More than one-third (36%) of female ophthalmologists agree that there is a glass ceiling preventing them from reaching their career aspirations as an ophthalmologist, according to J&J Vision’s recent Women in Ophthalmology survey.

The survey, conducted between July 20-Aug. 31, 2023, by Ipsos, included interviews from more than 100 female ophthalmologists at a wide range of ages in their educational and professional journey in the continental United States, Alaska and Hawaii. It included questions related to the survey respondents’ medical school experience, patient harassment, mentorship and more.

“The survey reflects disproportionate inequities faced by women ophthalmologists today, which is better than it was in the past but certainly not keeping pace with the pace of change in the broader construct of women's equity experiences,” says Lori Tierney, president, Americas, J&J Vision. “It is surveys like these that help gauge perception from industry professionals in the new generation. They're our best tool to determine how we're doing, how far we’ve come and how much further we have to go.”

Key survey results

• 32% have had their competence in ophthalmology questioned due to their gender
• 34% believe their medical school experience could have been different had they been male
• 45% aspire to advocate for better ophthalmology treatment for their community; and 36% aspire to better serve under-represented communities
• 32% said they’ve had patients’ disrespect or harass them; 11% said that faculty/staff or fellow students were disrespectful/harassed them during medical school
• 66% say their professional ophthalmology experience would be better if they received mentorship from other ophthalmologists of the same gender, yet only 26% received mentorship; 56% say they aspire to mentor new ophthalmologists as they advance in their careers.

Ms. Tierney says she was surprised at the number of female ophthalmologists who believe the glass ceiling still exists. “It shows that we have work to do to improve the opposite feeling where nothing should be a barrier for any professional to achieve their aspirations.”

Lisa K. Feulner, MD, PhD, the founder and CEO of Advanced Eye Care & Aesthetics in Bel Air, Md., and Ophthalmology Management’s chief medical editor, says that while she still sees women who experience a negative impact on their career based on their gender, she believes it is a much smaller number of young women today than in her generation.

“For my generation, it was pretty much an expected experience. At that time, there were very few women in ophthalmology. If you wanted to succeed, you just put your nose to the grindstone, and you tried to be better, work harder, never complain, never say anything because there weren't women who were judging you, promoting you, getting you a job or grading you — they were all men for the most part.”

A different experience in medical school for women

Another statistic that stood out for Ms. Tierney was that 34% of respondents believe their medical school experience could have been different had they been male. “When you think about the work of a medical student, the student part is about really understanding and appreciating that technical skill and competency that comes with the field of study,” she says. “Gender should not impact the quality of education received.”

Harassment due to gender and age

The study also explored women who experienced harassment, with 32% of those surveyed reporting patients being disrespectful or harassing them or their competencies being questioned as a byproduct of their gender or their age.

“That also came as a surprise to me, because there is equity in credentials as it relates to what it takes to be a female ophthalmologist,” Ms. Tierney explains. “In order to drive industry change and empower female ophthalmologists and recognize where they stand today and evolve to a position of strength and equity, I think a culture of inclusion is so critically important. We have to focus on tackling the barriers, and we're now getting a better understanding of what those barriers are that prevent diversity, equity and inclusion from flourishing in the profession.”

While harassment still exits, Dr. Feulner feels that today’s generation is more inclined to speak up about it as well as other issues they don’t like. “Today, women don’t have a problem saying, ‘I’m going to report you. This is completely unacceptable, and I have a right to feel this way.’”

Also, women today are more inclined to speak up about issues not related to harassment, Dr. Feulner says. For example, she recalls seeing a younger ophthalmologist stand up for herself when a male colleague had questioned her actions. “I was in awe of her because we just didn't do that.”

Mentorship is highly important to women

Of the women surveyed: 66% say their professional ophthalmology experience would be better if they received mentorship from other ophthalmologists of the same gender, yet only 26% received mentorship; and 56% say they aspire to mentor new ophthalmologists as they advance in their careers.

Ms. Tierney says these stats on mentoring really speak to opportunities and a sense of optimism. “Not only are female ophthalmologists seeking that mentoring engagement, but they too are holding themselves accountable to being that mentor for people who are in their place in the future. That to me was really encouraging.”

Dr. Feulner has seen the value of being a mentor first-hand and the importance younger female ophthalmologists place on being mentored.

“When I was starting out, I never had a mentor, so I am hugely passionate about it,” she says. “One new addition to my team, a female optometrist, said that the main reason she joined my practice was because ‘Dr. Feulner is pro woman, loves to mentor and made me feel welcome and accepted.’”

Dr. Feulner also mentors a young female ophthalmologist and finds pleasure in helping her to grow. “We talk once a week about what she needs to do, how I can help her, how I can move her forward and who I need to introduce her to.”

Leadership and discussions of race

While women have come a long way since the early days of ophthalmology, Dr. Feulner still feels a lot more needs to be done, particularly when it involves women of color.

“Women of color were so limited in my generation. I only knew one African American woman who was a pediatric ophthalmologist, and only heard of one other ophthalmologist,” she recalls. “We need to increase access and opportunity to women of color at an earlier stage of their careers. I have med students who rotate through, as well as residents and high school students. But in my opinion, there needs to be a concerted effort to focus on expanding opportunities for women, especially for women of color, at all stages of their careers.”

Moving forward, communication from one woman to another is going to be critical, Dr. Feulner says, and having more women in industry, particularly in positions of power, will also be critical. “Unfortunately, the women executives or rising executives between companies do not have a support group amongst themselves where they can co-develop women to develop women of power using their collective knowledge. The success of women in industry would help women in medicine.”

John A. Hovanesian, MD, an eye surgeon at Harvard Eye Associates, Laguna, Calif., agrees that it is important to champion for women of color in ophthalmology.

“For more than 10 years, I have been advocating for more women and particularly women of color in positions of leadership in our publications and at our meetings to represent the specialty that eye care is becoming,” he says. “Eye care is no different than most specialties in having been male dominated for a long time. So, it's not surprising that there are these ingrained attitudes and behaviors, particularly by older members of the profession who tend to be the ones in the leadership positions.”

At the same time, Dr. Hovanesian says we should not blame those older male members of the profession so much as to recognize the background that they come from.

“It is important that we help to fill our residency programs and our leadership positions with women so that we balance that in the future,” he says. “Another great way to do that is to encourage young women — first, to be interested in the sciences and, secondly, to take interest in medicine for those who we think are suitable for ophthalmology specifically.”

How J&J is driving the change forward

To help spark change in diversity in eye care, J&J supports organizations like Women in Ophthalmology (WIO) and Ophthalmic World Leaders, says Ms. Tierney. Additionally, J&J sponsored the 2023 WIO mentorship program and granted funds to support the Rabb-Venable program for underrepresented medical students, residents and fellows. J&J also has programs such as WiSTEM²D that helps support young women of all ages who are interested in pursuing a career in STEM. OM