognition. Foster community, inspire mentorship, elevate awareness of gender bias. Create policies for breastfeeding, family leave, and sexual harassment.	Female EM residents and attending physicians at an academic institution; formed via a bottom‐up approach with resident leaders, supported by faculty sponsors, engaging junior residents early on to facilitate future leadership roles.	Funded five residents to attend a national conference; financial faculty supportership; plan to solicit alumni donations, fundraise, and negotiate with department chair for time buy down for program leadership.	Awards working group to nominate female residents and attending physicians for local and national awards. Ideas gathered during meetings were disseminated to all EM physicians via email.	1‐ to 2‐h events at varied locations. Wellness events were child‐friendly. Some sessions were open to male colleagues.	Female residents and faculty members; one citywide event included five residency programs. Some events included male colleagues.	Nominated five residents and two attending physicians for professional organization awards (four nominees won). More female residents attended and presented at EM conferences than in prior years.		“Speed dating” introductory event. Workshop with a professional speaking coach. Discussion panel, journal club, small‐group discussions. Fitness events such as dance and yoga classes. Volunteering to cook a meal together for the guests of a winter shelter. Monthly female faculty dinners to promote mentorship and wellness at the faculty level.
8	Marshall 2020 17	Enhance social support, leadership training, and professional mentorship and networking opportunities. Cultivate solidarity and mentorship among female residents, alumnae, and faculty.	Two female attending physicians, three female resident physicians.	Two female faculty members split the cost of each event.		Six evening events annually, 2–3 h each. Hosted in participant homes or restaurants.	Female residents, faculty, and alumni of a residency training program.	An anonymous, online survey was sent to participants using a SWOT (strengths, weaknesses, opportunities, and threats) format: 32/43 (74.4%) completed the survey. All respondents were female, with 40.6% residents, 37.5% faculty, and 34.4% alumnae. Themes relating to the “strength” domain included: (1) creating a dedicated space. (2) networking community. (3) building solidarity. (4) providing forward guidance.	35/48 (73%) of eligible participants attended one or more events.	A professional development activity at each meeting. Maintaining unstructured time for social interaction and networking. Kern's six‐step approach to curriculum development.
9	Lee 2021 18	Establish a cross‐institutional consortium to promote career advancement, academic productivity, peer networking, and work–life integration for women faculty. Address challenges of gender inequities and career advancement for women in academic EM. Prior initiatives at these hospitals had goals to increase academic productivity, address departmental concerns such as parental leave policies and breast‐feeding resources, community outreach, advocacy for greater equity in the promotion process.	Volunteer faculty from each of four sites (at least two per site) as site champions, which was a formally recognized leadership role.	Combined resources between four hospitals; initial funding was committed from each department chair and used to provide for speaker's fees and food as needed.	Information sharing about institutional policies. Sponsorship at regional organized conferences. Manuscript writing.	One to four annual events at varying times across the four hospital sites.	80 women EM faculty at four hospitals affiliated with one medical school, including 28 instructors, 40 assistant professors, 12 associate professors, and 0 full professors.	Postworkshop surveys.	Meeting attendance varied from 11 to 43 members.	Seminars, workshops, networking dinners, conferences, lectures. Iterative cycle framework of “identify, learn, develop, and assess” —core focus areas via informal needs assessments at all the sites. Topics for consortium events were chosen annually by consensus.
10	Chumpitazi 2022 19	Address salary and leadership disparities in PEM. Provide mentorship and sponsorship opportunities. Assist in career development.	Women in PEM Career Development Subcommittee, American Academy of Pediatrics (AAP) Section on Emergency Medicine Women in PEM Committee (composed of 10 PEM physicians throughout the United States, from various career stages and academic ranks).				Women physicians at varying career stages, including academic ranks from instructor to professor.			Developed with an intersectional approach that addresses the overlapping systemic disadvantage resulting from other forms of discrimination.
11	Li‐Sauerwine 2022 20	Establish a mentorship group for women faculty and residents (Resident and Female Faculty Tribe, RAFFT). Serve as a form of value signaling for residents, faculty, and prospective applicants, conveying to all that advancement of women in EM is part of our academic mission. Professional development for women in academic EM.	Self‐selected planning group of five faculty and four chief residents.	Funded by the Sam Kiehl III Ohio State University Emergency Medicine Resident Wellness Endowment.	Session‐related reference materials (e.g., published articles, audio and video resources) and a discussion guide for the chosen topic.	Ten monthly sessions, in person or virtually. Alternating days and evenings to facilitate attendance.	22 faculty/fellows and 18 residents in the sample year at a single academic center.	Participants were surveyed: Out of the 24 survey participants who attended at least one session and completed the pre‐ and post‐surveys, most participants reported a positive benefit, with respect to professional development (79.2%), job satisfaction (83.3%), professional well‐being (70.8%), and personal well‐being (79.2%). Several participants provided a postsurvey free‐text response indicating positive impact on their sense of community within the department.	39/51 (76%) of eligible women attended at least one session.	Curricular sessions were led by faculty and residents (including some planning members from program leadership and some nonplanning member volunteers). Flipped‐classroom model. A planning group identified potential curricular topics using an iterative Delphi process.

Abbreviation: PEM, pediatric emergency medicine.

FIGURE 1.

PRISMA diagram.

Program objectives

The most commonly cited program objectives included providing mentors and role models for female‐identifying faculty and residents (n = 9, 90%), offering career advice and promoting professional advancement and leadership skills (n = 5, 50%), increasing academic recognition for women (n = 4, 40%), and promoting work–life balance and integration (n = 2, 20%).

Study population

In all 10 studies (100%), program leadership involved faculty attendings, and in three additional studies (30%) the leadership included women residents. Participants in most studies (n = 7, 70%) included female faculty at varying career stages, residents, and in some cases, residency program alumni. Two programs consisted of only female faculty, and one consisted of female residents only. Most programs were based at a single institution or residency program (n = 6, 60%). Two programs (20%) held regional events, including participants from multiple hospital sites in the same city. Two programs (20%) were national programs based in American societies for EM or pediatric EM. Program size varied from four participants to 350. Although no groups included men as participants of the program, one invited men to some events.

Program design

Meeting frequency varied among programs. Most programs reported between four and 10 meetings per year. The settings varied from cafes and restaurants to faculty members’ homes. A few programs held live virtual sessions (n = 3, 30%), including one program whose sessions were exclusively virtual. Programs also organized wellness events that were children and guest friendly. Meeting attendance varied from program to program, with attendance rates as low as six participants and as high as 150 participants recorded. Activities varied among each group and included networking dinners, didactics, faculty development sessions, journal clubs, speaker development programs, fitness events, volunteering, and workshops.

Resources

Asynchronous resources were provided by most groups (n = 7, 70%), some of which included listservs to enhance communication and mentorship for female EM physicians. Several programs (n = 4, 40%) also included a repository of books for self‐directed learning; educational articles about challenges faced by women in academics; and skills integral to academics such as public speaking, interviewing, and teaching techniques. Two groups (20%) included awards nomination committees to increase academic recognition for members.

Funding

Funding differed from program to program. Four women's professional development programs (n = 4, 40%) were funded by the department(s), while other programs were funded by enforcing an annual membership fee (n = 1, 10%), a grant or endowment (n = 2, 20%), alumni donations (n = 1, 10%), or faculty splitting the cost (n = 1, 10%). Three programs (30%) mentioned planning free or inexpensive events or advocating for a budget to the chair or department to ensure ongoing support.

Program evaluation

Program evaluation methods varied. Seven (70%) programs used reaction surveys, including a SWOT analysis. A few programs administered surveys after each event (n = 2, 20%). One group (10%) conducted interviews with past and present leaders to elicit themes and modes of improvement for the upcoming year. Several groups also measured program outcomes in the forms of participant award nominations and winners, participant promotion, and institutional policy creation.

Program outcomes

Though programs used varying outcome measures to evaluate their programs, several themes arose within their data. Overall, program participants reported increased mentorship, increased recognition, and improvements in their sense of community, job satisfaction, and well‐being.

In one program, 81.8% of senior residents said the events provided them with mentorship and insight into life as an academician that they have not received elsewhere. ¹² In another program, 87% of the members who responded to the survey reported that the organization provided mentors and role models. ¹¹

Actively nominating women for awards within one program resulted in two departmental, two institutional, and one national award for female faculty and residents. ¹¹ In another program, nominating five residents and two attending physicians for professional organization awards resulted in four awardees. ¹⁶

In one program aimed to enhance presentation abilities, participants reported improved speaking skills, confidence, and drive to present externally. ¹⁵ From the program that sent a SWOT analysis, the themes related to the “strength” domain included creating a dedicated space, networking community, building solidarity, and providing forward guidance. ¹⁷ Many participants of one program commented that their program had a positive impact on their sense of community within the department. ²⁰ They also reported a positive benefit with respect to personal development (79.2%), job satisfaction (83.3%), professional well‐being (70.8%), and personal well‐being (79.2%). ²⁰

Curriculum planning and topical analysis

Regarding curricular planning, two groups used Kern's six‐step model for curriculum development, ²⁰ two groups focused curricular topics based on literature, one group identified curricular topics using an iterative Delphi process, and one used an iterative cycle framework of “identify, learn, develop, and assess.”

By far the most frequently encountered topic was on mentorship and coaching (n = 8, 80%). This was followed by compensation and/or negotiation (n = 5, 50%), leadership skills (n = 5, 50%), and career advancement and promotion, including interviewing skills (n = 5, 50%). (Table 2).

TABLE 2.

Topics.

Topics	Articles a
Mentorship, sponsorship and/or coaching	1, 2, 4, 6, 7, 9, 10, 11
Compensation and/or negotiation	2, 3, 7, 9, 11
Leadership skills	2, 5, 7, 9, 10
Career advancement and promotion, including interviewing skills	2, 7, 9, 10, 11
Wellness	4, 5, 7, 10
Research skills	2, 7, 8, 9
Teaching skills including presentation design and public speaking	2, 6, 7, 10
Finances	4, 8, 10
Networking	1, 8, 9
Work–life balance or work–life integration	2, 9, 11
Teamwork and communication	2, 9, 10
Time management	4, 9, 10
Advocacy skills	5, 10
Community service	7, 10
Evaluations/feedback	7, 10
Diversity, equity, and inclusivity	9, 10
Clinical skills including efficiency	10, 11
Imposter syndrome	11
Stress management	1
Award recognition	7

^a Article numbers correspond to the study number designations within Table 1 that included the listed topics.

Barriers to program implementation and suggestions to overcome

Several barriers to program success were identified, including attendance, inclusion and optics, funding, sustainability, and assessing impact on participants (Table 3). Authors made suggestions to address these barriers, such as alternating days and evenings to facilitate attendance, including male colleagues who can help encourage and promote the women's professional development group, fundraising and soliciting alumni donations for funding, identifying resident leaders in each class year to build a governing body, and expanding the mentorship pool by recruiting alumni or joining with national organizations. Some programs suggested providing asynchronous learning credits, planning in advance, or having specific dates scheduled off from clinical duties for female residents who were on ED rotations.

TABLE 3.

Barriers identified and suggestions to overcome.

Barriers identified	Suggestions to overcome a
Attendance	4, 7, 8, 9, 11—Alternating days and evenings to facilitate attendance (i.e., postconference, early evenings, breakfast events); varied venues (on campus, in houses, at restaurants); involve children. 2—Providing asynchronous learning credits. 4—Advanced planning; review of the clinical schedule to select session dates/times when the fewest female physicians were working. 6—Small cohorts within the women's groups to help with scheduling issues. 8—More structure to the events, to prevent redundancy and defaulting to vent sessions. 8—Female residents were scheduled off from clinical duties, with the exception of those on off‐service rotations.
Inclusion/optics	2, 7, 8—Organize events that include nonfemale colleagues; identify male allies who can encourage and promote these events. 4—Ensuring inclusivity and not focusing solely on motherhood; resident inclusion. 8— Including nurses and male physicians at occasional sessions.
Sustainability	1,7—Mentorship pool: Expanding a female mentor pool by recruiting alumni and using a mosaic of vertical and peer mentoring; join with national orgs. 2, 7—Leadership turnover: Identify resident leaders at each level of training to build a pipeline, identify both senior and junior faculty members to serve as faculty leaders, encourage negotiations with department chair to allow clinical time adjustments for faculty members who take on a robust leadership role. 9—Meeting professional and personal needs of all participating individuals (because the consortium includes faculty at all career stages); evaluating consortium activities to adapt programming for evolving faculty needs. 9—Codifying the governance structure to ensure sustainability (different leadership roles within the group); establish a formal leadership structure with titles and term limits and compensated time for consortium leadership. 9—Recommend use of site champions for local recruitment and event organization.
Funding	7—Plan free or inexpensive events, attending physician sponsorship, alumni fund, fundraising events; ask for discounts on activities for residents. 6, 9—Budget with ongoing sponsorship; advocate for budget to chair/department; combine resources across several institutions.
Assessing impact on participants	11—Survey completion rates limit evaluation of program impact. 11—Further data need to be collected on whether longitudinal participation across all training years of our program would alter the program's impact on participants. 11—Track progress in collective faculty recruitment, retention, advancement, and work climate over time.

^a Article numbers correspond to the study number designations within Table 1 that discussed suggestions to overcome the above barriers.

Several groups reported sustainability as a barrier for reasons such as leadership turnover, difficulty meeting the needs of all group members, creating and maintaining structure within the group, or small mentorship pool. To overcome these barriers, groups mentioned identifying resident leaders in each class year to build a governing body or including junior and senior faculty. One of the studies mentioned monitoring and evaluating group activities to adapt programming as needed to cater to each member and expanding the mentorship pool by recruiting alumni or joining with national organizations.

Only one study mentioned the barrier of assessing impact on participants. It reported that survey completion rates limited a true evaluation of the program's impact on the members. As a result, the program plans to track progress of faculty recruitment, retention, advancement, and work climate longitudinally.

DISCUSSION

This scoping review provides a descriptive review of practices of women's professional development programs in EM. We identified 11 studies that described 10 programs for final analysis, which is quite low. This may be due to the fact that programs and research are still emerging in this area, and funding that supports research in gender equity in EM is limited to a handful of organizations.

The most cited program objectives included providing mentors and role models for female‐identifying faculty and residents, offering career advice and promoting professional advancement and leadership skills, and raising academic recognition for women. Evidence has shown that mentorship is a key component of women's success, advancement, and satisfaction in medicine. ²² Mentorship is critical because it can provide the informal guidance and knowledge that is unique to each department or system to help women navigate unseen challenges. We also found that raising academic recognition for women was frequently cited. Despite some progress in closing the gender gap in national award recognition for women in EM, women are still proportionally underrepresented as award winners when compared to men. ²³ An equitable award structure would signify value and could help women in EM work toward equitable promotion and retention. These program objectives may provide guidance to new and developing women's professional development programs for EM physicians.

Regarding program reach, most programs were based at a single institution or residency program and several were regional or national. There are benefits and disadvantages to each model. Institutional programs may be better equipped to advocate on the local level but may suffer additional resource limitations and cultural barriers. A benefit of larger national organizations may be combined reach, centralized efforts, and greater backing for advocacy. Specific specialty‐related topics, such as work–life balance, may be best discussed in a group of physicians within the same specialty. Certain aspects of the EM work environment such as shiftwork, overnight and holiday shifts, unpredictable work schedules, and the physically demanding nature of our work can uniquely impact EM physicians’ work–life balance. Additionally, faculty at different career stages have different needs and goals with respect to career advancement and may benefit from programs that are specific to early‐, mid‐, or late‐career faculty. Therefore, there may be no one‐size‐fits‐all program, and programs need to be positioned appropriately for their stated mission.

Common curricular topics included mentorship and coaching, compensation and/or negotiation, leadership skills, and career advancement and promotion. These topics are important, given that recent studies have demonstrated that academic women emergency physicians hold fewer leadership roles and are paid less than men emergency physicians. ²⁴ Women's professional development programs have been shown to result in higher promotion and retention rates and other positive outcomes. However, experts caution that such programs can serve as a signal that women are “deficient and need fixing … when deployed in the absence of any broader effort to advance women and without accountability from managers and leaders.” ²⁵ We must be mindful of the messaging that these programs send and ensure that advocacy efforts and meaningful national, institutional, and departmental policy changes that ensure equitable opportunities for advancement for women are also employed.

Several challenges and barriers to the success of women's professional development programs in EM were identified, including a lack of funding and support, difficulty in recruiting participants, lack of institutional recognition and support, lack of time and scheduling conflicts, and difficulty in sustaining the program over time. Regarding funding, only 40% of programs were funded by the department, 20% by grant or endowment, and the remainder relied on funding from participants, faculty, and program alumni. This lack of funding was cited as a barrier to program implementation and continued success, and requiring women participants to pay for the events when they're already underpaid compared to men will further increase the income gap among men and women. The need for institutional or departmental funding is highlighted as well as compensation for titled roles within the programs that can support program sustainability and longevity. ¹⁸

Attendance was cited as another common barrier to program success, and this may be due to the shiftwork nature and need for 24/7 staffing of the emergency department. Authors suggested alternating time of day, advanced planning with protected time from clinical duties, and improved events with more structure and continuing medical education credits for participants. The suggestions provided to overcome these barriers to success may be useful to other programs.

As noted above, the number of studies included for final analysis was quite low. We employed a strict set of inclusion criteria. It should be noted that several national programs exist for the broader women in medicine community, such as those at the American Association of Medical Colleges (AAMC), the American Medical Women's Association (AMWA), and the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM® program). ²⁶ , ²⁷ , ²⁸ , ²⁹ , ³⁰ Although these programs were excluded because the published studies do not specify the specialties of physician attendees, the objectives of these programs appear similar to those described in our included studies.

This study provides valuable insights into the practices and research about current women's professional development programs for EM physicians that can guide the creation of newer programs. Santhosh et al. ³¹ describe strategies for forming an effective women's group broken down into four steps: (1) formation of a group including target audience selection, objective setting, and stakeholder engagement; (2) early stages including culture setting and structured programming; (3) advocating for institutional change; and (4) sustaining the group. Many of the included programs describe taking similar steps in their development. The findings can inform the development of programs that address the unique challenges faced by female physicians in EM, promote gender equity and inclusion, and support the advancement of women in leadership positions.

LIMITATIONS

The limitations of this study include lack of gray literature inclusion, which includes conference presentations, for which the inclusion of these was not feasible. While Society for Academic Emergency Medicine (SAEM) and American College of Emergency Physicians (ACEP) abstracts are published, they are not indexed at the subject level in reference databases, such as PubMed. Therefore, searching for abstracts in these sources would be quite resource‐intensive, and the information in abstracts may not be dependable, given these are not peer‐reviewed.

We are also aware that there may be programs that exist for which the research is in progress and the results of our scoping review may change if we were to repeat the search in the future. Despite our best efforts to contact the original authors, there are also missing data from some of the programs that we were unable to include in Table 1.

Another limitation of our review is that the included programs focus on physicians who practice in academic institutions, while many female EM physicians practice in community settings. This limits the generalizability of the review.

FUTURE DIRECTIONS

Future studies are needed to collect information on women's groups that have not been published, evaluate alignment of program characteristics to assessment data, and investigate the impact of including male and nonbinary colleagues in group activities. Additional research is needed to evaluate programs using outcome metrics, which can be based off the WOMENTUM Modified Delphi Study and can guide the development of “best practice” recommendations. ⁵ Lastly, further research can also compare educational frameworks and methodologies for this use purpose and compare the structure and efficacy of EM programs to programs from other specialties.

CONCLUSIONS

In conclusion, this scoping review highlights the importance of women's professional development groups in providing mentorship, career advice, and professional development opportunities for female faculty and residents. The study identified various challenges and barriers that these groups face and provided suggestions on how to overcome them.

By creating opportunities for women to connect with mentors, network with peers, and advocate for themselves, we can help address the systemic barriers that prevent women from reaching their full potential in the field of medicine.

AUTHOR CONTRIBUTIONS

Stacey Frisch and Bobbie Ann Adair White conceived the study and designed the study. Stacey Frisch performed the literature review. Stacey Frisch, Riddhi Desai, and Bobbie Ann Adair White extracted and analyzed the data. Stacey Frisch and Riddhi Desai drafted the manuscript. Stacey Frisch, Riddhi Desai, Arlene S. Chung, Jennifer S. Love, and Bobbie Ann Adair White interpreted the data and contributed to manuscript revision.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

Supporting information

Data S1:

Data S2.

Frisch S, Desai R, Chung AS, Love JS, Adair White BA. Women's professional development programs for emergency physicians: A scoping review. AEM Educ Train. 2024;8:e10971. doi: 10.1002/aet2.10971