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  • Item type:Publication,
    Women Emergency Physicians and Gender Disparities from Entry to Advancement Open PDF 
    (Elsevier BV, 2026-07)
    Sethuraman, Kinjal N.
    ;
    Lall, Michelle D.
    ;
    Gorman, Emily F.
    ;
    Zeidan, Amy J.
    ;
    Agrawal, Pooja
    STUDY OBJECTIVE: We sought to summarize the last 20 years of published research on gender experience and disparities in the emergency medicine workforce. METHODS: We conducted a scoping review by searching MEDLINE ALL, Embase, Cochrane Central Register of Controlled Trials, and Scopus from 2003 to 2024, to identify original research investigating gender experience and disparities among physicians in emergency medicine in North America. We abstracted study design, sample characteristics, and outcomes. We analyzed data using an ad hoc iterative thematic analysis of the content areas as well as a synthesis of the key findings and research limitations. RESULTS: We identified 5,740 candidate publications and, after exclusions, included 191 (99% observational studies). We identified 15 themes: (1) workforce, (2) childbearing, (3) attrition, (4) evaluations, (5) bias and discrimination, (6) wellness, (7) professional development groups and mentorship, (8) authorship, (9) editorial board membership, (10) research grants, (11) national speakers, (12) awards, (13) leadership roles, (14) academic rank and promotion, (15) financial compensation and one subtheme (pediatric emergency medicine). We mapped these themes to 5 domains: (1) Recruitment and Retention, (2) Culture and Environment, (3) Academic Scholarship, (4) Recognition and Promotion, and (5) Clinical Care and Decisionmaking. There were 3 to 33 publications per theme. The quality of evidence was variable. We found fewer disparities, and improvement over time in the percentage of women academic faculty, women authorship, national speaking, and educational awards. We found consistent evidence of gender disparities disadvantaging women emergency physicians in financial compensation, editorial board membership, executive leadership roles, academic rank, and experiences of gender bias, with little change over time. CONCLUSION: Although some areas remain understudied, our central findings confirm that gender-based disparities continue to exist among emergency physicians. Future efforts should be redirected toward the development and assessment of interventions that combat these disparities.
  • Item type:Publication,
    Beyond the Scores: Gendered Interpretations of Emergency Medicine Resident Assessments of Interdependent Performances Open PDF 
    (Ubiquity Press, Ltd., 2025-08-21)
    El Galad, Asil
    ;
    Sebok-Syer, Stefanie S.
    ;
    Panza, Michael
    ;
    Ng, Kristen
    ;
    Lingard, Lorelei
    PURPOSE: In medicine, gender bias and gendered language within assessments of individual performance are well established. Recent shifts toward assessing interdependence (the ability to work supportively and collaboratively within teams) demand we understand how gender bias and gendered language influence assessments. In exploring how faculty assess residents' interdependent performances, this study evaluated how gender-presentation influences faculty raters' assessments of residents' interdependence in Emergency Medicine (EM). METHODS: Using a multiple-methods (an experimental within-subjects study with follow-up interviews), 18 EM faculty from Canada and the United States assessed scripted videos of identical clinical encounters acted by male- and female-presenting residents. Faculty assessed female residents via anonymous online surveys and, six months later, assessed male residents via follow-up interviews using the same clinical scenarios. After every clip, faculty completed entrustable professional activity (EPA) and Milestone ratings and provided narrative justifications. Statistical analyses were conducted using Wilcoxon signed-rank tests to assess gender differences in EPA and Milestone scores. Qualitative data were analyzed using thematic analysis to identify recurring, gendered patterns in narrative justifications. RESULTS: Quantitative results revealed no gender differences in Milestone and EPA scores, except for the resuscitation entrustment rating, where male residents were rated less favorably (z = -3.09, p = 0.002). Qualitative findings uncovered subtle gender differences. For the same clinical performances, male residents were frequently described as leaders, while female residents as collaborative. Furthermore, male residents' help-seeking was framed as proactive, whereas female residents' help-seeking was indicative of lacking knowledge. Finally, bias was not consistent across genders: male leadership expectations could negatively flavor assessments of male collaborative performances. CONCLUSION: EPA and Milestone scores showed marginal gender-based differences, while narrative justifications reflected clear gendered expectations about residents' interdependence. These findings highlight the need for equity-oriented assessment practices that interrogate both the numbers and the narratives. As team-based competencies like interdependence become central to clinical training, ensuring that assessments reflect fair, unbiased interpretations are essential to supporting all learners equitably.
  • 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,
    First and last authorship by gender in emergency medicine publications- a comparison of 2008 vs. 2018 Open PDF 
    (2021)
    Webb, Johnlukas
    ;
    Cambron, John
    ;
    Xu, K. Tom
    ;
    Simmons, Michael
    ;
    Richman, Peter
    Background and objectives Recently, investigators reported that there remain substantial disparities in the proportion of women within emergency medicine (EM) who have achieved promotion to higher academic rankings, received grant funding, and attained departmental leadership positions. In 2007, women were first authors on 24% of EM-based peer-reviewed articles. Currently, 28% of the academic EM physician workforce is comprised of women. The goal of this study was to identify whether the proportion of female first authors of original research published in three U.S.-based EM journals increased in 2018 as compared to 2008. Methods This was a retrospective review of published original research articles during 2008 and 2018 in the journals Academic Emergency Medicine (AEM), American Journal of Emergency Medicine (AJEM), and Annals of Emergency Medicine (Annals). Review articles, opinion pieces, consensus statements, practice recommendations based on current guidelines, and case reports were excluded from analysis. Investigators conducted a review of each article to identify the gender of the study's first and last authors. A study author blinded to the previous author's data abstraction reviewed a sample of 25 articles to assess for inter-rater reliability (kappa). Categorical data are presented as frequency of occurrence and analyzed by chi-square. Results Overall for the study journals, there were 368 original research articles published in 2008 vs. 580 in 2018. There were no significant differences noted for the proportion of female first author publications during 2008 vs 2018 overall (28% vs 30%; p = 0.38), within AJEM (29% vs 28%; p = 0.85), and observed at Annals (25% vs 24%; p = 0.82) respectively. However, there was a significant increase in the number of first author publications by females between the two periods within AEM (28% vs 45%; p < 0.01). There were no significant differences noted for the proportion of female last author publications during 2008 vs. 2018 overall (21% vs 22%; p = 0.70) and within each respective journal: AEM 22%% vs 26% (p = 0.51), AJEM 22% vs 19% (p = 0.55), and Annals 19% vs 22% (p = 0.20). Inter-rater reliability for author gender within the sample articles was excellent (0.83). Conclusion While female physicians make up a disproportionate 28% of the academic workforce, we found that they were proportionally represented as first authors within several of the most prominent U.S.-based EM journals. Female resident physicians remain underrepresented as first authors and women remain underrepresented as last authors in the same journals.
  • Item type:Publication,
    The Impact of Faculty Gender on Resident Evaluations of Faculty Performance in Emergency Medicine
    (2024)
    Beaulieu, Allison M.
    ;
    Hunold, Katherine M.
    ;
    Mitzman, Jennifer
    ;
    Li-Sauerwine, Simiao
    INTRODUCTION: Gender bias impacts the promotion and tenure of female emergency medicine (EM) physicians and limits their ability to advance in academic rank. Many factors influence the promotion and tenure process including research, evaluations, opportunities for leadership, sponsorship, and mentorship. The goal of this study is to determine if resident evaluations of EM faculty differ by faculty gender. METHODS: A quantitative analysis was used to examine 14,613 teaching evaluations of faculty by residents at a single academic center (The Ohio State University Wexner Medical Center, Columbus) in the years 2017-2019. Anonymized ratings of male and female faculty on a five-point Likert scale were compared using Fischer's exact test and adjusting for multiple comparisons. RESULTS: Male faculty were more likely to hold the rank of Associate Professor or Professor. When taking both faculty gender and rank into account, male Clinical Instructors and Assistant Professors had significantly higher evaluation scores by residents in the domain of resident autonomy than their female counterparts. Regardless of gender or faculty rank, the majority of faculty received scores greater than four. CONCLUSION: A significant gender difference was found in resident evaluation scores of faculty in the domain of resident autonomy at the level of Clinical Instructor and Assistant Professor. Resident autonomy refers to the degree of supervision by faculty which evolves over time and is primarily based on level of training. This is important as it demonstrates a gender difference in scores that could be used to determine faculty compensation and promotion. Evaluation tools used for promotion and tenure of academic faculty should be evaluated for implicit bias and appropriate statistical analysis.
  • Item type:Publication,
    COVID-19 medical papers have fewer women first authors than expected Open PDF 
    (2020)
    Andersen, J.P.
    ;
    Nielsen, M.W.
    ;
    Simone, N.L.
    ;
    Lewiss, R.E.
    ;
    Jagsi, R.
    The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researchers facing the challenges of these disruptions. Here we report the results of an analysis that compared the gender distribution of authors on 1893 medical papers related to the pandemic with that on papers published in the same journals in 2019, for papers with first authors and last authors from the United States. Using mixed-effects regression models, we estimated that the proportion of COVID-19 papers with a woman first author was 19% lower than that for papers published in the same journals in 2019, while our comparisons for last authors and overall proportion of women authors per paper were inconclusive. A closer examination suggested that women’s representation as first authors of COVID-19 research was particularly low for papers published in March and April 2020. Our findings are consistent with the idea that the research productivity of women, especially early-career women, has been affected more than the research productivity of men. © Andersen et al.