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  • Item type:Publication,
    Examining Differential Rater Functioning and Bias in the Holistic Review of Residency Applications Open PDF 
    (Journal of Graduate Medical Education, 2026-06)
    Barnes, Leandra A.
    ;
    Sebok-Syer, Stefanie S.
    ;
    Wind, Stefanie A.
    ;
    Nord, Kristin M.
    ;
    Laidlaw, Kathrina
    BACKGROUND: The impact of rater bias in applicant selection for residency interviews using holistic review is poorly understood. OBJECTIVE: To measure faculty raters' bias toward applicant gender and underrepresented in medicine (URiM) status in their recommendations to offer residency interviews. METHODS: In this cross-sectional study, applicant (n=3875) and faculty rater (n=69) data within a single institution's dermatology residency application database from 2014 to 2023 were examined for differences in rater judgments to interview applicants as measured by logits (ie, a standardized unit of scoring difference) using the many-facet Rasch model, a statistical method that accounts for variations among raters, applicants, and scoring for applicant gender (23% women, 14% men, and 63% unknown) and URiM status (26% White, 21% non-White non-URiM, 12% URiM, 41% unknown). RESULTS: Rater bias, as measured in logits using the rater severity measure, was minimal for applicant gender (-0.12, 0.08 logits) and URiM status (-0.07, 0.04 logits). However, raters were more lenient (ie, likely to favor an interview) when the applicant's and rater's gender (-1.74 logits, SE 0.05) or URiM status (-0.46 logits, SE 0.05) were concordant. Conversely, raters were more severe (ie, unlikely to favor an interview) when discordant on gender (1.74 logits, SE 0.05) or URiM status (0.46 logits, SE 0.05). More than 50% of individual raters exhibited substantial gender bias, and approximately 33% for URiM status bias when concordant. CONCLUSIONS: Raters were more likely to favor offering interview invitations to applicants with concordant gender or URiM status and less likely to favor interviewing applicants with discordant gender or URiM status.
  • Item type:Publication,
    The workplace culture, mental health and wellbeing of early- and mid-career health academics: a cross-sectional analysis Open PDF 
    (2024)
    Marck, Claudia H.
    ;
    Ayton, Darshini
    ;
    Steward, Trevor
    ;
    Koay, Hui-Fern
    ;
    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.
  • Item type:Publication,
    Declining racial and ethnic representation in clinical academic medicine: A longitudinal study of 16 US medical specialties Open PDF 
    (2018)
    Lett, Elle
    ;
    Orji, Whitney U.
    ;
    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.
  • Item type:Publication,
    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.
    ;
    Lehrer, Eric J.
    ;
    Wang, Ming
    ;
    Holliday, Emma
    ;
    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.
  • Item type:Publication,
    Gender Parity Analysis of the Editorial Boards of Influential Dermatology Journals: Cross-Sectional Study Open PDF 
    (2024)
    Szeto, Mindy D.
    ;
    Sivesind, Torunn E.
    ;
    Kim, Lori S.
    ;
    O'Connell, Katie A.
    ;
    Sprague, Kathryn A.
    This study underscores the persistent underrepresentation of women in academic dermatology leadership positions by examining the gender composition of editorial boards across top dermatology journals, emphasizing the urgent need for proactive strategies to promote diversity, equity, and inclusion.
  • Item type:Publication,
    Gender Representation in Authorship of Academic Dermatology Publications During the COVID-19 Pandemic: Cross-Sectional Study Open PDF 
    (2024)
    Szeto, Mindy D.
    ;
    Laughter, Melissa R.
    ;
    Maymone, Mayra B. C.
    ;
    Patel, Payal M.
    ;
    Sivesind, Torunn E.
    Analyses of women dermatology literature authorship from 2018 to 2022 reveal a slight increase in total female authors, female first authors, and female senior authors with no substantial immediate impact of COVID-19 on current trends, encouraging future examination of long-term effects and ongoing promotion of systemic initiatives to support gender equity.
  • Item type:Publication,
    A gender gap in the dermatology literature? Cross-sectional analysis of manuscript authorship trends in dermatology journals during 3 decades Open PDF 
    (2009)
    Feramisco, J.D.
    ;
    Leitenberger, J.J.
    ;
    Redfern, S.I.
    ;
    Bian, A.
    ;
    Xie, X.-J.
    Background: Despite a dramatic influx of female dermatologists during the last 30 years, women in academic dermatology departments remain relatively clustered in junior faculty positions. Research in other specialties showing a disparity in the academic productivity of women has led to many hypotheses regarding factors that may place them at a competitive disadvantage. It is unknown, however, whether similar differences in academic productivity might also serve as barriers to advancement in dermatology, or whether any productivity gap actually exists in this specialty that experienced a more substantial entry of women. Objective: Because publication in peer-reviewed journals is one of the core measures of academic productivity used in the promotion process, we evaluated trends in the prevalence of female authorship in top dermatology journals during the last 3 decades. Methods: We conducted an observational study of trends in the sex distribution of US authors in 3 prestigious general dermatology journals (in 1976, 1986, 1996, and 2006) and 3 subspecialty dermatology journals (in 2006 only). Journals were chosen based on published impact factors and citation half-lives. Results: During the last 3 decades, the proportion of women authoring manuscripts in the 3 major general dermatology journals increased from 12% to 48% of US-affiliated first authors (P < .001) and from 6.2% to 31% of US-affiliated senior authors (P < .001). Separate analyses by journal and by article type showed similar increases. The prevalence of female authors in subspecialty journals in 2006 was slightly more variable. Limitations: Although the publications selected for this study capture many of the most respected US journals in dermatology, they may not be representative of all journals in which dermatologists publish. Conclusions: Female dermatologists are authoring publications in growing numbers that match or exceed their prevalence in the academic and overall workforce. This suggests that other factors (differences in productivity outside of the publishing arena, differences in job descriptions or opportunities, differences in career aspirations, a lack of institutional support or flexibility, or gender bias) may be associated with the ongoing reduced advancement of women to senior academic dermatology ranks relative to their male colleagues, and further research is warranted to explore these possibilities. © 2009 American Academy of Dermatology, Inc.