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Women in Surgery Open PDF
(American Medical Association (AMA), 2006-04-01)
Gargiulo, Debra A.
HYPOTHESIS: Women are deterred from a surgical career owing to a lack of role models rather than lifestyle considerations. DESIGN: Survey. SETTING: University teaching hospital. PARTICIPANTS: Surgery and obstetrics/gynecology attending physicians, residents, and medical students. INTERVENTION: Questionnaire. MAIN OUTCOME MEASURES: Potential deterrents to a surgical career. RESULTS: Men and women had a similar interest in a surgical career before their surgical rotation (64% vs 53%, P = .68). A similar percentage developed a mentor (40.0% vs 45.9%, P = .40). Women were far more likely to perceive sex discrimination (46.7% vs 20.4%, P = .002), most often from male attending physicians (33.3%) or residents (31.1%). Women were less likely to be deterred by diminishing rewards (4.4% vs 21.6%, P = .003) or workload considerations (28.9% vs 49.0%, P = .02). They were also less likely to cite family concerns as a deterrent (47.8% vs 66.7%, P = .02) and equally likely to be deterred by lifestyle during residency (83.3% vs 76.5%, P = .22). However, women were more likely to be deterred by perceptions of the "surgical personality" (40.0% vs 21.6%, P = .03) and the perception of surgery as an "old boys' club" (22.2% vs 3.9%, P = .002). CONCLUSIONS: Men and women are very similar in what they consider important in deciding on a surgical career. Women are not more likely to be deterred by lifestyle, workload issues, or lack of role models. However, the perceived surgical personality and surgical culture is a sex-specific deterrence to a career in surgery for women.
A Systematic Review of Gender-Based Differences in Hirsch Index Among Academic Surgeons Open PDF
(2019)
Myers, S.P.
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Reitz, K.M.
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Wessel, C.B.
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Neal, M.D.
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Corbelli, J.A.
Background: The h-index is a commonly used bibliometric in academic medicine which enumerates the number of publications (h) that have been cited h times. Recent investigations have suggested that gender-based differences in h-index may exist among academic physicians. We systematically reviewed studies of academic surgeons’ h-index, hypothesizing that a significant difference would exist between the h-index of men and women at all academic ranks. Methods: Peer-reviewed journal articles authored by academic surgeons of any subspecialization in the United States between January 1, 2006, and November 20, 2017, were reviewed. We excluded studies of trainees or gender-based differences in funding without mention of h-index. Two reviewers assessed article quality using the Newcastle-Ottawa criteria. Pooled estimates of standard mean differences (SMD) in h-index between genders were calculated using random-effects meta-analyses. A subgroup analysis based on the academic rank was performed. Heterogeneity was assessed using the I 2 statistic. Sensitivity analyses determined the effect of study on h-index. Meta-regression identified whether surgical specialty contributed to heterogeneity. Results: Twelve articles comparing h-index between genders were selected from 7950. Men possessed higher h-indices than women (SMD, 0.547; P < 0.001; I 2 = 89.5%). Men exhibited higher h-indices at the assistant rank (SMD, 0.12; 95% confidence interval [CI], 0.01-0.24; P = 0.039) but not at the associate (SMD, 0.14; 95% CI, −0.06 to 0.33; P = 0.165) or full professor (SMD, 0.12; 95% CI, −0.08 to −0.31; P = 0.25) ranks. Conclusions: The h-index is higher for men than that for women in academic surgery overall but not at individual ranks. Further investigations are necessary to address limitations in h-index and to further characterize the relationship between h-index, gender, and promotion. © 2018 Elsevier Inc.
Gender disparities in scholarly productivity of US academic surgeons Open PDF
(Academic Press Inc., 2016)
Mueller, C.M.
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Gaudilliere, D.K.
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Kin, C.
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Menorca, R.
;
Girod, S.
Background Female surgeons have faced significant challenges to promotion over the past decades, with attrition rates supporting a lack of improvement in women's position in academia. We examine gender disparities in research productivity, as measured by the number of citations, publications, and h-indices, across six decades. Materials and methods The online profiles of full-time faculty members of surgery departments of three academic centers were reviewed. Faculty members were grouped into six cohorts by decade, based on year of graduation from medical school. Differences between men and women across cohorts as well as by academic rank were examined. Results The profiles of 978 surgeons (234 women and 744 men) were reviewed. The number of female faculty members in the institutions increased significantly over time, reaching the current percentage of 35.3%. Significant differences in number of articles published were noted at the assistant and full but not at the associate, professor level. Women at these ranks had fewer publications than men. Gender differences were also found in all age cohorts except among the most recent who graduated in the 2000s. The impact of publications, as measured by h-index and number of citations, was not consistently significantly different between the genders at any age or rank. Conclusions We identified a consistent gender disparity in the number of publications for female faculty members across a 60-year span. Although the youngest cohort, those who graduated in the 2000s, appeared to avoid the gender divide, our data indicate that overall women still struggle with productivity in the academic arena. © 2016 Elsevier Inc. All rights reserved.
Gender Disparity in Surgery: An Evaluation of Surgical Societies Open PDF
(Mary Ann Liebert, Inc., Publishers, 2019)
Lyons, Nicole B.
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Bernardi, Karla
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Huang, Lillian
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Holihan, Julie L.
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Cherla, Deepa
Background: The percentage of female surgeons and surgery residents has increased slowly to 24% and 35%, respectively. However, women remain under-represented in surgical leadership positions (<20%). Society awards and leadership positions are used for hiring and promoting surgeons. We hypothesized that within the Surgical Infection Society (SIS), females are under-represented.Methods: The SIS website and databases were consulted for the number of female members, awardees, and leaders. Representation was divided into four time periods: 2000–2005, 2006–2010, 2011–2015, and 2016–2017 and compared for changes over time utilizing a Χ2 test. In addition, we reviewed the council members of five other surgical societies and compared the percentage of female representation in leadership positions.Results: Since the SIS was founded, there have been 587 members of whom only 135 (23%) are female. There has been an increase in female membership over time (p < 0.001). The number of female awardees rose from 37% during the first two study periods to more than 50% in the last two periods (p = 0.002). However, female representation in leadership positions decreased from 26% in 2000–2005 to less than 15% in the last three study periods (p = 0.234). Similar disparities emerged when comparing the SIS with other surgical societies: Women have represented only 24% (range 8%–42%) of leaders and 4% (range 0–11%) of society presidents.Conclusions: Female surgeons are under-represented in the SIS membership and leadership positions. Whereas the number of female surgeons and residents has increased, these trends have not occurred with council membership and leadership within the SIS. There is a need to address this gender disparity.
Declining racial and ethnic representation in clinical academic medicine: A longitudinal study of 16 US medical specialties Open PDF
(2018)
Lett, Elle
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Orji, Whitney U.
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Sebro, Ronnie
OBJECTIVE: To evaluate trends in racial, ethnic, and sex representation at US medical schools across 16 specialties: internal medicine, pediatrics, surgery, psychiatry, radiology, anesthesiology, obstetrics and gynecology, neurology, family practice, pathology, emergency medicine, orthopedic surgery, ophthalmology, otolaryngology, physical medicine and rehabilitation, and dermatology. Using a novel, Census-derived statistical measure of diversity, the S-score, we quantified the degree of underrepresentation for racial minority groups and female faculty by rank for assistant, associate, and full professors from 1990-2016. METHODS: This longitudinal study of faculty diversity uses data obtained from the American Association of Medical Colleges (AAMC) Faculty Roster from US allopathic medical schools. The proportion of professors of racial minority groups and female faculty by rank was compared to the US population based on data from the US Census Bureau. The Roster includes data on 52,939 clinical medical faculty in 1990, and 129,545 in 2016, at the assistant professor level or higher. The primary measure used in this study was the S-score, a measure of representation based on the probability of the observed frequency of faculty from a racial/ethnic group and sex, given the racial and ethnic distribution of the US. Pearson correlations and 95% confidence intervals for S-score with time were used to measure trends. RESULTS: Blacks and Hispanics showed statistically significant trends (p<0.05) towards increasing underrepresentation in most specialties and are more underrepresented in 2016 than in 1990 across all ranks and specialties analyzed, except for Black females in obstetrics & gynecology. White females were also underrepresented in many specialties and in a subset of specialties trended toward greater underrepresentation. CONCLUSIONS: Current efforts to improve faculty diversity are inadequate in generating an academic physician workforce that represents the diversity of the US. More aggressive measures for faculty recruitment, retention, and promotion are necessary to reach equity in academia and healthcare.
Women authors of surgical research Open PDF
(2005)
Kurichi, Jibby E.
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Kelz, Rachel R.
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Sonnad, Seema S.
HYPOTHESIS: The number of women authors in the surgical literature has increased during the past 20 years. DESIGN: Randomly selected issues of odd-year journals in Archives of Surgery and Annals of Surgery from January 1, 1985, to December 31, 2003, were reviewed. We determined the gender of each author and reported trends in the occurrence of women authors over time. RESULTS: The percentage of women authors has increased over time and parallels the percentage of women faculty in academic surgery positions. A much higher percentage of women authors than men authors are nonphysicians. The trend for increased authorship by women over time was significant in Archives of Surgery. CONCLUSION: Although the number of women first authors is low, their contributions to the field of surgery should be acknowledged, and efforts to provide women with the resources and opportunities to conduct research and publish their findings should be a focus for surgical departments looking to increase their research productivity.
Sex Bias in Hand Surgery Research Open PDF
(2018)
Kalliainen, Loree K.
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Wisecarver, Ian
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Cummings, Allison
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Stone, Jennifer
It has been long recognized that sex-based biases related to participant inclusion exist in research. To help address inequities in research participation, the National Institutes of Health Revitalization Act was passed into law in 1993. Although this act was primarily designed to increase inclusion of females and minorities in research funded by National Institutes of Health, it has also helped raise global awareness of the value of routinely including females and minority groups in research. Subsequent work has demonstrated a continued gap in inclusion of females in medical and surgical research and female animals and cell lines in basic science research. Hand surgeons have recognized that certain conditions have greater incidence in one sex over the other, but there has been no widespread discussion on whether, when, and how sex should be used as an outcomes variable. This review investigated the recent hand surgery literature to assess for equity in inclusion of both sexes in research as well as whether outcomes were analyzed based on sex.
The "gender gap" in authorship of academic medical literature--a 35-year perspective Open PDF
(2006)
Jagsi, Reshma
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Guancial, Elizabeth A.
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Worobey, Cynthia Cooper
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Henault, Lori E.
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Chang, Yuchiao
BACKGROUND: Participation of women in the medical profession has increased during the past four decades, but issues of concern persist regarding disparities between the sexes in academic medicine. Advancement is largely driven by peer-reviewed original research, so we sought to determine the representation of female physician-investigators among the authors of selected publications during the past 35 years. METHODS: Original articles from six prominent medical journals--the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine (Ann Intern Med), the Annals of Surgery (Ann Surg), Obstetrics & Gynecology (Obstet Gynecol), and the Journal of Pediatrics (J Pediatr)--were categorized according to the sex of both the first and the senior (last listed) author. Sex was also determined for the authors of guest editorials in NEJM and JAMA. Data were collected for the years 1970, 1980, 1990, 2000, and 2004. The analysis was restricted to authors from U.S. institutions holding M.D. degrees. RESULTS: The sex was determined for 98.5 percent of the 7249 U.S. authors of original research with M.D. degrees. The proportion of first authors who were women increased from 5.9 percent in 1970 to 29.3 percent in 2004 (P<0.001), and the proportion of senior authors who were women increased from 3.7 percent to 19.3 percent (P<0.001) during the same period. The proportion of authors who were women increased most sharply in Obstet Gynecol (from 6.7 percent of first authors and 6.8 percent of senior authors in 1970 to 40.7 percent of first authors and 28.0 percent of senior authors in 2004) and J Pediatr (from 15.0 percent of first authors and 4.3 percent of senior authors in 1970 to 38.9 percent of first authors and 38.0 percent of senior authors in 2004) and remained low in Ann Surg (from 2.3 percent of first authors and 0.7 percent of senior authors in 1970 to 16.7 percent of first authors and 6.7 percent of senior authors in 2004). In 2004, 11.4 percent of the authors of guest editorials in NEJM and 18.8 percent of the authors of guest editorials in JAMA were women. CONCLUSIONS: Over the past four decades, the proportion of women among both first and senior physician-authors of original research in the United States has significantly increased. Nevertheless, women still compose a minority of the authors of original research and guest editorials in the journals studied.
Prevalence of female authors in case reports published in the medical literature Open PDF
(2019)
Hsiehchen, D.
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Hsieh, A.
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Espinoza, M.
IMPORTANCE Underrepresentation of female authors in research publications is prevalent, but it is unclear whether this is attributable to sex disparities in research conduct or authorship practices. Case reports are a poorly understood component of the biomedical corpus, and the production of anecdotal observations is not confounded by factors associated with disparities in female representation in research publications. Whether female authorship disparities exist in nonresearch publications of clinical information is unknown. OBJECTIVES To examine the authorship of case reports and elucidate factors associated with sex disparity. DESIGN AND SETTING Cross-sectional study of all case reports published by US authors in 2014 and 2015 indexed in PubMed performed from July 2015 to July 2018. MAIN OUTCOMES AND MEASURES The primary outcome measure was the proportion of female first authors. The secondary outcome measures were the proportion of female last authors and female authorship representation among different clinical specialties. RESULTS Bibliometric data was abstracted from 20 427 case reports published across 2538 journals. A total of 7252 (36%) and 4825 (25%) case reports had a female first and last author, respectively. In comparison, 44%and 34%of US trainees and physicians, respectively, were female in 2015. Among adult case reports, female authorship was more prevalent in academic environments compared with community settings (34.0%vs 28.2%for female first authors and 23.4%vs 19.7% for female last authors). Across states, the proportions of female first authors and last authors were universally less than the proportions of female trainees and active female physicians, respectively. Female first authorship was associated with larger author teams (odds ratio [OR], 1.02; 95%CI, 1.01-1.03), an academic affiliation (OR, 1.16; 95%CI, 1.06-1.27), and a female last author (OR, 1.58; 95%CI, 1.47-1.70). Relative to general internal medicine, specialties dominated by male clinicians were less frequently associated with female first authors. Several exceptions displaying a relatively equivalent tendency for male and female first authorship included oncology (OR, 0.97; 95%CI, 0.81-1.16), ophthalmology (OR, 0.87; 95%CI, 0.72-1.05), and radiation oncology (OR, 0.94 95%CI, 0.56-1.56). CONCLUSIONS AND RELEVANCE The underrepresentation of women among first and last authors in publications of case reports underscores the pervasiveness of sex disparities in medicine. Collaboration and female mentors may be critical instruments in upsetting longstanding practices associated with sex bias. Not all clinical specialties were associated with lower-than-expected female authorship, and further exploration of specialty-specific norms in publication and mentorship may elucidate specific barriers to female authorship. © 2019 JAMA Network Open.All right reserved.
Scientific Impact of Women in Academic Surgery Open PDF
(2008)
Housri, N.
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Cheung, M.C.
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Koniaris, L.G.
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Zimmers, T.A.
Objective: To evaluate the scientific impact of women in the surgical literature. Methods: Gender of the principal investigator of every abstract presented at the 2002, 2003, and 2004 annual meetings of the Association for Academic Surgery and Society of University Surgeons was identified by internet search. Resulting publications were identified using PubMed. Journal impact factor and number of article citations were determined using ISI Web of Knowledge. Results: The principal investigator's gender was identified for 649 (98.8%) of the 657 abstracts presented at the 2002-2004 AAS meetings. Women authored 9.1% of abstracts and 11.8% of total resulting publications. The publication rate of abstracts by women was significantly higher than that of men (69.5% versus 52.4%, P = 0.0132). There was a trend toward higher average impact factors of journals in which female authors published (3.265 versus 2.673, P = 0.0626). There was no significant difference in mean number of citations per publication. The principal investigator's gender was identified for all 337 (100%) abstracts presented at the 2002-2004 SUS meetings. Women authored 11.0% of abstracts and 11.2% of resulting publications. Publication rates and average citation numbers were similar for female and male authors. The average impact factors of journals in which women published were significantly higher (4.741 versus 3.348, P = 0.0082). Conclusions: Although women comprise a small proportion of principal investigators on abstracts presented at these conferences, the quality of their presented work is equal to or better than those of their male counterparts. © 2008 Elsevier Inc. All rights reserved.

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