In this historic year, the presidency of the Brazilian Council of Ophthalmology (CBO) is, for the first time, assumed by a woman: Dr. Wilma Lelis. Her strong and ethical leadership represents more than a personal achievement— it symbolizes decades of quiet resistance by thousands of women who have walked, often at the margins, through the corridors of conferences, emergency departments, laboratories, and surgical theaters of Brazilian ophthalmology.

The medical field and ophthalmology is no exception still carries deep structural marks of a system that, for many years, overlooked or minimized the presence of women. Today, although women constitute the majority of medical students in Brazil, they remain a minority in leadership positions, senior academic ranks, decision-making committees, and on the main stages of scientific events. The election of a woman to lead our Council is, therefore, a milestone that calls for reflection and for the reconstruction of pathways toward equity.

Women in medicine: progress and persistent barriers

The feminization of medicine is ongoing, yet disparities remain evident. Although women now represent more than half of new medical registrations in Brazil, their progression into leadership roles continues to be limited by both invisible and tangible barriers. Women are less frequently promoted, receive lower salaries than their male colleagues with similar training and productivity, and remain underrepresented in surgical specialties and scientific leadership positions. These disparities become even more pronounced when considering race: Black and Indigenous women face compounded discrimination and restricted access to opportunities.

A study published in the New England Journal of Medicine found that female physicians are 21% less likely to attain full professorships in US medical schools, even with comparable academic productivity¹. A Lancet analysis reported gender pay gaps of up to 33% within the United Kingdom’s public health system². In Brazil, data from the Federal Council of Medicine reinforce that, despite increasing female representation, women continue to earn less and hold fewer leadership roles³.

Ophthalmology: a reflection of broader inequalities

Ophthalmology—a specialty requiring technical precision and continuous updating—remains predominantly male, particularly in surgical subspecialties and decision-making spheres. How often is a woman the only speaker on a scientific panel? How often is she invited to moderate, but not to lead? How many female ophthalmologists are appointed to editorial boards, awards committees, or course leadership?

Meaningful transformation will not occur spontaneously with time; it requires intentionality, institutional commitment, and policies that actively promote equity. The leadership of Dr. Wilma Lelis at the helm of the CBO should not be seen as an admirable exception, but as the beginning of a new era—one in which women naturally occupy decision-making spaces, just as they already excel in clinics, classrooms, and outpatient care.

Equity is not charity—it is a marker of quality

A growing body of evidence shows that gender diversity in medicine improves the quality of care. A study published in JAMA Internal Medicine reported that older hospitalized patients cared for by female physicians experience lower mortality and readmission rates⁴. Equity, therefore, is not only a matter of fairness; it is a strategic requirement for improving clinical outcomes.

Moving forward with clarity, skill, and courage

Our demands are not seeking symbolic praise or ceremonial inclusion. We seek recognition of competence, equal opportunities, supportive professional networks, safe work environments free from harassment, and genuine prospects for academic and scientific advancement.

Medicine will become more just when women’s names cease to be exceptions and instead become a constant presence—when female leadership is no longer newsworthy but simply expected.

To the women who paved the way, facing silence, exclusion, and structural sexism, we express our deepest gratitude.

To today’s and tomorrow’s female ophthalmologists, we share a collective responsibility: to move forward with courage, purpose, and commitment to the generations who will follow.

REFERENCES

1. Jena AB, Khullar D, Ho O, Olenski AR, Blumenthal DM. Sex Differences in Academic Rank in US Medical Schools in 2014. JAMA. 2015;314(11):1149-58.

2. Woodhams C, Dacre J, Parnerkar I, Sharma M. Pay gaps in medicine and the impact of COVID 19 on doctors' careers. Lancet. 2021;397(10269):79-80.

3. Conselho Federal de Medicina (CFM). Demografia Médica 2020. https://www.gov.br/saude/pt-br/composicao/sgtes/acoes-em-educacao-em-saude/cfm-e-usp/07-relatorio-demografia-medica-no-brasil_2020-5.pdf

4. Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med. 2017;177(2):206-213.

AUTHORS INFORMATIONS
	» Fernanda Belga Ottoni Porto https://orcid.org/0000-0002-4308-1766 http://lattes.cnpq.br/3705547122177092

Received on: July 12, 2024.
Accepted on: July 19, 2024.