Table 1.

Some methods to improve gender balance at all levels of critical care medicine

Level	Method to improve gender balance
Institutional	Establish and enforce codes of conduct in universities, hospitals, critical care societies Create institutional diversity working groups Ensure gender balance in committees and as speakers at conferences and scientific events (apply quota if deemed appropriate) Be transparent when developing pathways to promotion
Education	Provide training on gender equity and bias for all ICU professionals, starting at medical school/nursing college Develop a mentorship program to support and encourage junior female staff
Pay gap	Pay men and women equally and publish metrics of salaries and gender diversity in scientific, academic and research activities
Leadership	Ensure women are given the same responsibilities in the workplace as their male counterparts: rounds, seminars, family discussions, etc Promote female intensivists as role models Actively call out to women to apply for leadership roles, e.g., to become ICU director Consider, if not already in place, introducing term limits for leadership positions
Biases* and barriers	Identify and eliminate implicit and subconscious bias to create a safe working environment Provide a supportive, flexible environment for optimal balance between professional and family life for both men and women Provide conditions like maternity leave and in-hospital nursery schools in order to facilitate female intensivists during their early motherhood period Encourage women to apply for grants and awards (possibly by giving them alternately to a male and female intensivist) Develop objective criteria for hiring, evaluation, and promotion to limit effects of implicit and subconscious bias

*For the purpose of this manuscript the meaning of bias is the tendency to prefer one gender over another. It is a form of unconscious bias, or implicit bias, which occurs when one individual unconsciously attributes certain attitudes and stereotypes to another person or group of people