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Women Emergency Physicians and Gender Disparities from Entry to Advancement Open PDF
(Elsevier BV, 2026-07)
Sethuraman, Kinjal N.
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Lall, Michelle D.
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Gorman, Emily F.
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Zeidan, Amy J.
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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.
Gender- and Sex-equitable Submission Guidelines in Emergency Medicine Journals Are Associated with Enhanced Publication Metrics Open PDF
(California Digital Library (CDL), 2026-01-16)
Manes, Akash
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Lall, Michelle D.
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Knight, Starr
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Raja, Ali S.
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Khosa, Faisal
Introduction: Gender and sex equity-promoting (GSEP) clinical research is essential to improving diversity and inclusivity in medicine. In this study we aimed to compare journal impact metrics in emergency medicine (EM) between journals that integrated gender- and sex-based considerations and those that did not. Methods: We searched the 2023 Journal Citations Report (Clarivate Analytics) for EM journals. Submission guidelines of each EM journal were examined according to the SAGER (Sex and Gender Equity in Research) guidelines and stratified as conforming or non-conforming depending on whether at least one SAGER criterion was met. Our primary outcome measure was the journal impact factor. Secondary outcome measures included other citation and influence metrics: total citations; 5-year journal impact factor; journal citation indicator; article influence score, normalized Eigenfactor score; citable items; total articles; and immediacy index. Results: Based on our classification system informed by the SAGER criteria, most journals (66%, 31/47) were classified as non-compliant. The EM journals that conformed to the sex and gender equity guidelines were rated higher than non-conforming journals across all studied journal metrics. We found that conforming journals had a significantly higher median difference (MD) than non-conforming EM journals in total citations (MD 1,586; GSEP: 3,599 vs non-GSEP: 901); 2023 2-year journal impact factor (MD 0.8; 2.3 vs 1.4); 5-year journal impact factor (MD 0.7; 2.5 vs 1.9); article influence score (MD 0.26; 0.76 vs 0.47); normalized Eigenfactor score (MD 0.79; 1.06 vs 0.26); citable items (MD 37; 103 vs 56), and total articles (MD 41; 87 vs 42). All differences were statistically significant (P < 0.05). Conclusion: Using criteria informed by the Sex and Gender Equity in Research guidelines, most EM journals (66%) were classified as non-conforming to these guidelines. This indicates a significant gap in the integration of gender- and sex-based considerations in EM research publication practices.
Organizational and Systems-Based Framework to Guide a Departmental Approach to Academic and Leadership Advancement for Women in Emergency Medicine Open PDF
(Elsevier BV, 2026-06)
Zachrison, Kori S.
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Kapanadze, Mariam
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James, Dara
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Al Jalbout, Nour
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Cash, Rebecca E.
OBJECTIVES: To address gender disparities in career advancement in academic emergency medicine, we sought to identify specific and actionable approaches that an academic department could develop or enhance to create a sustainable pathway for advancement of women in academic and leadership roles. METHODS: This project took place in an urban academic department of emergency medicine and included 3 phases: (1) a literature review to assess the current landscape, (2) interviews with key informants, and (3) a consensus process to organize and prioritize strategies. RESULTS: Our literature review identified 55 manuscripts and key themes of mentorship, training, grant success, data and benchmarks, recognition, and institutional policies. Across 20 interviews with internal and external faculty members, themes that emerged were programs and training, barriers, facilitators, mentorship, and individual and system components. During our consensus review, potential strategies were organized by relative feasibility and importance. Ultimately, strategies for building standardized systems were prioritized for their achievability based on available resources and alignment with department priorities and policy. CONCLUSION: There are several strategic options that academic departments may pursue to address gender equity challenges. This includes building standardized systems to support equitable advancement of all faculty members across domains, including salary, support, and opportunities. Standardized approaches ensure that departments not only promote gender equity but also facilitate the professional growth and promotion of all faculty members.
Beyond the Scores: Gendered Interpretations of Emergency Medicine Resident Assessments of Interdependent Performances Open PDF
(Ubiquity Press, Ltd., 2025-08-21)
El Galad, Asil
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Sebok-Syer, Stefanie S.
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Panza, Michael
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Ng, Kristen
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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.
Gender equity in authorship of emergency medicine publications in <scp>Australasia</scp> Open PDF
(Wiley, 2024-12-10)
Joyce, Laura R
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Hamill, Laura M
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Rogan, Alice
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Collins, Amanda
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Beck, Sierra
Objective To evaluate gender authorship trends in the official journal of the Australasian College for Emergency Medicine (ACEM), Emergency Medicine Australasia (EMA). Methods A bibliometric review of author gender in EMA during the 10‐year period 2013–2022. The gender of first/last authors were determined by www.genderize.io, or a manual internet search where gender was not determined with at least 90% certainty. Descriptive statistics were used with percentages of women as first and last author compared to current percentages of ACEM Fellows (FACEMs) who identify as women. Results The final analysis included 1703 articles. Women accounted for 27.4% fewer authors than men (36.3% vs 63.7%). Women were outnumbered by men by 20.0% among first authors (40% vs 60%), and 36.2% (31.9% vs 68.1%) for last authors. When the last author was a woman, there was a similar rate of women (49.2%) and men (50.8%) as first authors. However, when the last author was a man, first authors were 37.1% women versus 62.9% men. If the last author was a woman, there was a 60% greater probability that the first author was also a woman (odds ratio 1.6, 95% CI 1.3–2.1). First authorship rate by women was equal to or exceeds the proportion of women FACEMs, however, last authorship by women still lags behind. Conclusion The emergency medicine community in Australasia must continue to tackle existing gender disparities which exist in our specialty. A creative and active strategy on the part of publishers, editors, academics and authors is needed to redress this balance.
Impact of a Women-focused Professional Organization on Academic Retention and Advancement: Perceptions From a Qualitative Study Open PDF
(2019)
Lin, Michelle P.
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Lall, Michelle D.
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Samuels-Kalow, Margaret
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Das, Devjani
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Linden, Judith A.
OBJECTIVES: Organizations to promote career networking and mentorship among women are recommended as a best practice to support the recruitment and retention of women physicians; however, the impact of such organizations is unknown. Our primary objective is to describe the impact of a national woman-focused organization for academic emergency physicians on retention and advancement. METHODS: We conducted semistructured interviews of past and present organization leaders, as well as members at varying stages in their careers. Physicians with experience in qualitative methods conducted interviews and coded all transcripts using inductive content analysis techniques. Themes were reviewed and discussed to ensure consensus. RESULTS: We performed 17 interviews lasting 20 to 30 minutes each, resulting in 476 total minutes of transcript. Participants represented varying stages of career experience, ranging from 2 to 35 years since residency completion (median = 9.5 years). Median years of participation in the woman-focused organization was 10 years. Over half (53%) of participants were past presidents of the organization. The dominant themes encompassed facilitating academic advancement through scholarly productivity, leadership experiences, awards, and promotions; mentorship and sponsorship; peer support and collaborations; reduced professional isolation; and initiatives to address systemic gender inequities and challenges, including strategies to navigate bias, promote pay equity, and advocate for family-friendly workplace policies. DISCUSSION: Active participation in a woman-focused professional organization enhances members' career retention and advancement by creating opportunities and relationships that facilitate leadership, enabling scholarly work to advance equity and inclusion, and cultivating a sense of belonging. While challenges and barriers persist, the myriad benefits of a women-focused professional organization reported by members and leaders represent important steps toward greater equity for women and other underrepresented groups in academic medicine.
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.
Breaking the Gender Gap: A Two-part Observational Study of the Gender Disparity Among Korean Academic Emergency Physicians Open PDF
(2020)
Lee, Mi Jin
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Kim, ChangHo
OBJECTIVES: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. METHODS: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians' demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. RESULTS: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/ vice-chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. CONCLUSIONS: A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.
Examining the Gender Gap in Emergency Medicine Research Publications Open PDF
(2022)
Jacobs, S.A.
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Van Loveren, K.
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Gottlieb, D.
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Brave, M.
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Loman, J.
Study objective: The objective of this study was to describe the proportion of female authors on original research articles and editorials across 4 emergency medicine journals from 2013 to 2019. A secondary objective was to examine the gender composition of middle authors in relation to the genders of their respective first and last authors. Methods: In this observational study, we selected 4 journals in emergency medicine using the Journal of Citation Reports and prior literature to analyze genders of all authors from research articles and editorials published from January 2013 to September 2019. Reviewers identified author genders through web searches with matching academic qualifications or used a gender identification application programming interface to identify likelihood of male or female identity. The primary outcome was the proportion of female authors in each position. Results: Selected publications included 2,980 original research articles with 18,224 authors (median 6, interquartile range [IQR] 4 to 8) and 433 editorials with 986 authors (median 2, IQR 1 to 2). Women occupied 34.9%, 24.3%, and 36.5% of first, last, and middle author positions on original research articles and 23.8%, 20.5%, and 34.2% of first, last, and middle author positions among editorials, respectively. Publications with female first and last authors (n=340 articles) had a larger proportion of female middle authors (49%, 634/1,290) compared to publications with male first and last authors (n=1667 articles, female middle authors 33% [2,215/6,771]). Conclusion: Over the 7 years examined, female authorship in these emergency medicine journals increased. A more pronounced gender gap exists in editorial authorship compared to research articles. On publications where the first and last author were women, a higher proportion of middle authors were women. © 2021 American College of Emergency Physicians
Emergency Medicine Journal Editorial Boards: Analysis of Gender, H-Index, Publications, Academic Rank, and Leadership Roles Open PDF
(2021)
Hutchinson, Daria
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Das, Priya
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Lall, Michelle D.
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Hill, Jesse
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Fares, Saleh
Introduction: Our goal in this study was to determine female representation on editorial boards of high-ranking emergency medicine (EM) journals. In addition, we examined factors associated with gender disparity, including board members’ academic rank, departmental leadership position, h-index, total publications, total citations, and total publishing years.Methods: In this retrospective study, we examined EM editorial boards with an impact factor of 1 or greater according to the Clarivate Journal Citations Report for a total of 16 journals. All board members with a doctor of medicine or doctor of osteopathic medicine degree, or international equivalent were included, resulting in 781 included board members. We analyzed board members’ gender, academic rank, departmental leadership position, h-index, total publications, total citations, and total publishing years.Results: Gender disparity was clearly notable, with men holding 87.3% (682/781) of physician editorial board positions and women holding 12.7% (99/781) of positions. Only 6.6% (1/15) of included editorial board chiefs were women. Male editorial board members possessed higher h-indices, total citations, and more publishing years than their female counterparts. Male board members held a greater number of departmental leadership positions, as well as higher academic ranks.Conclusion: Significant gender disparity exists on EM editorial boards. Substantial inequalities between men and women board members exist in both the academic and departmental realms. Addressing these inequalities will likely be an integral part of achieving gender parity on editorial boards.

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