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  • Item type:Publication,
    Factors associated with homophobia in medical students from eleven Peruvian universities. Open PDF 
    (2019)
    Nieto-Gutierrez, Wendy
    ;
    Komori-Pariona, Jorge K.
    ;
    Sánchez, Alice G.
    ;
    Centeno-Leguía, Dercy
    ;
    Arestegui-Sánchez, Liz
    BACKGROUND: The consequences of homophobia can affect the integrity, mental and physical health of homosexual individuals in society. There are few studies in Peru that have evaluated homophobia in the medical student population. OBJECTIVE: To establish the social, educational and cultural factors associated with homophobia among Peruvian medical students. METHODS: A cross-sectional analytical study was conducted in 12 medicine schools in Peru. Homophobia was defined according to a validated test, which was associated with other variables. Statistical associations were identified. RESULTS: The lowest percentages of homophobic students (15-20%) were found in the four universities in Lima, while universities in the interior of the country had the highest percentages (22-62%). Performing a multivariate analysis, we found that the frequency of homophobia was lower for the following variables: the female gender (PRa=0.74; 95% CI, 0.61-0.92; p=0.005), studying at a university in Lima (PRa=0.57; 95% CI, 0.43-0.75; p<0.001), professing the Catholic religion (PRa=0.53; 95% CI, 0.37-0.76; p<0.001), knowing a homosexual (PRa=0.73; 95% CI, 0.60-0.90; p=0.003) and having treated a homosexual patient (PRa=0.76; 95% CI, 0.59-0.98; p=0.036). In contrast, the frequency of homophobia increased in male chauvinists (PRa=1.37; 95% CI, 1.09-1.72; p=0.007), adjusted by four variables. CONCLUSIONS: Homophobia was less common in women, in those who study in the capital, those who profess Catholicism and those who know/have treated a homosexual. In contrast, male chauvinists were more homophobic.
  • Item type:Publication,
    Male Chauvinism Among Peruvian Medical Students: Related Socio-Educational Factors in 12 Peruvian Universities. Open PDF 
    (2019)
    Mejia, Christian R.
    ;
    Pulido-Flores, Jordy
    ;
    Quiñones-Laveriano, Dante M.
    ;
    Nieto-Gutierrez, Wendy
    ;
    Heredia, Paula
    INTRODUCTION: Male chauvinism is rooted in certain populations, but it has not been measured among those who will be responsible for healthcare. OBJECTIVE: To determine the factors associated with male chauvinism among the medical students of 12 Peruvian universities. METHODS: Cross-sectional multicentre analytical study, with previously collected data, which used validated tests to measure male chauvinism and strong religious beliefs. In addition, other social and educational factors were analysed and the data was crossed. Descriptive and analytical statistics were obtained. RESULTS: In the multivariate analysis, we found an association between male chauvinism and religious non-believers (RP=1.88; 95% CI, 1.47-2.40), as well as being female (RP=0.35; 95% CI, 0.27-0.46). Of the 12 universities evaluated, the least chauvinistic university was in Lima. Using this university as a comparison category, the statistically more chauvinistic universities were a private university in Chiclayo (α=3.63; p<0.001), followed by a university in Huancayo (α=3.20; p=0.001), Huancayo national university (α=2.79; p<0.001) and the public university of Ica (α=2.32; p=0.006); the crossed data were adjusted for age. CONCLUSIONS: It was found that male chauvinism is greater among non-religious believers, men and in some universities, with a predominance of universities in the central highlands of Peru or that had migrants from the mountains. This is important, since it gives us an overview about this trait in those who will be responsible for the future healthcare of Peruvians.
  • Item type:Publication,
    Quantifying gender disparity in physician authorship among commentary articles in three high-impact medical journals: an observational study Open PDF 
    (2020)
    Mamtani, Mira
    ;
    Shofer, Frances
    ;
    Mudan, Anita
    ;
    Khatri, Utsha
    ;
    Walker, Rachael
    BACKGROUND: Scholarship plays a direct role in career advancement, promotion and authoritative recognition, and women physicians remain under-represented as authors of original research articles. OBJECTIVE: We sought to determine if women physician authors are similarly under-represented in commentary articles within high-impact journals. DESIGN/SETTING/PARTICIPANTS: In this observational study, we abstracted and analysed author information (gender and degree) and authorship position from commentary articles published in three high-impact journals between 1 January 2014 and 16 October 2018. PRIMARY OUTCOME MEASURE: Authorship rate of commentary articles over a 5-year period by gender, degree, authorship position and journal. SECONDARY OUTCOME MEASURES: To compare the proportion of men and women physician authorship of commentaries relative to the proportion of men and women physician faculty within academic medicine; and to examine the gender concordance among the last and first authors in articles with more than one author. RESULTS: Of the 2087 articles during the study period, 48% were men physician first authors compared with 17% women physician first authors (p<0.0001). Of the 1477 articles with more than one author, similar distributions were found with regard to last authors: 55% were men physicians compared with only 12% women physicians (p<0.0001). The proportion of women physician first authors increased over time; however, the proportion of women physician last authors remained stagnant. Women coauthored with women in the first and last authorship positions in 9% of articles. In contrast, women coauthored with men in the first and last author positions, respectively, in 55% of articles. CONCLUSIONS: Women physician authors remain under-represented in commentary articles compared with men physician authors in the first and last author positions. Women also coauthored commentaries with other women in far fewer numbers.
  • Item type:Publication,
    Gender in authorship and editorship in medical education journals: A bibliometric review Open PDF 
    (2021)
    Madden, Caoimhe
    ;
    O'Malley, Róisín
    ;
    O'Connor, Paul
    ;
    O'Dowd, Emily
    ;
    Byrne, Dara
    CONTEXT: Gender bias has been observed in the authorship and editorship of academic literature in varied medical specialties. This is important as peer-reviewed publications, and participation on editorial boards, are closely related to academic productivity and advancement. The aim of this paper was to examine whether gender-based disparities in authorship and editorship exist in leading medical education journals. METHODS: A retrospective bibliometric review was conducted of articles published at eight different time-points across a 49-year time period (specifically: 1970, 1980, 1990, 2000, 2005, 2010, 2015 and 2019) in four leading medical education journals (Academic Medicine, BMC Medical Education, Medical Education and Medical Teacher). First and last (as a proxy for senior) author gender was determined for each article, along with the gender of the 2019 editorial board members of each journal. Chi-square tests for trend were conducted to examine variations in author gender distributions over time, and binomial tests of proportions were conducted to examine gender distributions in authorship and editorship in 2019. Logistic regression analyses were carried out to determine factors that predicted the odds of authorship by women. RESULTS: A total of 5749 articles were included. A significant trend of increased women as first and last authors was observed across all journals. The percentage of women first authors increased from 6.6% in 1970 to 53.7% in 2019 (P < .001), and women last authors increased from 9.5% in 1970 to 46% in 2019 (P < .001). Overall, the distributions of women first authors, last authors and editorial board members in 2019 indicated greater gender parity than many other fields of medicine. CONCLUSIONS: Positive progress towards gender parity has been made in medical education scholarship. However, future research and efforts are needed to ensure the continued participation, and highlighting, of women in medical education scholarship and to address other factors which may hinder academic advancement for women in this field.
  • Item type:Publication,
    When perception is reality: Resident perception of faculty gender parity in a university-based internal medicine residency program. Open PDF 
    (2019)
    Lukela, Jennifer Reilly
    ;
    Ramakrishnan, Aditi
    ;
    Hadeed, Nicole
    ;
    Del Valle, John
    INTRODUCTION: Although women have entered medical school and internal medicine residency programs in significant numbers for decades, women faculty remain underrepresented in senior and departmental leadership roles. How residents perceive this gender disparity is unknown. We sought to assess resident perception of gender parity among departmental leadership and teaching faculty in our internal medicine department, and to determine the actual gender distribution of those faculty roles. METHODS: An anonymous cross-sectional survey was distributed to evaluate resident perception of gender representation of various faculty roles. Using conference schedules, resident evaluations, and our department website, we determined the actual representation of women faculty in department leadership roles, and in clinical and educational activities. RESULTS: 88 of 164 residents (54%) responded. Women residents were less likely than men to perceive that women faculty were equally represented in department leadership (45% men agreed vs. 13% women, p < 0.05), clinical teaching roles (55% men agreed vs. 28% women, p < 0.05), or facilitating educational conferences (45% men agreed vs. 28% women, p = 0.074). In 2017, the internal medicine department at our institution comprised 815 faculty members, 473 men (58%) and 342 women (42%). At that time, women faculty held 5% of senior departmental leadership positions and 21% of educational leadership positions. During the year preceding survey distribution, women faculty attended on internal medicine inpatient wards for 33% of the total number of weeks, staffed 20% of morning reports, and facilitated 28% of noon conferences. DISCUSSION: Women residents in our internal medicine training program perceived a gender disparity among faculty in leadership and educational positions to a greater extent than male residents. The perception of women trainees was accurate. In addition to disproportionate underrepresentation in leadership positions, women faculty were underrepresented in prominent educational positions, including attending on inpatient services and serving as discussants at educational conferences.
  • Item type:Publication,
    Gender differences in faculty rank among academic physicians: a systematic review and meta-analysis Open PDF 
    (2021)
    Li, Ben
    ;
    Jacob-Brassard, Jean
    ;
    Dossa, Fahima
    ;
    Salata, Konrad
    ;
    Kishibe, Teruko
    OBJECTIVE: Many studies have analysed gender bias in academic medicine; however, no comprehensive synthesis of the literature has been performed. We conducted a pooled analysis of the difference in the proportion of men versus women with full professorship among academic physicians. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Education Resources Information Center and PsycINFO were searched from inception to 3 July 2020. STUDY SELECTION: All original studies reporting faculty rank stratified by gender worldwide were included. DATA EXTRACTION AND SYNTHESIS: Study screening, data extraction and quality assessment were performed by two independent reviewers, with a third author resolving discrepancies. Meta-analysis was conducted using random-effects models. RESULTS: Our search yielded 5897 articles. 218 studies were included with 991 207 academic physician data points. Men were 2.77 times more likely to be full professors (182 271/643 790 men vs 30 349/251 501 women, OR 2.77, 95% CI 2.57 to 2.98). Although men practised for longer (median 18 vs 12 years, p<0.00002), the gender gap remained after pooling seven studies that adjusted for factors including time in practice, specialty, publications, h-index, additional PhD and institution (adjusted OR 1.83, 95% CI 1.04 to 3.20). Meta-regression by data collection year demonstrated improvement over time (p=0.0011); however, subgroup analysis showed that gender disparities remain significant in the 2010-2020 decade (OR 2.63, 95% CI 2.48 to 2.80). The gender gap was present across all specialties and both within and outside of North America. Men published more papers (mean difference 17.2, 95% CI 14.7 to 19.7), earned higher salaries (mean difference $33 256, 95% CI $25 969 to $40 542) and were more likely to be departmental chairs (OR 2.61, 95% CI 2.19 to 3.12). CONCLUSIONS: Gender inequity in academic medicine exists across all specialties, geographical regions and multiple measures of success, including academic rank, publications, salary and leadership. Men are more likely than women to be full professors after controlling for experience, academic productivity and specialty. Although there has been some improvement over time, the gender disparity in faculty rank persists. PROSPERO REGISTRATION NUMBER: CRD42020197414.
  • Item type:Publication,
    Gender Disparities in Medical Student Research Awards: A 13-Year Study from the Yale School of Medicine Open PDF 
    (Lippincott Williams and Wilkins, 2018)
    King, J.T.
    ;
    Angoff, N.R.
    ;
    Forrest, J.N.
    ;
    Justice, A.C.
    Purpose The Liaison Committee on Medical Education mandates instruction in research conduct, and many U.S. Medical schools require students to complete a research project. All Yale School of Medicine (YSM) graduating students submit a research thesis, and ∼5% are awarded highest honors. Gender disparities exist in areas related to physician research productivity, including academic rank, research funding, and publications. The authors asked whether gender disparities exist for medical student research. Method The authors conducted a retrospective review of 1,120 theses submitted by graduating medical students from 2003 to 2015 at YSM and collected data on gender, mentoring, research type, sponsoring department, and other characteristics. Multivariate logistic regression modeling examined gender differences in medical student research awards. Results Women authored 50.9% of theses, but earned only 30.9% of highest honors awards (OR 0.41; 95% CI: 0.23, 0.74). Among factors associated with increased receipt of highest honors that differed by gender, men were more likely than women to work with a mentor with a history of three or more thesis honorees, take a fifth year of study, secure competitive research funding, undertake an MD-master of health science degree, and conduct laboratory research (all P <.001). After adjustment for these factors, and for underrepresented in medicine status and sponsoring department, women remained less likely to receive highest honors (OR 0.51; 95% CI: 0.27, 0.98). Conclusions Women YSM students were less likely to receive highest honors for medical research. Gender disparities in postgraduate biomedical research success may start during undergraduate medical education. © 2018 by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited.
  • Item type:Publication,
    The gender gap in science: How long until women are equally represented? Open PDF 
    (2018)
    Holman, Luke
    ;
    Stuart-Fox, Devi
    ;
    Hauser, Cindy E.
    Women comprise a minority of the Science, Technology, Engineering, Mathematics, and Medicine (STEMM) workforce. Quantifying the gender gap may identify fields that will not reach parity without intervention, reveal underappreciated biases, and inform benchmarks for gender balance among conference speakers, editors, and hiring committees. Using the PubMed and arXiv databases, we estimated the gender of 36 million authors from >100 countries publishing in >6000 journals, covering most STEMM disciplines over the last 15 years, and made a web app allowing easy access to the data (https://lukeholman.github.io/genderGap/). Despite recent progress, the gender gap appears likely to persist for generations, particularly in surgery, computer science, physics, and maths. The gap is especially large in authorship positions associated with seniority, and prestigious journals have fewer women authors. Additionally, we estimate that men are invited by journals to submit papers at approximately double the rate of women. Wealthy countries, notably Japan, Germany, and Switzerland, had fewer women authors than poorer ones. We conclude that the STEMM gender gap will not close without further reforms in education, mentoring, and academic publishing.
  • Item type:Publication,
    COVID-19 Threatens Progress Toward Gender Equity Within Academic Medicine Open PDF 
    (2021)
    Woitowich, Nicole C.
    ;
    Jain, Shikha
    ;
    Arora, Vineet M.
    ;
    Joffe, Hadine
    Women remain underrepresented within academic medicine despite past and present efforts to promote gender equity. The authors discuss how the COVID-19 pandemic could stymie progress toward gender parity within the biomedical workforce and limit the retention and advancement of women in science and medicine. Women faculty face distinct challenges as they navigate the impact of shelter-in-place and social distancing on work and home life. An unequal division of household labor and family care between men and women means women faculty are vulnerable to inequities that may develop in the workplace as they strive to maintain academic productivity and professional development without adequate assistance with domestic tasks and family care. Emerging data suggest that gender differences in academic productivity may be forthcoming as a direct result of the pandemic. Existing gender inequities in professional visibility, networking, and collaboration may be exacerbated as activities transition from in-person to virtual environments and create new barriers to advancement. Meanwhile, initiatives designed to promote gender equity within academic medicine may lose key funding due to the economic impact of COVID-19 on higher education. To ensure that the gender gap within academic medicine does not widen, the authors call upon academic leaders and the broader biomedical community to support women faculty through deliberate actions that promote gender equity, diversity, and inclusion. The authors provide several recommendations, including faculty needs assessments; review of gender bias within tenure-clock-extension offers; more opportunities for mentorship, sponsorship, and professional recognition; and financial commitments to support equity initiatives. Leadership for these efforts should be at the institutional and departmental levels, and leaders should ensure a gender balance on task forces and committees to avoid overburdening women faculty with additional service work. Together, these strategies will contribute to the development of a more equitable workforce capable of transformative medical discovery and care.
  • Item type:Publication,
    Plafond de verre pour les femmes dans les carrières hospitalo-universitaires en France Open PDF 
    (2019)
    Rosso, C.
    ;
    Leger, A.
    ;
    Steichen, O.
    OBJECTIVE: To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. METHODS: Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors). RESULTS: Women represent 49% of the medical staff but 15% of full professors. This underrepresentation of women is more important among intensivists/anesthesiologists than technique-based specialists (such as radiologists, biologists…). There is no difference in scientific output, marital status and parenthood between women and men. On the other hand, there is a difference in attitudes highlighted by the EVAR risk-taking scale as well as in the burden of familial involvement and the prejudices felt by women during the academic selection process. CONCLUSION: The glass ceiling exists in one of the largest French hospital group. Career development principles promote merit, but should decrease the benefit of "masculine" attitudes in the competition for academic positions. Academic selection criteria should evolve to limit the disadvantage of women related to deeper familial involvement and less competitive strategies and risk-taking attitudes.