Gender equity in medicine has advanced significantly, and recently the discourse is shifting toward a more nuanced approach that considers the multifaceted nature of personal identity and the structural barriers that medical professionals may need to overcome. 

According to Christopher E. Brightling, MD, PhD, a professor of respiratory medicine at the University of Leicester, UK, who spoke at the European Respiratory Society (ERS) International Congress 2025, there is a compelling business case for diversity—it “improves financial performance, increases innovation, and improves institutional reputation.” But fundamentally, he said, “it’s the right thing to do.” 

Hilary Pinnock, MD, PhD, a primary care respiratory medicine specialist at the University of Edinburgh, UK, recalled that when she attended medical school about three decades ago, only 20%-25% of her class were women, whereas now, women represent the majority at her institution. “Things have come a long way,” she said. But that progress has yet to translate worldwide and to the highest levels of leadership. According to the World Health Organization, although 70% of the global health workforce comprises women, only 25% of them hold senior positions.

How Is the ERS Doing? 

Judith Garcia-Aymerich, MD, PhD, the former ERS secretary general and head of the noncommunicable diseases and environment program at ISGlobal, Barcelona, Spain, presented a snapshot of the society’s progress. Currently, ERS membership is nearly balanced, with 49% female members and 50% male members; 1% identify as nonbinary or prefer not to disclose their gender.

A predominant female presence is in the leadership, with the executive committee comprising 10 women and five men. 

Historical imbalances in awards are also being addressed. After implementing changes to the nomination and selection process, the ERS has seen dramatic improvement, said Brightling. “We went from around 80% of the senior awards going to men to a 60:40 split,” he said.

Despite this progress, speakers acknowledged that the work is far from over. “It’s a constant effort, and only those who are behind running the programs know how difficult it is,” said Garcia-Aymerich. She emphasized the importance of continuing to promote diversity, which includes inviting more people from countries outside the EU.

Pinnock agreed. “This isn’t just gender,” she argued. “It is about embracing diversity of all. How do we embrace and support those who are less able to achieve what they want to achieve in respiratory care?” 

The Imposter in the Room

A significant barrier to equity is the internalized pressure known as the impostor phenomenon. Sanne Feenstra, PhD, an assistant professor of organizational psychology at Vrije Universiteit Amsterdam, Netherlands, defined it as:

These feelings create a “disconnect between how you perceive yourself and how you think others perceive you.” She noted that the phenomenon may have some positive side effects — for example, leaders who feel like impostors may be more empathetic and attuned to their teams — but for the most part, its consequences are negative. 

In the short term, Feenstra said, the impostor phenomenon can fuel a drive to work harder, but it eventually often leads to burnout. Other negative outcomes include the chronic stress of worry of being “found out” and a tendency toward self-handicapping, where people subconsciously sabotage their own success to have a ready-made excuse for failure.

Although men also experience the impostor phenomenon, research shows that women tend to experience it more or more strongly, Feenstra explained. The phenomenon was first described in the 1970s as a female experience when women began entering management positions in larger numbers. The issue, she argued, is that societal stereotypes of a good leader (competitive, dominant) align with stereotypes of men, while stereotypes of a good woman (communal, friendly, warm) are often seen as contradictory to leadership. 

She said women experience the impostor phenomenon more often not because they are women, but because of the barriers they systematically encounter. “It is a normal response to a dysfunctional context,” she said. 

Work environments that foster a performance climate, with a heavy focus on individual output, rankings, and rivalry, exacerbate feelings of being an imposter. On the contrary, a “mastery” climate focuses on valuing inputs rather than outputs. This means prioritizing and recognizing factors such as effort, learning, personal development, and collaboration. This approach shifts the focus from “who is the best” to “how are we all improving,” Feenstra explained. A mastery climate reduces the intense rivalry and upward social comparison that often fuel the impostor phenomenon. It creates a more psychologically safe space for both men and women, where mistakes are viewed as learning opportunities, which can mitigate the fear of being “found out.”

Beyond a Single Story 

Laura Delgado Ortiz, MD, PhD, a postdoctoral researcher at the Barcelona Institute for Global Health (ISGlobal), cautioned that focusing solely on gender stereotypes gives a “single image,” when in reality, identity is nuanced and layered. For herself, being a woman, a migrant, and an early-career professional are all identities that shape her experiences and the opportunities available to her, and yet even those three layers “don’t give my whole story,” she said.

True equity is only possible when we acknowledge the interplay of these different identity layers, she explained. Simply focusing on one aspect, such as gender, misses the bigger picture of how systems of power and privilege affect people differently based on their unique combination of identities. “If we are talking about equity, we can’t talk only about gender. We need to talk about it intersectionally,” Delgado Ortiz said.

Brightling, Pinnock, Garcia-Aymerich, Feenstra, and Delgado Ortiz report no relevant financial relationships.

Manuela Callari is a freelance science journalist specializing in human and planetary health. Her work has been published in The Medical Republic, Rare Disease Advisor, New Scientist, The Guardian, MIT Technology Review, and others.