Introduction

Obstetrics and gynaecology (O&G) is the medical and surgical specialty providing specialist women’s healthcare. Beyond clinical practice, trainees and specialists involved in obstetrics and gynaecology are also involved in research, advocacy, policy development, education and leadership. In Australia and New Zealand the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is the training and accreditation body for obstetrics and gynecology (1). RANZCOG also leads Australia and New Zealand in women’s health advocacy and policy development.

Historically RANZCOG has had a masculinised membership. However in line with other medical specialties (2), significant feminisation has occurred over the last two decades (3). Females make up 46% of RANZCOG specialists and 80% of RANZCOG trainees in 2017 (4). This means obstetrics and gynaecology is now one of the most feminised medical specialties, both in Australia and internationally (2, 5-8). Despite this feminisation a gender leadership gap is apparent at a national level for RANZCOG (9), with only one of the current RANZCOG national board female, and only one female college president since RANZCOG inception in 1998. This lack of female representation within leadership positions is also apparent at an international level (10-14).

The ‘pipeline argument’ holds that after enough time elapses, leadership should reflect trainee gender cohorts, even if historic gender leadership gaps have existed (15-17). This argument would assume that 20 years is sufficient time for specialists to advance to career positions at which promotion to leadership positions is common (18). Despite this, RANZCOG has a persistent gender leadership gap within its national board (9). This gender leadership inequity is increasingly being challenged by the broader O&G membership, with a growing focus on advancing women in leadership (19). No publication has reported the gender of those in leadership positions in the broader RANZCOG landscape or associated Australian and New Zealand institutions.

Why does all this matter? #

Currently disparity exists between the gender of the RANZCOG board and that of the broader membership of RANZCOG. This challenges the ‘authenticity’ of RANZCOG’s leadership representation. Gender leadership inequality also highlights the ethical consideration of social fairness that demands gender equality in leadership (20).

Within the general literature diversity in leadership, especially gender diversity, has been associated with improved health outcomes and improved organisational performance (21-27). Beyond these health and organisational outcomes, there is also an acknowledgement that authentic gender equity will not be achieved without a societal commitment of equal opportunity, including all societal institutions (28).

Although diversity in medical school and specialist training programs has improved, the ‘pipeline’ to leadership positions in most medical specialties for women and minority groups is ‘leaky’, with few women or minorities reaching the top (15, 29-34). In her past role as president of the Australian and New Zealand College of Anaesthetists, Professor Kate Leslie applauds the suggestion that leadership should model gender and racial diversity rather than merely reflecting it (16).