• Justin Mausz, Sarah Salvis, Dominique Arseneau-Bruneau, and Elizabeth A Donnelly.
• Operations, Peel Regional Paramedic Services, Brampton, Ontario, Canada.
• Prehosp Emerg Care. 2023 Jan 1; 27 (8): 108310871083-1087.

IntroductionLike other public safety professions, paramedicine has historically been a male-dominated occupation. Although women are increasingly choosing paramedicine as a career, participation in leadership roles remains limited. Drawing on data from a comprehensive mental health survey, we describe the proportion of women in leadership in a single, large, urban paramedic service in Ontario, Canada.MethodsWe distributed an in-person, paper-based survey during the fall 2019 - winter 2020 continuing medical education sessions. Participating paramedics completed a demographic questionnaire alongside a battery of mental health screening tools. We assessed the demography of the workforce and explored differences in employment classification, educational achievement, clinician level (e.g., primary vs. advanced care), and participation in formal leadership roles along self-reported gender lines.ResultsOut of 607 paramedics attending, we received 600 completed surveys, with 11 excluded for missing data, leaving 589 for analysis and a 97% response rate. Women comprised 40% of the active-duty paramedic workforce, with an average of 8 years of experience. Compared to men, women were more than twice as likely to have university degrees (odds ratio [OR] 2.02, 95% compatibility interval [CI] 1.45-2.83), but almost half as likely to practice at the advanced care paramedic level (OR 0.61, 95% CI 0.42-0.88), and potentially less likely to be employed full-time (OR 0.77, 95% CI 0.54-1.09). Women were nearly 70% less likely to hold leadership roles in the service compared to men (OR 0.36, 95% CI 0.14-0.90), occupying 20% of leadership positions.ConclusionAlthough paramedicine is witnessing an encouraging shift in the demography of its workforce, our results point to a potential under-representation of women in leadership roles. Future research should focus on identifying and ameliorating barriers to career advancement among women and other historically underrepresented people.

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