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Program Director Gender and Female Representation in United States Anesthesiology Residency Programs: A Website Content Analysis Open PDF
(Informa UK Limited, 2026-07)
Dankievitch, Korinne
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Malgieri, Christopher James
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Corman, Benjamin HP
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Hayward, Geoffrey
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Argo, Jonathan
PURPOSE: Female program directors (PD) have been suggested to influence gender representation and recruitment; however, their impact within anesthesiology residency programs remains unclear. This study evaluated whether PD gender is associated with differences in female resident and faculty representation and anesthesiology residency program website content. METHODS: Anesthesiology residency programs participating in the 2024-2025 National Resident Matching Program (NRMP) Match were identified through the American Medical Association's Fellowship and Residency Electronic Interactive Database (FREIDA). Program websites were evaluated for 13 predefined criteria across three domains: leadership and strategic vision, representation, and resources. Program characteristics, including full-time faculty and residents, were extracted. Scores across domains were compared by program director gender. Data presented as mean (standard deviation) or percentage (%). RESULTS: A total of 160 programs were included in the analysis; 38% were led by female and 62% by male program directors. Women represented 35% of residents and full-time faculty across all programs. Programs led by female program directors was associated with lower female representation among residents (27.9% vs. 42.8%) and full-time faculty (27.4% vs. 44.4%, p<0.001) compared to male-led programs. The mean overall website content score was 6.45 ± 3.11, with no difference by program director gender (6.82 ± 3.04 vs. 6.21 ± 3.13, p=0.253). However, representation domain scores were higher in programs with female program directors (2.20 ± 0.95 vs.1.82 ± 1.06; p=0.042). CONCLUSION: Women represent more than one-third of anesthesiology program directors, residents, and full-time faculty, reflecting continued progress toward gender equity within the specialty. However, programs led by female program directors had lower female representation among residents and full-time faculty, despite stronger emphasis on visual and descriptive representation within website content. Together, these findings suggest that while leadership equity remains important, recruitment, representation, and workforce equity are shaped by broader structural and institutional factors beyond program director gender alone.
Trends in Authorship in Anesthesiology Journals Open PDF
(2019)
Miller, Joanna
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Chuba, Emuejevoke
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Deiner, Stacie
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DeMaria, Samuel
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Katz, Daniel
Despite increasing representation in medicine, women continue to be a minority in academic practice and leadership, especially in male-dominated fields like anesthesiology. Differences in compensation and participation in leadership may represent barriers to career advancement for women in anesthesiology. Key factors for promotion in academic anesthesiology are research, funding, and publication. As such, designation as a first or senior author on a publication in a professional journal may act as currency for promotion. Here, we examine the prevalence of female first and senior authorship of original research articles published in Anesthesiology and Anesthesia & Analgesia during the years 2002, 2007, 2012, and 2017. Other manuscript characteristics assessed in relation to author gender included study type, subspecialty topic, and total number of authors. Of 2600 manuscripts studied, analysis of authorship by year demonstrated an increase in female first authorship, senior authorship, and editorial board membership by 10%, 9%, and 6%, respectively. Women made up a higher percentage of first authors on manuscripts with female senior authors. More nonexperimental studies had female senior authors than experimental studies. Female first authors had greater representation in the subspecialties of neuroanesthesia, obstetrical anesthesia, pain management, and pediatric anesthesia. Median number of authors was unrelated to senior author gender. This study shows increasing female first and senior authorship, as well as editorial board composition in 2 popular, high-impact anesthesiology journals. Recognizing gender-based trends in publications is important to develop strategies for the recruitment, retention, and advancement of women in anesthesiology.
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.
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.
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.
Women Representation as First and Corresponding Authors in Neuroanesthesiology and Neurocritical Care Journals: A Retrospective Analysis Open PDF
(2021)
Gupta, Nidhi
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Banerjee, Shraya
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Choudhury, Kalyanpury J.
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Prabhakar, Hemanshu
INTRODUCTION: There is limited literature on the representation of women in leading roles in neuroanesthesiology and neurocritical care academia. We aimed to determine the representation of women as first and corresponding authors in articles published in 3 dedicated journals of neuroanesthesiology and neurocritical care during last 5 years. METHODS: Articles published in the Journal of Neurosurgical Anesthesiology, Neurocritical Care, and Journal of Neuroanaesthesiology and Critical Care between July 1, 2015 and June 30, 2020 were included in this study. The primary outcome was the proportion of women first authors, and secondary outcomes were the percentage of women corresponding authors, and representation of women as first and corresponding author by article type and country of affiliation. RESULTS: Of the 1164 articles included in the study, 403 (34.6%) had a woman first author. Women first authorship was highest for Special Articles (5/11; 45.5%), Clinical Reports (44/113; 38.9%) and Narrative Review Articles (58/151; 38.4%) and lowest for Original Research Articles (198/597; 33.2%). Women accounted for 29.6% (344/1164) of corresponding authors across all article types. Overall, the United States and India had the highest representation of women first authors (159/403; 39.0% and 107/344; 31.0%, respectively), and India also had highest proportion of women corresponding authors (107/272; 39.3%). CONCLUSIONS: Women were underrepresented compared with men as first author of articles published in 3 dedicated neuroanesthesiology and neurocritical care journals over the last 5 years. Women had the lowest representation as authors of Original Research Articles.
Women authorship in pain research: A bibliometric analysis from 2002 to 2021 Open PDF
(2023)
Zhong, H.
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Poeran, J.
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Cozowicz, C.
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Illescas, A.
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Liu, J.
Objectives: There is a lack of data on the distribution of women first and senior authorships in pain journals. Using articles published in top North American pain journals over the past two decades, we sought to describe the prevalence and changes in women representation among first and last authors. Methods: We retrieved all published research articles in four pain journals (Regional Anesthesia and Pain Medicine, Clinical Journal of Pain, Pain and The Journal of Pain) from 2002 to 2021 using the easyPubMed package. Subsequently, the ‘gender’ package in R was used to determine authors' gender by first names. Trends in gender authorship change over time were assessed. Results: The final cohort consisted of 20,981 authors (from an initial total of 11,842 publications and 23,684 authors retrieved). Women authors were more often first compared to senior authors (46.7% vs. 30.5%). The proportion of women first authors (46.2% in 2002 vs. 48.4% in 2021) and women senior authors (22.4% in 2002 vs. 36.3% in 2021) increased over the course of the study period (all p-value <0.001). The Clinical Journal of Pain having the highest percentage of women authors and Regional Anesthesia and Pain Medicine had the lowest percentage of women authors. Discussion: Our data demonstrated increasing women authorship in pain journals in the past 20 years, largely driven by an increase in first authorships. There still remains a large gap between first and senior authorship, indicative of disparity in the role that women play in research. © 2023 European Pain Federation - EFIC ®.
Gender of Abstract Presenters at the Annual Meetings of the Society of Cardiovascular Anesthesiologists and American Society of Anesthesiologists: 2016 to 2020 Open PDF
(2022)
Pan, S.
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Shillcutt, S.
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Oakes, D.
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Muehlschegel, J.D.
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Shore-Lesserson, L.
Objective: The purpose of this study was to assess gender in abstract poster presentations at the Society of Cardiovascular Anesthesiologists (SCA) and American Society of Anesthesiologists (ASA) Annual Meetings from 2016 through 2020 to determine possible gender disparities in anesthesia overall as compared to cardiothoracic anesthesia. Design: A bibliometric study Setting: Publicly available data from the SCA and ASA websites. Participants: Presenting and senior authors of abstracts at the SCA and ASA Annual Meetings. Interventions: None. Measurements and Main Results: Abstract data on presenting and senior authors were collected for the years 2016 through 2020 for both annual meetings. Observed gender of abstract authors was compared to expected gender based on the gender distribution of cardiac anesthesiologists for the SCA or of all anesthesiologists for the ASA. From 2016 to 2020, the proportion of women senior authors on abstracts was significantly underrepresented (2016-2019, p < 0.05). At the SCA meetings, there was no significant difference in the observed versus expected proportion of women presenting and senior authors. The percentage of woman physicians' abstract-presenting authors at the ASA was overrepresented compared to the expected proportion for each year (2016-2020, p < 0.001). Conclusion: At the SCA, women were appropriately represented as both presenting and senior abstract authors. At the ASA, there was significant overrepresentation of women as presenting authors and underrepresentation of women as senior authors. These results suggested that abstract presentation is not a barrier to academic advancement. © 2021 Elsevier Inc.
Gender Differences in Authorship in the Journal of Cardiothoracic and Vascular Anesthesia: A 28-Year Analysis of Publications Originating From the United States, 1990-2017 Open PDF
(2019)
Pagel, Paul S.
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Freed, Julie K.
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Lien, Cynthia A.
OBJECTIVE: Gender-based differences in scholarship among cardiothoracic anesthesiologists have not been studied. The authors examined the gender distribution of authorship of original research articles, case reports, review articles, and editorials in the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) originating from the United States during four 3-year intervals to determine temporal changes in productivity of women in cardiothoracic anesthesiology. The authors tested the hypothesis that scholarly output of women has increased progressively in JCVA over time concomitant with greater participation in first, last, and corresponding author roles. DESIGN: Observational study. SETTING: Internet analysis. PARTICIPANTS: Authors of research articles, case reports, review articles, and editorials published in JCVA in 1990-92, 1999-2001, 2008-10, and 2015-17. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The gender of each author was determined by inspection of the first name. If gender could not be established easily, the author's institutional website was examined or an internet search using the Google search engine was conducted. First, last, and corresponding authors as well as coauthors were noted for each article. A total of 1,195 publications with 4,982 authors (1,032 women; 20.7%) were examined. Gender was identified positively in 98.5% of authors. Women were first, last, and corresponding authors on 22.4%, 10.3%, and 14.6% of publications, respectively. The percentage of women who were authors increased from 12.1% in 1990-92 to 20.9% in 1999-2001 (p < 0.05), but plateaued in 2008 to 2010 (22.3%) and 2015 to 2017 (22.9%). Greater percentages of women were first authors (26.2%), senior authors (11.8%), and corresponding authors (16.6%) in 2015 to 2017 compared with 1990 to 1992 (9.6%, 7.0%, and 8.7%, respectively; p < 0.05 for each). The contributions of women to research articles and case reports were primarily responsible for these observed increases, although women also made a substantial impact with review articles in 2015 to 2017. The percentage of publications that included at least 1 female author in any capacity increased in a time-dependent manner (p < 0.05) from 31.0% (1990-1992) to 74.4% (2015-2017). The proportion of female first or last authors (35.0%) appearing in JCVA during 2015 to 2017 was modestly higher than the current percentage of female cardiothoracic anesthesiologists practicing in departments with accredited fellowship programs (29.1%). CONCLUSION: The results indicate that scholarly output of women rose in JCVA over time, but gains in productivity have plateaued more recently. These findings are encouraging, but women continue to be underrepresented in corresponding and last author roles.
A 50-year analysis of gender differences in United States authorship of original research articles in two major anesthesiology journals Open PDF
(2019)
Pagel, P.S.
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Freed, J.K.
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Lien, C.A.
Underrepresentation of women in academic medicine is strongly linked to differences in men’s and women’s scholarship and has been shown to substantially reduce the overall quality of research. An authorship “gender gap” exists in most medical specialties, but differences in research article authorship have only been recently suggested in anesthesiology. We analyzed authorship of US research articles published in Anesthesiology and Anesthesia and Analgesia (journals that publish two-thirds of all anesthesiology-related articles) from 1967 to 2017 to test the hypothesis that publication of anesthesiology research articles by women authors has progressively increased over time along with greater involvement in first, last, and corresponding author roles. Research articles appearing in Anesthesiology and Anesthesia and Analgesia in 1967, 1977, 1987, 1997, 2007, and 2017 were identified. The corresponding author was used to determine the country of origin of each article; only articles originating from the US were included in the analysis. Each author’s gender was determined by inspection of the first name and verified using the author’s institutional website or an internet search if necessary. First, last, and corresponding authors as well as co-authors were noted for each article. Federal grant support was also identified if present. Gender was identified in 98.2% of authors. A total of 1350 research articles with 6165 authors (1319 female; 21.4%) originated from the US. The percentage of women authors increased in a time-dependent manner in Anesthesiology from 6.2% in 1967 to 31.3% in 2017. The proportion of women who were first, last, and corresponding authors increased from 5.1%, 8.9%, and 2.5%, respectively, in 1967 to 37.0%, 22.2%, and 25.9% in 2017, respectively. The number of women co-authors per article also increased over time. Similar results were observed in Anesthesia and Analgesia. The percentage of articles that included at least one woman rose progressively over time in both journals (e.g., Anesthesiology, 12.6% in 1967 versus 90.7% in 2017). Articles published in Anesthesiology were more likely to be supported by a federal grant than those in Anesthesia and Analgesia. The percentage of women first authors of US research articles in Anesthesiology and Anesthesia and Analgesia increased from 1967 to 2017 and approaches the proportion who currently hold academic appointments. Women’s last and corresponding authorship also increased during the past 50 years, but women continue to be relatively underrepresented in these roles. © 2019, Akadémiai Kiadó, Budapest, Hungary.

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