Gender, race and ethnicity biases experienced by hospital physicians: an umbrella review to explore emerging biases in the evidence base.

Abstract

Objectives: To examine the authorship and content of systematic reviews (SRs) of biases experienced by medical professionals through a gender lens.

Design: Review of SRs.

Data sources: We searched PubMed, Embase, PsycINFO and CINAHL from inception. Searches were conducted in May 2022 and updated in October 2023.

Eligibility criteria: Reviews of studies reporting biases experienced by hospital physicians at any stage of their careers and in any country. Reviews were included if they used systematic methods to search the literature and synthesise the data. Non-English language publications were excluded.

Data extraction and synthesis: The main theme of each eligible review was identified through qualitative thematic analysis. We used NamSor to determine the first/last authors' gender and computed the proportion of female authors for each review theme.

Results: 56 articles were included in the review. These covered 12 themes related to gender, race and ethnicity bias experienced by physicians at any stage of their careers. The overall proportion of female authors was 70% for first authors and 51% for last authors. However, the gender of authors by theme varied widely. Female authors dominated reviews of research on discrimination and motherhood, while male authors dominated reviews on burnout, mental health and earnings. Only six reviews were identified that included race and ethnicity; 9 out of the 12 first and last authors were female.

Conclusions: Understanding the potential for a gendered evidence base on biases experienced by hospital physicians is important. Our findings highlight apparent differences in the issues being prioritised internationally by male and female authors, and a lack of evidence on interventions to tackle biases. Going forward, a more collaborative and comprehensive framework is required to develop an evidence base that is fit for purpose. By providing a point of reference, the present study can help this future development.