Abstract
Introduction: Despite increased advocacy, women and professionals from low- and middle-income countries (LMICs) remain underrepresented in global surgery. To address this, the Gender Equity Initiative in Global Surgery (GEIGS) launched an annual General Assembly (GA). This study evaluates trends in academic representation and leadership at the GA, emphasizing pathways to equitable mentorship, academic voice, and faculty development. Methods: A retrospective cross-sectional analysis of GEIGS GA speakers from 2020 to 2025 was performed. Data from conference records and public sources included gender, country of practice, degree(s), leadership role, citation count, prior speaking experience, and topic area. Linear regression assessed trends in gender representation. Results: A total of 104 speakers were identified. Women comprised 83.7% (n = 87; p < 0.001). Leadership positions were held by 64.4% (n = 67). The most common degrees were MD (62.5%) and PhD (16.4%); 15.4% (n = 16) were medical students. Of the speakers, 60.6% (n = 63) practiced in high-income countries (HICs) and 39.4% (n = 41) in LMICs. Representation by women was consistent across regions: 84.1% in HICs and 82.9% in LMICs. Among LMIC speakers, 65.9% held leadership roles, 34.2% multiple degrees, and 68.3% prior speaking experience. No significant differences in academic qualifications were observed between HIC and LMIC speakers (p > 0.05). Conclusion: The GEIGS GA demonstrates that intentional, equity-focused planning can achieve high female participation and meaningful inclusion of LMIC professionals. These findings provide a practical framework for promoting equitable representation in global surgery conferences. Continued attention to supporting LMIC voices in leadership and academia may help sustain progress.