Battling Bias in Science

Diversity, equity, and inclusion (DEI) are hot topics in many fields, but why are they so important in science? This was the question posed by Sotiria Palioura MD, PhD at an ESCRS BOSS “Hidden Bias in Science” symposium.

“After all, we’re trained to be objective and to provide equal treatment to all, irrespective of their background, gender, or socioeconomic status. Yet we’re all part of a system that creates unconscious biases, and this starts early in life.”

Dr Palioura cited the “Draw-A-Scientist” studies, which show children overwhelmingly depict scientists as male, shaping how girls see themselves in scientific roles. This bias can extend beyond childhood perceptions: “Just five years ago, a Google search for famous scientists showed men with only one woman, Marie Curie, and no person of colour.”

In another study, researchers evaluated identical resumes with the names John, Jamal, or Jennifer for a postdoc position. Both male and female reviewers rated John as more competent, hireable, and a stronger leader than Jennifer and Jamal, who were both offered lower salaries.

This pattern persists in clinical practice. While 46% of residents are women, only 25% become full professors. Disparities are worse for underrepresented ethnic groups, who make up 35% of the US population but only 7% of full professors.

In ophthalmology, women hold fewer than 20% of department chair positions and are fewer than 40% of residency programme directors. As of 2019, ophthalmology was one of five specialties with no female editor-in-chief among its top 10 journals. Women are senior authors of less than 30% of publications in these journals while men dominate invited editorials by more than 75%.

Women receive less grant funding, hold half as many industry partnerships as men, handle fewer surgical cases, and earn 42% less than men, even after adjusting for age, location, and specialty.

These inequities affect patient care too. It wasn’t until 1993 that law mandated the inclusion of women in NIH research. “So, for decades, the research we relied on to diagnose disease and guide patient treatment has been based on only half the patient population.”

Steps towards inclusivity

“Now that we’ve diagnosed the problem, we need to come up with the treatment plan,” Dr Palioura continued. “There’s from different fields coming together to find a place for their ideas to meet, collide, and build on each other.

“When building your team—whether hiring staff, faculty, trainees, or students—you should look for diversity of expertise, as it’s a key factor for team success.”

And what’s the solution to fixing inequities with gender and underrepresented groups? “We need to cite them, invite them to speak, nominate them for awards, mentor, and support people outside of our usual network. We must recognise unconscious biases and identify barriers,” she stressed.

“Now that you are aware of these issues, you’re not going to be part of the problem—you’re going to be part of the solution.”

Dr Palioura spoke during the 2024 ESCRS Congress in Barcelona.

The ESCRS BOSS programme (Building Our Sustainable Society) is a key initiative to address the issues of diversity, equity, and inclusion in ophthalmology. Click here for more information.

Sotiria Palioura MD, MSc, PhD is a US-trained Surgeon Ophthalmologist from Greece who is certified both by the American and the European Boards of Ophthalmology.