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

Understanding gaps in inclusivity is essential to advancing equity, diversity, and inclusion (EDI) in healthcare institutions. In academic health systems, perceptions of equity and inclusion are increasingly recognized as relevant to health workforce organization and leadership structures. This study aimed to describe the socio-demographic profile and explore perspectives on equity and belonging in a large medical department at a Canadian academic centre. A cross-sectional survey was administered to physicians and scientists in the Department of Medicine at The Ottawa Hospital in Ottawa, Canada. Of the 297 respondents (59.9% response rate), 43% ( n = 128) identified as women and 25% ( n = 73) as racialized. Most women were younger, aged 25–44 years ( n = 69; 53.9%); while a greater proportion of men were over 55 years ( n = 61, 39.6%). After adjusting for age, women were 74% less likely than men to feel that members of different genders were treated equitably in the Department (aOR: 0.26; 95% CI, 0.14–0.48, p < 0.001) and 57% less likely to view leadership opportunities as fair and equitable (aOR: 0.43; 95%CI, 0.25–0.72, p = 0.001). Respondents over 55 years old were more than twice as likely as their younger peers (aged 25–44 years) to perceive access to leadership opportunities as fair and equitable (aOR: 2.26, 95%CI: 1.19–4.29, p = 0.01) after adjusting for gender. Racialized respondents were less likely to feel their opinion was valued ( p = 0.03) or to view leadership opportunities as equitable ( p < 0.01). In this study of a single academic medicine department, perceptions of equity, inclusion, and belonging varied significantly by gender, age, and race. These findings suggest that representation alone may not fully capture experiences of inclusion and belonging. Further work is needed to better understand the cultural and organizational factors associated with inclusion and belonging in academic medicine departments, and to identify strategies that promote more equitable experiences across groups.