Sex-Related Differences in Speaker Introductions at Ophthalmology Grand Rounds.

Abstract

Purpose: Sex bias remains a pervasive reality in academic medicine, often reflected in subtle linguistic choices, which can skew perceptions of competence and perpetuate workplace inequity. This study aims to investigate the relationship between host sex, speaker sex, and speaker introduction practices in ophthalmology grand rounds events.

Design: Cross-sectional study.

Methods: Publicly accessible videos of English-language ophthalmology grand rounds and other teaching events uploaded by academic institutions in the United States and Canada from January 2019 to June 2024 were analyzed by two independent reviewers. The primary outcome was the proportion of male and female speakers introduced with the formal title "Dr." by the event host. Secondary outcomes included the proportion of male and female speakers introduced with their academic degrees, current academic appointments, awards or achievements, and research interests. Univariable and multivariable logistic regressions adjusted for the speaker's degree type(s), academic appointment, and affiliation were performed using Stata v17.0.

Results: Of 1,450 videos screened, 399 speaker introductions across 298 ophthalmology teaching sessions were analyzed. The formal title "Dr." was employed by the event host in 75.2% (n = 300/399) of speaker introductions. In multivariable analysis, female speakers were significantly less likely to be introduced by their formal title (OR = 0.55, 95% CI: 0.25-0.78, P < .001), academic degrees (OR = 0.61, 95% CI: 0.35-0.97, P = .03) and their awards or achievements (OR = 0.62, 95% CI: 0.35-0.95, P = .04) compared to male speakers. Interaction terms between speaker and host sex were significant for formal title use (P = .03) and academic degrees (P = .04), prompting subgroup analyses by host sex. Findings were consistent when stratified by male hosts, while there was no difference in the likelihood of introducing male or female speakers with their formal titles, academic degrees, or awards/achievements when introduced by female hosts. Female speakers were significantly more likely to present on nonclinical topics compared to male speakers (OR = 2.39, 95% CI: 1.36-4.79, P < .001).

Conclusions: When introduced by male hosts, female speakers were less likely to be addressed using a formal title compared with male speakers, while no significant differences were observed when female hosts introduced speakers of either sex. A standardized approach to introducing speakers may be beneficial in mitigating sex biases during grand rounds and other academic events.