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  • Item type:Publication,
    Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review Open PDF 
    (2021)
    Misra, Vaidehi
    ;
    Safi, Frozan
    ;
    Brewerton, Kathryn A.
    ;
    Wu, Wei
    ;
    Mason, Robin
    OBJECTIVES: Evaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics. DESIGN: Cross-sectional review. DATA SOURCES: Medline database. ELIGIBILITY CRITERIA: Articles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries. DATA EXTRACTION: Key data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors' likely gender; this was quantified using adjusted ORs (aORs). RESULTS: We included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe. CONCLUSIONS: Women were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women's authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it. PROSPERO REGISTRATION NUMBER: CRD42020186702.
  • 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,
    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,
    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,
    The "gender gap" in authorship of academic medical literature--a 35-year perspective Open PDF 
    (2006)
    Jagsi, Reshma
    ;
    Guancial, Elizabeth A.
    ;
    Worobey, Cynthia Cooper
    ;
    Henault, Lori E.
    ;
    Chang, Yuchiao
    BACKGROUND: Participation of women in the medical profession has increased during the past four decades, but issues of concern persist regarding disparities between the sexes in academic medicine. Advancement is largely driven by peer-reviewed original research, so we sought to determine the representation of female physician-investigators among the authors of selected publications during the past 35 years. METHODS: Original articles from six prominent medical journals--the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine (Ann Intern Med), the Annals of Surgery (Ann Surg), Obstetrics & Gynecology (Obstet Gynecol), and the Journal of Pediatrics (J Pediatr)--were categorized according to the sex of both the first and the senior (last listed) author. Sex was also determined for the authors of guest editorials in NEJM and JAMA. Data were collected for the years 1970, 1980, 1990, 2000, and 2004. The analysis was restricted to authors from U.S. institutions holding M.D. degrees. RESULTS: The sex was determined for 98.5 percent of the 7249 U.S. authors of original research with M.D. degrees. The proportion of first authors who were women increased from 5.9 percent in 1970 to 29.3 percent in 2004 (P<0.001), and the proportion of senior authors who were women increased from 3.7 percent to 19.3 percent (P<0.001) during the same period. The proportion of authors who were women increased most sharply in Obstet Gynecol (from 6.7 percent of first authors and 6.8 percent of senior authors in 1970 to 40.7 percent of first authors and 28.0 percent of senior authors in 2004) and J Pediatr (from 15.0 percent of first authors and 4.3 percent of senior authors in 1970 to 38.9 percent of first authors and 38.0 percent of senior authors in 2004) and remained low in Ann Surg (from 2.3 percent of first authors and 0.7 percent of senior authors in 1970 to 16.7 percent of first authors and 6.7 percent of senior authors in 2004). In 2004, 11.4 percent of the authors of guest editorials in NEJM and 18.8 percent of the authors of guest editorials in JAMA were women. CONCLUSIONS: Over the past four decades, the proportion of women among both first and senior physician-authors of original research in the United States has significantly increased. Nevertheless, women still compose a minority of the authors of original research and guest editorials in the journals studied.
  • 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 and Byline Placement of Co-first Authors in Clinical and Basic Science Journals With High Impact Factors Open PDF 
    (2018)
    Aakhus, Erin
    ;
    Mitra, Nandita
    ;
    Lautenbach, Ebbing
    ;
    Joffe, Steven
    The practice of acknowledging equal contributions of 2 or more co-first authors is increasingly common. However, first author position may carry the most prestige and be important for hiring and promotion. In this study, we investigated whose name is listed first when co-first authors are of different genders.