The pursuit of gender equity in GI: ‘We must move together’ with a growth mindset
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This month’s Healio Exclusive highlights an essential dialogue on gender disparities in medicine, particularly in gastroenterology, and the persistent barriers women face in achieving leadership roles.
Despite significant growth in the number of women in the field, the data remain sobering: Women comprise just 21% of practicing gastroenterologists, with far fewer in leadership positions. In the article, Amy Oxentenko, MD, FACP, AGAF, FACG, Rinarani Sanghavi, MD, MBA, and Nancy D. Spector, MD, thoughtfully illustrate how inequities in pay, opportunity and sponsorship fuel this underrepresentation.
‘Scaffolding for Success’
One particularly poignant issue discussed in this article is the “glass cliff,” by which women are placed in precarious leadership roles without adequate support or resources. Success in these roles requires more than a title: It demands preparation, mentorship and tangible support.
As a physician executive leader who has navigated complex leadership transitions and contributed to health system redesigns, I have seen firsthand how critical it is to equip women leaders with the tools, resources and institutional support they need to succeed. Elevating women is just the first step: We must also ensure they have the appropriate scaffolding for success.
The article critiques the traditional norms that often discourage women from applying for leadership or career advancement roles, unless overqualified. Oxentenko’s advice to “apply even if you don’t check all the boxes” is both empowering and necessary. Too often, women fall into the perfectionism trap, waiting to feel perfectly ready before stepping forward.
My message is simple: Go for it. Growth comes from leaning into discomfort and embracing challenges as opportunities for development. None of us are ever fully ready and that’s OK. Progress is better than perfection. Each step forward creates a ripple effect, inspiring others to follow.
Seek Growth Opportunities
The path to leadership requires a growth mindset. In my administrative leadership roles, I have learned that leadership is not about having all the answers: It is about being open to learning, reflection and continuous improvement.
Leadership coaching, mentorship and sponsorship are three essential tools advocated by Sanghavi and are vital for cultivating a pipeline of qualified and confident women leaders. For all aspiring leaders, I offer this advice: Lean into discomfort, seek growth opportunities and cultivate relationships with sponsors and mentors who will challenge you to think bigger.
Ask yourself: Who is pushing me outside my comfort zone? Who is advocating for me when I’m not in the room? These relationships can be transformative.
Keys to Advancing Equity
The compounded inequities faced by women of color are especially concerning. Black women, for example, make up only 2.8% of gastroenterologists, a stark disparity that reflects the broader systemic barriers.
Intersectionality of race and gender must continue to remain central to equity discussions. Representation matters. Seeing women of color in positions of leadership sends a powerful message to those aspiring to follow the same path. It reminds them that their professional goals are valid, their voices are essential and their presence at the table is nonnegotiable.
As Spector emphasized, allyship is critical. Advancing equity cannot fall solely on the shoulders of those most marginalized. True allyship requires intentionality, accountability and action. We must reject the “queen bee” mentality — a mindset by which women in leadership fail to support other women out of fear of losing their status or exclusivity. This behavior weakens our collective strength. Instead, we must embrace the principle of lifting as we climb.
As leaders, it’s our responsibility to recognize and celebrate the talents of others, sponsor them for leadership roles and actively advocate for their inclusion in critical decision-making spaces.
Systemic Change Alone is ‘Not Enough’
Fixing the “leaky pipeline” in medicine requires both systemic and cultural change. Institutions must adopt transparent pay structures, create inclusive hiring practices, establish leadership term limits and implement leadership development programs. I have seen how data-driven decisions can drive change. Systems that track pay equity, leadership diversity and promotion pathways create accountability and momentum for reform.
But systemic change alone is not enough. Each of us must also commit to personal accountability, from how we support and advocate for one another to how we confront unfair norms and model allyship. Our actions set the tone for progress. Leaders at every level should ask: Who am I sponsoring right now? Who have I invited to sit at the table? If you don’t have an answer, it’s time to re-evaluate.
Finally, strategic career planning and negotiating for what you are worth are also important. Empowerment starts with preparation and understanding your professional market value. Knowledge of salary structures, productivity metrics, promotion criteria and skills-level education equips women to advocate for themselves and for each other. This is an area in which mentorship and sponsorship are especially critical.
Our time is now. The pursuit of gender equity in gastroenterology and medicine more broadly requires urgency, humility and collective commitment. This means sharing opportunities, sponsoring others and using our influence to create pathways for those behind us.
We cannot act in silos. We must move together with purpose, courage and a resolve to create a culture of authenticity and support. By letting go of perfectionism, embracing a growth mindset and fostering allyship, progress will continue. And while personal accountability is critical, we also need systemic and policy change.
With this dual approach — individual action and institutional reform — we can ensure that women in medicine not only have a seat at the table but also thrive in these roles.
- For more information:
- Anita Afzali, MD, MPH, MHCM, FACG, AGAF, is the James F. Heady Endowed Chair in Internal Medicine, professor and executive vice chair of clinical operations in internal medicine at University of Cincinnati College of Medicine. She also serves as associate chief medical officer at UC Health and participated in the Executive Leadership in Health Care fellowship program. She can be reached at afzaliaa@ucmail.uc.edu.
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