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Systematic review of interventions to improve gender equity in graduate medicine
  1. Sinéad Lydon1,2,
  2. Emily O'Dowd3,
  3. Chloe Walsh3,
  4. Angela O'Dea4,
  5. Dara Byrne1,2,
  6. Andrew W Murphy3,
  7. Paul O'Connor1,3
  1. 1 School of Medicine, National University of Ireland, Galway, Ireland
  2. 2 Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
  3. 3 Department of General Practice, National University of Ireland, Galway, Ireland
  4. 4 Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
  1. Correspondence to Dr Sinéad Lydon, School of Medicine, National University of Ireland, Galway, Ireland; sinead.lydon{at}


Women are substantially underrepresented in senior and leadership positions in medicine and experience gendered challenges in their work settings. This systematic review aimed to synthesise research that has evaluated interventions for improving gender equity in medicine. English language electronic searches were conducted across MEDLINE, CINAHL, Academic Search Complete, PsycINFO and Web of Science. Reference list screening was also undertaken. Peer-reviewed studies published between 2000 and March 2020 that evaluated interventions to improve gender equity, or the experiences of women, in academic or clinical medicine were reviewed. Dual reviewer data extraction on setting, participants, type of intervention, measurement and outcomes was completed. Methodological rigour and strength of findings were evaluated. In total, 34 studies were included. Interventions were typically focused on equipping the woman (82.4%), that is, delivering professional development activities for women. Fewer focused on changing cultures (20.6%), ensuring equal opportunities (23.5%) or increasing the visibility or valuing of women (23.5%). Outcomes were largely positive (87.3%) but measurement typically relied on subjective, self-report data (69.1%). Few interventions were implemented in clinical settings (17.6%). Weak methodological rigour and a low strength of findings was observed. There has been a focus to-date on interventions which Equip the Woman. Interventions addressing systems and culture change require further research consideration. However, institutions cannot wait on high quality research evidence to emerge to take action on gender equity. Data collated suggest a number of recommendations pertaining to research on, and the implementation of, interventions to improve gender equity in academic and clinical settings.

  • human resource management
  • medical education & training
  • general medicine (see internal medicine)

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  • Twitter @sinead_lydon, @poc_doctor

  • Contributors All authors contributed to the design of the study. EO conducted the electronic searches. SL, EO and PO conducted the reference list screening. SL, EO, CW, AO and PO completed data extraction, coding and synthesis. EO and CW assessed the methodological rigour of included studies. All authors contributed to the analysis and interpretation of the resulting data. SL drafted the initial manuscript and all authors contributed to revising and refining it. All authors reviewed and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.