Canadian academic medicine survey finds uneven perceptions of equity and belonging

A cross-sectional survey of 297 physicians and scientists found marked differences in how colleagues perceived equity, inclusion and belonging within a large Canadian academic medicine department. Women were 74% less likely than men to say that members of different genders were treated equitably and 57% less likely to view leadership opportunities as fair and equitable. Respondents over 55 were more than twice as likely as those aged 25–44 to consider access to leadership opportunities equitable, while racialized respondents were less likely to feel their opinions were valued.

The study examined the Department of Medicine at The Ottawa Hospital in Ottawa, Canada, and had a response rate of 59.9%. Among the 297 respondents, 43%—128 people—identified as women, while 25%, or 73 people, identified as racialized. The age profile also differed by gender. Most women respondents were aged 25–44, accounting for 69 of 128 women, or 53.9%. A greater proportion of men were over 55: 61 men, representing 39.6% of male respondents. These demographic findings describe the composition of the survey sample rather than the full department workforce.

After adjustment for age, women had lower odds than men of perceiving equitable treatment across genders. The adjusted odds ratio was 0.26, with a 95% confidence interval of 0.14–0.48 and p<0.001. Women also had lower odds of viewing leadership opportunities as fair and equitable, with an adjusted odds ratio of 0.43, a 95% confidence interval of 0.25–0.72 and p=0.001. These are adjusted associations between gender and respondents’ assessments; the cross-sectional survey does not establish that gender caused the differences or show how experiences changed over time.

Age was associated with a contrasting assessment of leadership opportunities. After adjustment for gender, respondents over 55 were more than twice as likely as those aged 25–44 to view access to leadership opportunities as fair and equitable. Their adjusted odds ratio was 2.26, with a 95% confidence interval of 1.19–4.29 and p=0.01. Racialized respondents were less likely to feel that their opinion was valued, a difference reported at p=0.03, and were less likely to view leadership opportunities as equitable, with p<0.01. The reported results do not provide effect sizes for the racialized-group comparisons, so the magnitude of those differences cannot be quantified from the study’s abstract.

Together, the findings indicate that representation alone does not fully describe whether an academic medical department is experienced as equitable and inclusive by the people working there. The survey connected differences in perceived treatment, leadership access and recognition to gender, age and race, highlighting experiences that could be obscured by an institution’s aggregate demographic profile. Because the research covered one department and relied on a cross-sectional survey, it cannot identify the cultural and organizational mechanisms behind the reported associations or determine whether the same pattern occurs elsewhere. The authors call for further work to understand those factors and to identify strategies that promote more equitable experiences across groups, while the present results establish the need to examine inclusion directly rather than using representation as its sole measure.

Subject of Research: Perceptions of equity, inclusion and belonging among physicians and scientists in one Canadian academic medicine department

Article Title: Equity, diversity and inclusion in a large academic department of medicine

Article References: Moledina, A., McNeill, K., Richards, K., Munro, C., Knoll, G., & Malcolm, J. (2026). Equity, diversity and inclusion in a large academic department of medicine. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15376-3

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15376-3

Keywords: academic medicine, equity, workplace inclusion, gender disparities, leadership access, racial diversity, departmental culture, belonging, cross-sectional survey, diversity, inclusion, large