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Advancing gender equity in gynecology and obstetrics: perspectives from the German workforce Open PDF
(Springer Science and Business Media LLC, 2025-08-27)
Neuhold, Jasmin
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von Versen-Höynck, Frauke
PURPOSE: Despite the high proportion of women in medical education and clinical training, female physicians remain underrepresented in leadership and academic positions in Gynecology and Obstetrics in Germany. This study investigates structural and cultural factors contributing to this disparity and highlights trends in workforce composition and recognition in the field. METHODS: We conducted a descriptive, cross-sectional analysis using publicly available data from the German Federal Statistical Office and the German Medical Association (2004-2024), as well as database from the German Society for Gynecology and Obstetrics (DGGG). RESULTS: In 2023, women comprised 73% of gynecologists in Germany. Female representation declined with advancing career stage. In 2024, 82% of resident physicians at German university hospitals were women, while they held 26% of department head positions in Gynecology and Obstetrics. Female membership in the DGGG reached 75%, with 40% on the executive board. In 2022, 65% of major awards went to men, while women received most poster and lecture prizes (61%) at the biannual conference. CONCLUSIONS: While gender diversity in the clinical workforce has improved, systemic inequities persist in academic and leadership domains. Addressing these requires structural reforms, increased transparency in recruitment and promotion processes, and targeted programs supporting women's professional advancement. Enhanced visibility, mentorship, and inclusive institutional policies are essential to ensure gender-equitable development in the specialty.
Gender dynamics in authorship of scientific publications in obstetrics and gynaecology: a 10-year bibliometric analysis of six high-impact journals Open PDF
(BMJ, 2026-01)
Bobotis, Stergios
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Stathi, Dimitra
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Verigos, Emmanouil
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Geropoulos, Georgios
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Arsenaki, Elisavet
Objective Although obstetrics and gynaecology (O&G) is a predominantly female specialty, previous studies have suggested that women remain under-represented in academic authorship. This study evaluates trends in female and male first and last authorship in six leading O&G journals (Human Reproduction Update, American Journal of Obstetrics and Gynecology, British Journal of Obstetrics and Gynaecology, Obstetrics and Gynecology, Gynecologic Oncology and Best Practice & Research Clinical Obstetrics & Gynaecology) between January 2013 and December 2023. Methods A bibliometric analysis was conducted using the Web of Science database. The gender of the first and last authors was determined using Genderize.io, with a probability threshold of ≥75% for classification. Binary logistic regression was performed to model the probability of authorship by gender across journals. Results Among 57 310 publications, 38 455 first (43.8% male and 56.2% female) and 38 950 last authors (58.6% male and 41.4% female) were identified and analysed. Over the past decade, female authorship has shown a clear upward trend, with first authorship increasing from 43% (1141/2636) in 2013 to 69% (2769/4036) in 2023, and last authorship increasing from 29% (770/2700) to 54% (2180/4047). First authorship was statistically more likely to be held by women in Human Reproduction Update (1.23, 95% CI 1.02 to 1.48), American Journal of Obstetrics & Gynecology (1.63, 95% CI 1.58 to 1.70) and Obstetrics & Gynecology (2.33, 95% CI 2.22 to 2.45). However, female last authorship was significantly more likely only in Obstetrics & Gynecology (1.21, 95% CI 1.16 to 1.27). Conclusion Despite an increasing trend in female representation in first and last authorships over the past decade, a significant gender disparity persists. While women now constitute the majority of first authors, last authorship remains disproportionately male, reflecting ongoing barriers to female leadership in O&G research. These findings highlight the need for targeted institutional efforts to promote gender equity in academic medicine. Although obstetrics and gynaecology (O&G) is a predominantly female specialty, previous studies have suggested that women remain under-represented in academic authorship. This study evaluates trends in female and male first and last authorship in six leading O&G journals ( Human Reproduction Update , American Journal of Obstetrics and Gynecology , British Journal of Obstetrics and Gynaecology , Obstetrics and Gynecology , Gynecologic Oncology and Best Practice & Research Clinical Obstetrics & Gynaecology ) between January 2013 and December 2023. Methods A bibliometric analysis was conducted using the Web of Science database. The gender of the first and last authors was determined using Genderize.io, with a probability threshold of ≥75% for classification. Binary logistic regression was performed to model the probability of authorship by gender across journals. Results Among 57 310 publications, 38 455 first (43.8% male and 56.2% female) and 38 950 last authors (58.6% male and 41.4% female) were identified and analysed. Over the past decade, female authorship has shown a clear upward trend, with first authorship increasing from 43% (1141/2636) in 2013 to 69% (2769/4036) in 2023, and last authorship increasing from 29% (770/2700) to 54% (2180/4047). First authorship was statistically more likely to be held by women in Human Reproduction Update (1.23, 95% CI 1.02 to 1.48), American Journal of Obstetrics & Gynecology (1.63, 95% CI 1.58 to 1.70) and Obstetrics & Gynecology (2.33, 95% CI 2.22 to 2.45). However, female last authorship was significantly more likely only in Obstetrics & Gynecology (1.21, 95% CI 1.16 to 1.27). Conclusion Despite an increasing trend in female representation in first and last authorships over the past decade, a significant gender disparity persists. While women now constitute the majority of first authors, last authorship remains disproportionately male, reflecting ongoing barriers to female leadership in O&G research. These findings highlight the need for targeted institutional efforts to promote gender equity in academic medicine.
The workplace culture, mental health and wellbeing of early- and mid-career health academics: a cross-sectional analysis Open PDF
(2024)
Marck, Claudia H.
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Ayton, Darshini
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Steward, Trevor
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Koay, Hui-Fern
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Wiley, Joshua F.
There are reports of poor working conditions for early and mid-career academics (EMCAs) in universities, however, empirical data using validated tools are scarce. We conducted an online, cross-sectional survey using validated tools to assess workplace satisfaction, exposure to workplace abuse, and mental health. Participants included employees of medical and health faculties of two of the largest Australian universities, surveyed between October 2020 and January 2021.Overall, 284 participants responded. Many reported job insecurity: half (50.7%) working on contracts with less than one remaining year. Workloads were considerable, with 89.5% of participants working overtime and 54.8% reporting burnout. Workplace abuse in the forms of bullying (46.6%), sexual harassment (25.3%), sexism (49.8%) and racism (22.5%) were commonly reported. Clinically significant symptoms of depression (28.0%), anxiety (21.7%) and suicidal ideation or self-harm (13.6%) were reported; with a higher prevalence among those working more overtime, and those exposed to workplace abuse. Priorities include providing a stable and safe workplace, increasing accountability and transparency in addressing workplace abuse, and supporting professional development.In summary, EMCAs in our study were commonly exposed to precarious employment conditions and workplace abuse. Our findings provide empirical evidence on where universities and funding bodies should direct resources and change organisational risk factors, to improve workplace culture.
Gender imbalance in gynecologic oncology authorship and impact of COVID-19 pandemic Open PDF
(2022)
Mah, S.J.
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Makkar, M.
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Huang, K.
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Anpalagan, T.
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Reade, C.J.
Objective Despite increased participation of women in academic medicine in recent decades, gender disparities persist. The gender gap in authorship and editorial boards in gynecologic oncology, and impact of the COVID-19 pandemic, have not been recently evaluated. We examined gender representation and the impact of COVID-19 on authorship and editorial boards of two major peer-reviewed gynecologic oncology journals. Methods We conducted a bibliometric analysis of original articles published in Gynecologic Oncology and the International Journal of Gynecological Cancer, comparing the most contemporary 5-year period (2016-2020) to single years in the two prior decades (1996, 2006). To assess the early impact of COVID-19, we compared publications from May 2020-April 2021 to 2019. Editorial boards were analyzed for gender composition. First names, pronouns, and institutional photographs were used to determine gender. Results There were 3022 original articles published between 2016 and 2020, 763 in 2006, and 203 in 1996. Gender was identified for 91.3% of first authors (3641 articles) and 95.6% of senior authors (3813 articles). Men comprised the majority of the editorial boards in 2021 at 57% and 61% for Gynecologic Oncology and the International Journal of Gynecological Cancer, respectively. Men were overrepresented as senior authors across all study periods: 93% in 1996, 77% in 2006, and 58% in 2016-2020. Over time, representation of women as first and senior authors increased (7% in 1996, 42% in 2016-2020, p<0.00001). There was no immediate impact of the early pandemic on gender distribution of authorship. Conclusions Despite greater representation of women over time as authors in gynecologic oncology journals, there remains gender disparity in senior authorship and editorial board representation. This presents an opportunity for the academic publishing community to advocate for deliberate strategies to achieve gender parity. Although no impact of the early COVID-19 pandemic was found, this requires ongoing surveillance. ©
THE GENDER IMBALANCE IN GYNECOLOGIC ONCOLOGY AUTHORSHIP AND EDITORIAL BOARDS
(2021)
Mah, SJ
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Makkar, M
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Anpalagan, T
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Huang, K
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Reade, C
Objectives Despite increased participation of women in Medicine in recent decades, there remains gender disparity in Academic Medicine. Our objective was to examine gender diversity in authorship and editorial boards of 2 prominent peer-reviewed Gynecologic Oncology journals. Methods We performed a bibliometric analysis of original articles published in Gynecologic Oncology(GO) and International Journal of Gynecologic Cancer(IJGC), comparing 2016–2020 to two decades prior (1996). First names and photographs from institutional websites were used to identify subjective gender. Gender distribution was compared using chi-square tests. Results We included 3022 original articles between 2006–2020, and 201 in 1996. Gender was identified for 93% of first and 94.5% of senior(last) authors. Trends of gender representation in authorship and editorial boards over time are presented in the graphs below. Men were overrepresented as senior authors across both study periods: 93% in 1996, and 58% in 2016–2020. Over time, representation of women as senior authors increased(7% in 1996, 42% in 2016–2020, p<0.00001). This trend was also observed in first authorship(9% in 1996, 57% in 2016–2020, p<0.00001). Men continued to comprise the majority of editorial board members (86% in 1996, 59% in 2020). • Download figure • Open in new tab • Download powerpoint Abstract EPV246/#242 Figure 1 Conclusions There is an encouraging trend in female authorship, likely reflective of increased representation in the workforce. Nevertheless, gender disparity persists. This underlines an opportunity for the academic publishing community to participate in advocacy and decisive action to close the ‘gender gap’. The impact of the COVID-19 pandemic on this publication gap is being assessed by our group.
Trends in Female Authorship Over 5-Year Publication History in Neurovascular Surgery Open PDF
(2024)
Jelmoni, Alice J. M.
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Mascaro, Luca
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Mariola, Carlotta
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Conde, Marian Mora
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Uralov, Daniel
Nel 2023, la disuguaglianza di genere è ancora un problema con cui ogni neurochirurgo donna deve ancora confrontarsi. Le tendenze degli ultimi 10 anni indicano che il numero di neurochirurghi donne è in costante crescita. Tuttavia, le donne rimangono una minoranza in questo campo dove solo il 19% dei professionisti sono donne. 1 , 2 Anche se il numero delle donne in campo neurochirurgico è in costante aumento, siamo ancora lontani da una distribuzione equa. Negli Stati Uniti, le donne rappresentano solo il 6% dei neurochirurghi certificati dall’American Board of Neurological Surgery e l’8% dei neurochirurghi in formazione. Nel 2017, circa il 51% degli studenti di medicina negli Stati Uniti erano donne. 3 Alla fine del 2020, la Società Turca di Neurochirurgia ha dichiarato che il 5,5% degli specialisti in neurochirurgia registrati in Turchia sono donne. 4 Allo stesso modo, la Japan Neurological Society ha dichiarato che solo il 5,6% dei membri sono donne. 5 In Europa, secondo i dati raccolti nei primi anni 2000, la percentuale media di donne che lavorano come medici è pari al 40%, 1 , 2 ma la neurochirurgia non riflette questa tendenza. Non sono disponibili dati sull'attuale e accurata distribuzione di genere degli specializzandi e degli specialisti in neurochirurgia in ciascun paese europeo, se non da parte dei membri delle società ufficiali. 6 , 7 In Italia, sorprendentemente, il 36% dei neurochirurghi sono donne, 2 attualmente la percentuale più alta di neurochirurghi donne in Europa. È importante sottolineare che il tasso di donne residenti è del 55%, 8 anche se le società italiana ed europea nel 2022 riconoscono, rispettivamente, un tasso di iscrizione femminile del 25% e del 23%, a conferma che la percentuale di donne coinvolte in posizioni accademiche è ancora inferiore a quello degli uomini. La rappresentanza delle donne nei comitati editoriali sembra essere ancora più bassa per la chirurgia della colonna vertebrale rispetto ad altre discipline, un aspetto che dovrebbe essere migliorato anche in futuro. 9 , 10 Dai dati sopra citati emerge che, a livello globale, le posizioni di leadership e i titoli accademici sono ancora quasi esclusivamente appannaggio del genere maschile. Consentire ai neurochirurghi donne di impegnarsi nella ricerca e garantire parità di accesso rispetto ai colleghi uomini alle posizioni senior nella leadership del progetto può essere il punto di partenza per raggiungere l’uguaglianza di genere in neurochirurgia. Le autrici donne si stanno affermando sempre più nella letteratura scientifica, a conferma che esistono notevoli tentativi di espandere la componente femminile riguardo a discipline che fino a qualche anno fa erano considerate strettamente maschili. 10 Recentemente è stato dimostrato che la patologia neurochirurgica vascolare presenta il maggior contributo di autrici rispetto alle altre sottospecialità della chirurgia neurologica (neuro-oncologia, spinale, funzionale). 9 , 11 , 12 La ricerca, il finanziamento delle sovvenzioni e le posizioni accademiche dipendono dalla continua attività di pubblicazione scientifica. Aumentare il ruolo di primo piano delle donne neurochirurghi nelle pubblicazioni scientifiche potrebbe col tempo promuovere l’equità nella distribuzione delle posizioni accademiche nel mondo della neurochirurgia. 13 L'obiettivo di questa analisi bibliometrica è quello di ottenere una visione oggettiva sul coinvolgimento delle donne nella letteratura riguardante il campo neurovascolare identificando il numero di articoli in cui il primo autore è donna e di differenziare i risultati per paese e rivista e analizzare l'andamento nel corso gli anni.
Sex Differences in Academic Productivity Across Academic Ranks and Specialties in Academic Medicine: A Systematic Review and Meta-analysis Open PDF
(2021)
Ha, Giang L.
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Lehrer, Eric J.
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Wang, Ming
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Holliday, Emma
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Jagsi, Reshma
Importance: Despite equal numbers of men and women entering medical school, women are underrepresented in the upper echelons of academic medicine and receive less compensation and research funding. Citation-related publication productivity metrics, such as the h-index, are increasingly used for hiring, salary, grants, retention, promotion, and tenure decisions. Exploring sex differences in these metrics across academic medicine provides deeper insight into why differences are observed in career outcomes. Objective: To systematically examine the available literature on sex differences in h-index of academic faculty physicians across all medical specialties and all levels of academic rank. Data Sources: Medical literature with the term h-index found in PubMed and published between January 1, 2009, and December 31, 2018, was used. Study Selection: A PICOS (Population, Intervention, Comparison, and Outcomes), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and MOOSE (Meta-analysis of Observational Studies in Epidemiology) selection protocol was used to find observational studies that published h-indexes for faculty physicians that were stratified by sex. Studies were excluded if they were review articles, retracted, or unavailable online. Ultimately, 14 of 786 studies (1.78%) met the inclusion criteria. Data Extraction and Synthesis: Data from 9 studies across 16 specialties were examined using weighted random-effects meta-analyses. Five studies were excluded because of overlapping specialties with another study or because they were missing appropriate statistics for the meta-analysis. Four of these studies were included in qualitative synthesis to bring the total to 13 studies. Main Outcomes and Measures: The primary study outcome was the h-index. Results: The meta-analysis included 10 665 North American unique academic physicians across 9 different studies from the years 2009 to 2018. Of the 10 665 physicians, 2655 (24.89%) were women. Summary effect sizes for mean h-indexes of men and women and mean h-index difference between men and women were determined for all faculty physicians and at each academic rank. Overall, female faculty had lower h-indexes than male faculty (mean difference, -4.09; 95% CI, -5.44 to -2.73; P < .001). When adjusting for academic rank, female faculty still had lower h-indexes than male faculty at the ranks of assistant professor (mean difference, -1.3; 95% CI, -1.90 to -0.72; P < .001), associate professor (mean difference, -2.09; 95% CI, -3.40 to -0.78; P = .002), and professor (mean difference, -3.41; 95% CI, -6.24 to -0.58; P = .02). Conclusions and Relevance: In this systematic review and meta-analysis, women had lower h-indexes than men across most specialties and at all academic ranks, but it is unclear why these differences exist. These findings suggest that future investigation should be conducted regarding the causes of lower h-indexes in women and that interventions should be developed to provide a more equitable environment for all physicians regardless of sex.
The proportion of male and female editors in women's health journals: A critical analysis and review of the sex gap Open PDF
(2020)
Grinnell, Madison
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Higgins, Shauna
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Yost, Kelli
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Ochuba, Olivia
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Lobl, Marissa
BACKGROUND: Historically, women have been underrepresented in leadership positions in medicine. The reasons for this are multifactorial. In recent years, women's representation in medicine has improved. However, inequities in the proportion of men and women in medical leadership remain, especially with regard to editorial journal boards. OBJECTIVE: This study aimed to explore current trends of women in leadership positions on journal editorial boards. METHODS: A comprehensive search for women's health journals was performed in collaboration with university librarians in February 2019 using EMBASE, Scopus, SciFinder, and MEDLINE records for journals with relevance to women's health. Each journal was e-mailed to verify the accuracy of the journal editorial boards listed on their respective webpages. Five categories, as well as the totals for each journal, were analyzed for the proportion of women versus men: editor-in-chief, associate editor, deputy editor, and section editor, and other. RESULTS: Women comprised the minority of positions on women's health editorial boards. Of the total 1440 board members included, 602 members (42%) were women and 838 members (58%) were men. Women occupied 54 of 132 editor-in-chief positions (41%), 257 of 596 associate editor positions (43%), 13 of 42 deputy editor positions (30%), 46 of 120 section editor positions (38%), and 232 of 549 other editor positions (42%). CONCLUSION: Although the sex gap in leadership in medicine is improving, it is still present. Our findings suggest that women are underrepresented as editors at most levels in women's health journals centered on topics such as reproductive health, obstetrics and gynecology, perinatology, gynecological oncology, and breastfeeding. With sponsorship/mentorship for women, flexible scheduling, and considerate thought in leadership appointment, this sex gap will continue to improve.
Race, ethnicity, and gender in academic obstetrics and gynecology: 12-year trends Open PDF
(2020)
Wooding, Denise J.
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Das, Priya
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Tiwana, Sabeen
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Siddiqi, Javed
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Khosa, Faisal
Background Diversity among healthcare teams enhances team function and improves the quality of patient care and outcomes. Women and racial minorities are historically underrepresented in medicine. However, the representation of gender and racial or ethnic groups in academic obstetrics and gynecology in the United States has not been described in recent years. Objective This study aimed to describe the recent state and trends in gender and racial or ethnic disparities in academic obstetrics and gynecology. Study Design Data from the Association of American Medical Colleges between 2007 and 2018 were analyzed to describe the trends in the representation of women and racial (white, Asian, black) or ethnic (Hispanic) groups. The 12-year trends in representation by academic ranks (all academic physicians, full professor, associate professor, instructor), leadership positions (chairperson), and tenure (not on track for tenure, on track for tenure, or tenured) were depicted. The 12-year trends were assessed using linear regression to determine whether the slope depicting the change in representation of each group from 2007 to 2018 was significantly nonzero. In addition, average representation of each group across the 12-year period was compared using a Student t test (for gender) or analysis of variance (for race and ethnicity). Results In 2018, there were 152 institutions and 6302 academic physicians included in the data set. On average across the 12-year period, academic physicians in obstetrics and gynecology were 43% male, 57% female, 68% white, 12% Asian, 8% black, and 5% Hispanic. Across the 12-year period, there was an increase in the total number of physicians from 4755 to 6302 (+166 per year; 95% confidence interval, 146–186; P<.0001), a 15% increase in the proportion of women (+1.38% per year; 95% confidence interval, 1.08%–1.68%; P<.0001), and an increase in the proportion of physicians from racial minorities (Asian, +0.11% per year; 95% confidence interval, 0.08–0.15; P<.0001; black, +0.07% per year; 95% confidence interval, 0.04–0.09; P=.0002; Hispanic, +0.06% per year; 95% confidence interval, 0.02–0.1; P=.0039). There was a greater proportion of white physicians in higher academic ranks (eg, full professor), leadership positions (eg, chairperson), and tenure than the proportion of white physicians overall, whereas the opposite was true for black and Hispanic physicians. Although women now make up 64% of all academic physicians in obstetrics and gynecology, there remains a far higher proportion of males in leadership positions (chairperson) and higher academic ranks (full professor). Similarly, a greater proportion of males were tenured than females. Conclusion Across the 12-year period, the representation of women and racial minorities has increased in academic obstetrics and gynecology in the United States. There is now a predominance of women, but there remains a trend for a predominance of white and male physicians in higher academic ranks, leadership positions, and tenure. It will be important to assess how these groups are represented in the coming years as the changing demographics of incoming cohorts progress through their careers to more senior positions. Promoting diversity in medical schools, leadership positions, and higher academic ranks may be an important area of focus.
Women as Authors of Randomized Controlled Trials of Minimally Invasive Surgery: Systematic Review and Meta-Analysis of 3 Decades of Trials Open PDF
(2021)
Sayyid, Rashid K.
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Lokeshwar, Soum D.
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Luckenbaugh, Amy N.
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Hall, Mary E.
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Jones, Caitlin E.
BACKGROUND: Female authorship opportunities have lagged behind those of their male counterparts, with gender disparities most prominent in surgical specialties. Our objective was to determine trends of female first, last, and first or last authorships across time and surgical specialties and whether female first or last authorship was associated with journal impact factor. STUDY DESIGN: A systematic review of EMBASE (OvidSP), MEDLINE (OvidSP), and Cochrane (Wiley) databases from inception to December 22, 2017 was performed to identify all randomized controlled trials evaluating minimally invasive surgery vs classical surgical techniques. The primary end point was female first, last, and first or last authorship, with gender determined via an online search strategy and verified via Genderize.io. Secondary end point was journal impact factor, recorded from Clarivate Analytics InCites. RESULTS: There were 9,321 articles identified and 489 met our inclusion/exclusion criteria. Sixty-eight (13.9%) first and 60 (12.3%) last female authors were identified. A positive linear trend for female first (R2 = 0.35, Cochran-Armitage test for trend, p < 0.001), last (R2 = 0.30, p < 0.001), and first or last authorships (R2 = 0.40, p < 0.001) over time was identified. This trend was observed across surgical specialties except for orthopaedics. The highest calculated percentages of female first, last, and first or last authorships by the year 2017 were seen in obstetrics and gynecology (33.8%, 32.0%, and 43.8%, respectively), all significantly lower than the corresponding percentage of the female obstetrics and gynecology workforce in 2017 (57.0%). Neither female first nor last authorship positions were associated with journal impact factor. CONCLUSIONS: A significant increase in female first and last authorship in randomized controlled trials of minimally invasive surgical techniques in the last 3 decades has been observed, but continued efforts to bridge this gender gap are sorely needed.

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