Working in the Emergency Department (ED) is a "high-strain" occupation, characterized by intense psychological demands and limited control over workflow. While these demands are shared across the workforce, they disproportionately affect women, who experience higher rates of burnout, earlier career attrition, and greater psychological distress than their male peers [1]. These disparities manifest in numerous ways, including:

• Female emergency physicians face disproportionately high rates of workplace violence, including physical assault and verbal abuse from patients and visitors. Research suggests women are targeted more frequently, yet are less likely to report incidents and less likely to see action taken when they do [2].
  
  

• Women remain the primary caregivers for children and aging parents at far higher rates than men. The unpredictability and inflexibility of ED scheduling creates outsized disruption to their lives outside of work, contributing to burnout and early career departure [3].
  

• Female emergency medicine physicians experience significantly higher rates of infertility and pregnancy complications compared to the general population, likely due to the cumulative physical and circadian stress of shift work. Night shift work in particular is associated with increased rates of miscarriage, pre-term labor, hypertension, and preeclampsia [4].
  
  

• The structure of emergency medicine often fails to accommodate the demands of the postpartum period, which is critical for parent-infant bonding, breastfeeding, and mental health [5].
  
  

• The physical and circadian demands of shift work can significantly worsen perimenopause and menopause symptoms including: sleep disruption, fatigue, and cognitive effects, yet this stage of life is rarely acknowledged in workplace wellness or scheduling policy [6].

These realities make gender-conscious workplace policies not just beneficial, but essential. The model policies we present are designed to advance gender equity in Emergency Medicine and support long-term career sustainability. While they will support physicians of all genders across different stages of life and career, they center the experiences and challenges that women in emergency medicine disproportionately face.

In this section you will find core policy recommendations, the evidence behind them, and practical guidance for implementation.