By Elissa Fory, MD (left), and Diana Greene-Chandos, MD (right)
Earlier this year, the Neurocritical Care Society (NCS) Executive Committee and Board of Directors approved a proposal of the Women in NeuroCritical Care (WINCC) Section to provide on-site, drop-off childcare at the NCS Annual Meeting starting in 2019. To our knowledge, we are the first American neurology or critical care society to facilitate on-site, drop-off childcare at its annual academic meeting.1
Why did WINCC pursue and recommend this?
WINCC championed childcare at our Annual Meeting because of our members’ collective experiences. Parents of young children (usually mothers) may have difficulty attending academic meetings after having children. One major factor is lack of, or difficulty with, childcare2. After realizing that this was not unusual among WINCC members, we sent a survey to the entire NCS membership to find out what family-centered resources our membership might need the most.
The survey results were clear. Those who answered the survey wanted on-site, drop-off childcare (similar to a daycare) more than any other family resource at the Annual Meeting. About 80% of the respondents with children under the age of 16 as of October 2019 endorsed interest in or being likely to use on-site, drop-off childcare at this fall’s meeting. There was interest, although lesser, in use of a lactation room, private-hire babysitting or an infant-parents’ room with the meeting telecast.
Although NCS will be the first neurology-based annual meeting to facilitate on-site childcare, it has been happening for years in other specialties and is being added to other organizations’ meetings. In 2019, academic meetings that have childcare include:
- the American Academy of Pediatrics National Conference and Exhibition3,
- the American College of Obstetrics and Gynecology Annual Clinical and Scientific Meeting4,
- the American College of Physicians Internal Medicine Meeting5,
- the American Society of Hematology Annual Meeting & Exhibition6, and
- the Chest Annual Meeting7,
to name just a few.
Why should NCS or any professional organization think about its members’ children during planning?
One-half of medical students are women, as are 48% of neurology residents. More than one-third of NCS members and practicing neurologists in the United States are women. Yet women remain proportionally under-represented in positions of leadership and as full professors8. The American Academy of Neurology was founded in 1948, and has had one woman president, Sandra Olsen, for two of its 71 years in existence. The percentage of women in academic medicine decreases with increasing academic rank, with women making up only 14% of full professors in neurology at top academic institutions9.
This under-representation of women matters because groups and organizations perform better when they are more diverse. There is consistent evidence that companies with more gender-diverse leadership perform better financially10. Diversity promotes better running teams and better science by increasing collective intelligence, better utilizing each team member’s strengths and widening and changing the scope of scientific inquiry11.
The gender gap in business and medicine, especially in leadership roles, is likely due to combinations of organizational, societal and personal challenges, overt and subtle. These complex issues have been discussed at length in other writings12,13,14,15. Spousal employment and unpaid domestic work are particularly relevant here. Female physicians are almost twice as likely to have a partner who works full-time than male physicians (86% v. 45%)16. Pragmatically, this means women physicians with children are much less likely than men physicians with children to have a spouse whose main (unpaid) job is care of their children. This certainly can complicate plans for out-of-town work travel – or cancel them altogether2. And despite our generation’s attitude of egalitarianism in relationships, this does not translate into shared and equal domestic work. Professional women still bear the majority of the childcare responsibilities, coordination and housework14,16. An internal survey of WINCC members was consistent with these trends.
Which brings us back to on-site, drop-off childcare at academic meetings. The goal of on-site childcare is to support our members just when they are gaining momentum in their careers. This same early-to-mid career time is often when women are having children. In order to network, present original research, become involved in committees and even be considered for positions of leadership, people have to be able to attend the meeting. On-site, drop-off childcare is one solution addressing barriers to attendance and participation in academic meetings2, and it promotes equity for all our members – regardless of gender, family structure or discipline.
I am proud that the Neurocritical Care Society is leading this initiative for neurology and critical care. Let’s keep the conversation going.
1 The World Parkinson Congress has in the past offered childcare at its meeting, which is held every 3 years internationally.
2 Calisi RM, et al. “How to tackle the conference-childcare conundrum.” Proceedings of the National Academy of Science. 20 March 2018; 115(12): 2845-2849.
3 https://aapexperience.org/family-resources/#child. Accessed 25 June 2019.
4 https://annualmeeting.acog.org/family-and-fun/. Accessed 25 June 2019.
5 https://annualmeeting.acponline.org/registration-travel/guest-registration-and-child-care. Accessed 25 June 2019.
6 https://www.hematology.org/Annual-Meeting/Attendees/4237.aspx. Accessed 25 June 2019.
7 http://chestmeeting.chestnet.org/. Accessed 25 June 2019.
8 Ellin, Abby. “Gender disparities in neuroscience.” Brain and Life. Web extra. 4 Oct 2018. Accessed 25 June 25 2019.
9 McDermott M, and DJ Gelb, et al. “Sex differences in academic rank and publication rate at top-ranked US neurology programs.” JAMA Neurology. Aug 2018; 75(8): 956–961.
10 Burns, J. “The Results Are In: Women Are Great For Business, but Still Getting Pushed Out.” Forbes. 22 Sept 2017.
11 Nielsen, MW, S Alegria, et al. “Gender diversity leads to better science.” Proceedings of the National Academy of Science. 21 Feb 2017; 114(8): 1740-1742.
12 On Women and Leadership. Harvard Business Review Press; Boston, MA. 2019.
13 HBR Guide for Women at Work. Harvard Business Review Press; Boston, MA. 2019.
14 Criado Perez, Caroline. Invisible Women. Abrams Press; New York, NY. 2019.
15 Sandberg, Sheryl. Lean In: Women, Work, and the Will to Lead. Alfred A. Knopf, Inc; New York, NY. 2013.
16 Jolly S, KA Griffith, et al. “Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers.” Annals of Internal Medicine. 4 Mar 2014; 160(5): 344-353.