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Women in Surgery Open PDF
(American Medical Association (AMA), 2006-04-01)
Gargiulo, Debra A.
HYPOTHESIS: Women are deterred from a surgical career owing to a lack of role models rather than lifestyle considerations. DESIGN: Survey. SETTING: University teaching hospital. PARTICIPANTS: Surgery and obstetrics/gynecology attending physicians, residents, and medical students. INTERVENTION: Questionnaire. MAIN OUTCOME MEASURES: Potential deterrents to a surgical career. RESULTS: Men and women had a similar interest in a surgical career before their surgical rotation (64% vs 53%, P = .68). A similar percentage developed a mentor (40.0% vs 45.9%, P = .40). Women were far more likely to perceive sex discrimination (46.7% vs 20.4%, P = .002), most often from male attending physicians (33.3%) or residents (31.1%). Women were less likely to be deterred by diminishing rewards (4.4% vs 21.6%, P = .003) or workload considerations (28.9% vs 49.0%, P = .02). They were also less likely to cite family concerns as a deterrent (47.8% vs 66.7%, P = .02) and equally likely to be deterred by lifestyle during residency (83.3% vs 76.5%, P = .22). However, women were more likely to be deterred by perceptions of the "surgical personality" (40.0% vs 21.6%, P = .03) and the perception of surgery as an "old boys' club" (22.2% vs 3.9%, P = .002). CONCLUSIONS: Men and women are very similar in what they consider important in deciding on a surgical career. Women are not more likely to be deterred by lifestyle, workload issues, or lack of role models. However, the perceived surgical personality and surgical culture is a sex-specific deterrence to a career in surgery for women.
Advancing gender equity in gynecology and obstetrics: perspectives from the German workforce Open PDF
(Springer Science and Business Media LLC, 2025-08-27)
Neuhold, Jasmin
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von Versen-Höynck, Frauke
PURPOSE: Despite the high proportion of women in medical education and clinical training, female physicians remain underrepresented in leadership and academic positions in Gynecology and Obstetrics in Germany. This study investigates structural and cultural factors contributing to this disparity and highlights trends in workforce composition and recognition in the field. METHODS: We conducted a descriptive, cross-sectional analysis using publicly available data from the German Federal Statistical Office and the German Medical Association (2004-2024), as well as database from the German Society for Gynecology and Obstetrics (DGGG). RESULTS: In 2023, women comprised 73% of gynecologists in Germany. Female representation declined with advancing career stage. In 2024, 82% of resident physicians at German university hospitals were women, while they held 26% of department head positions in Gynecology and Obstetrics. Female membership in the DGGG reached 75%, with 40% on the executive board. In 2022, 65% of major awards went to men, while women received most poster and lecture prizes (61%) at the biannual conference. CONCLUSIONS: While gender diversity in the clinical workforce has improved, systemic inequities persist in academic and leadership domains. Addressing these requires structural reforms, increased transparency in recruitment and promotion processes, and targeted programs supporting women's professional advancement. Enhanced visibility, mentorship, and inclusive institutional policies are essential to ensure gender-equitable development in the specialty.
The workplace culture, mental health and wellbeing of early- and mid-career health academics: a cross-sectional analysis Open PDF
(2024)
Marck, Claudia H.
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Ayton, Darshini
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Steward, Trevor
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Koay, Hui-Fern
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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.
Gender imbalance in gynecologic oncology authorship and impact of COVID-19 pandemic Open PDF
(2022)
Mah, S.J.
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Makkar, M.
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Huang, K.
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Anpalagan, T.
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Reade, C.J.
Objective Despite increased participation of women in academic medicine in recent decades, gender disparities persist. The gender gap in authorship and editorial boards in gynecologic oncology, and impact of the COVID-19 pandemic, have not been recently evaluated. We examined gender representation and the impact of COVID-19 on authorship and editorial boards of two major peer-reviewed gynecologic oncology journals. Methods We conducted a bibliometric analysis of original articles published in Gynecologic Oncology and the International Journal of Gynecological Cancer, comparing the most contemporary 5-year period (2016-2020) to single years in the two prior decades (1996, 2006). To assess the early impact of COVID-19, we compared publications from May 2020-April 2021 to 2019. Editorial boards were analyzed for gender composition. First names, pronouns, and institutional photographs were used to determine gender. Results There were 3022 original articles published between 2016 and 2020, 763 in 2006, and 203 in 1996. Gender was identified for 91.3% of first authors (3641 articles) and 95.6% of senior authors (3813 articles). Men comprised the majority of the editorial boards in 2021 at 57% and 61% for Gynecologic Oncology and the International Journal of Gynecological Cancer, respectively. Men were overrepresented as senior authors across all study periods: 93% in 1996, 77% in 2006, and 58% in 2016-2020. Over time, representation of women as first and senior authors increased (7% in 1996, 42% in 2016-2020, p<0.00001). There was no immediate impact of the early pandemic on gender distribution of authorship. Conclusions Despite greater representation of women over time as authors in gynecologic oncology journals, there remains gender disparity in senior authorship and editorial board representation. This presents an opportunity for the academic publishing community to advocate for deliberate strategies to achieve gender parity. Although no impact of the early COVID-19 pandemic was found, this requires ongoing surveillance. ©
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.
Trends in Female Authorship Over 5-Year Publication History in Neurovascular Surgery Open PDF
(2024)
Jelmoni, Alice J. M.
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Mascaro, Luca
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Mariola, Carlotta
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Conde, Marian Mora
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Uralov, Daniel
Nel 2023, la disuguaglianza di genere è ancora un problema con cui ogni neurochirurgo donna deve ancora confrontarsi. Le tendenze degli ultimi 10 anni indicano che il numero di neurochirurghi donne è in costante crescita. Tuttavia, le donne rimangono una minoranza in questo campo dove solo il 19% dei professionisti sono donne. 1 , 2 Anche se il numero delle donne in campo neurochirurgico è in costante aumento, siamo ancora lontani da una distribuzione equa. Negli Stati Uniti, le donne rappresentano solo il 6% dei neurochirurghi certificati dall’American Board of Neurological Surgery e l’8% dei neurochirurghi in formazione. Nel 2017, circa il 51% degli studenti di medicina negli Stati Uniti erano donne. 3 Alla fine del 2020, la Società Turca di Neurochirurgia ha dichiarato che il 5,5% degli specialisti in neurochirurgia registrati in Turchia sono donne. 4 Allo stesso modo, la Japan Neurological Society ha dichiarato che solo il 5,6% dei membri sono donne. 5 In Europa, secondo i dati raccolti nei primi anni 2000, la percentuale media di donne che lavorano come medici è pari al 40%, 1 , 2 ma la neurochirurgia non riflette questa tendenza. Non sono disponibili dati sull'attuale e accurata distribuzione di genere degli specializzandi e degli specialisti in neurochirurgia in ciascun paese europeo, se non da parte dei membri delle società ufficiali. 6 , 7 In Italia, sorprendentemente, il 36% dei neurochirurghi sono donne, 2 attualmente la percentuale più alta di neurochirurghi donne in Europa. È importante sottolineare che il tasso di donne residenti è del 55%, 8 anche se le società italiana ed europea nel 2022 riconoscono, rispettivamente, un tasso di iscrizione femminile del 25% e del 23%, a conferma che la percentuale di donne coinvolte in posizioni accademiche è ancora inferiore a quello degli uomini. La rappresentanza delle donne nei comitati editoriali sembra essere ancora più bassa per la chirurgia della colonna vertebrale rispetto ad altre discipline, un aspetto che dovrebbe essere migliorato anche in futuro. 9 , 10 Dai dati sopra citati emerge che, a livello globale, le posizioni di leadership e i titoli accademici sono ancora quasi esclusivamente appannaggio del genere maschile. Consentire ai neurochirurghi donne di impegnarsi nella ricerca e garantire parità di accesso rispetto ai colleghi uomini alle posizioni senior nella leadership del progetto può essere il punto di partenza per raggiungere l’uguaglianza di genere in neurochirurgia. Le autrici donne si stanno affermando sempre più nella letteratura scientifica, a conferma che esistono notevoli tentativi di espandere la componente femminile riguardo a discipline che fino a qualche anno fa erano considerate strettamente maschili. 10 Recentemente è stato dimostrato che la patologia neurochirurgica vascolare presenta il maggior contributo di autrici rispetto alle altre sottospecialità della chirurgia neurologica (neuro-oncologia, spinale, funzionale). 9 , 11 , 12 La ricerca, il finanziamento delle sovvenzioni e le posizioni accademiche dipendono dalla continua attività di pubblicazione scientifica. Aumentare il ruolo di primo piano delle donne neurochirurghi nelle pubblicazioni scientifiche potrebbe col tempo promuovere l’equità nella distribuzione delle posizioni accademiche nel mondo della neurochirurgia. 13 L'obiettivo di questa analisi bibliometrica è quello di ottenere una visione oggettiva sul coinvolgimento delle donne nella letteratura riguardante il campo neurovascolare identificando il numero di articoli in cui il primo autore è donna e di differenziare i risultati per paese e rivista e analizzare l'andamento nel corso gli anni.
The "gender gap" in authorship of academic medical literature--a 35-year perspective Open PDF
(2006)
Jagsi, Reshma
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Guancial, Elizabeth A.
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Worobey, Cynthia Cooper
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Henault, Lori E.
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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.
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.
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Lehrer, Eric J.
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Wang, Ming
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Holliday, Emma
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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.
Women as Authors of Randomized Controlled Trials of Minimally Invasive Surgery: Systematic Review and Meta-Analysis of 3 Decades of Trials Open PDF
(2021)
Sayyid, Rashid K.
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Lokeshwar, Soum D.
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Luckenbaugh, Amy N.
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Hall, Mary E.
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Jones, Caitlin E.
BACKGROUND: Female authorship opportunities have lagged behind those of their male counterparts, with gender disparities most prominent in surgical specialties. Our objective was to determine trends of female first, last, and first or last authorships across time and surgical specialties and whether female first or last authorship was associated with journal impact factor. STUDY DESIGN: A systematic review of EMBASE (OvidSP), MEDLINE (OvidSP), and Cochrane (Wiley) databases from inception to December 22, 2017 was performed to identify all randomized controlled trials evaluating minimally invasive surgery vs classical surgical techniques. The primary end point was female first, last, and first or last authorship, with gender determined via an online search strategy and verified via Genderize.io. Secondary end point was journal impact factor, recorded from Clarivate Analytics InCites. RESULTS: There were 9,321 articles identified and 489 met our inclusion/exclusion criteria. Sixty-eight (13.9%) first and 60 (12.3%) last female authors were identified. A positive linear trend for female first (R2 = 0.35, Cochran-Armitage test for trend, p < 0.001), last (R2 = 0.30, p < 0.001), and first or last authorships (R2 = 0.40, p < 0.001) over time was identified. This trend was observed across surgical specialties except for orthopaedics. The highest calculated percentages of female first, last, and first or last authorships by the year 2017 were seen in obstetrics and gynecology (33.8%, 32.0%, and 43.8%, respectively), all significantly lower than the corresponding percentage of the female obstetrics and gynecology workforce in 2017 (57.0%). Neither female first nor last authorship positions were associated with journal impact factor. CONCLUSIONS: A significant increase in female first and last authorship in randomized controlled trials of minimally invasive surgical techniques in the last 3 decades has been observed, but continued efforts to bridge this gender gap are sorely needed.
The role of gender-specific factors in the choice of specialty training in obstetrics and gynecology: results from a survey among medical students in Germany Open PDF
(2022)
Riedel, Maximilian
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Hennigs, André
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Dobberkau, Anna Maria
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Riedel, Caroline
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Bugaj, Till Johannes
PURPOSE: The field of obstetrics and gynecology (OB/GYN) is facing growing competition for young professionals in Germany, with high interest rates among female graduates and a declining proportion of male students who choose residency training in the field. The aim of this study is to analyze general and gender-dependent factors that influence the decision for or against specialty training in OB/GYN among medical students in Germany. METHODS: Between February and November 2019, n = 346 medical students in their 5th and 6th year of undergraduate training at Heidelberg University received a questionnaire with 44 items. RESULTS: n = 286 students (61.3 female; 38.7% male) participated in the study. 28% of the female students and 9% of the male students had considered OB/GYN for their specialty training. The students reported different general and gender-specific influencing factors in their choice of a specialty. Both genders desired a good work-life-balance, however, in comparison with their female colleagues, male students had heavily weighted factors related to their later careers and professional success, including competition among colleagues. Male students had gained little practical experience during compulsory internships (26.9% for females vs. 8.8% for males) or had chosen their final-year elective in OB/GYN (15.9% for females vs. 5.5% for males). Female students had worried about the negative effects of their sex on their career (35.4% for females vs. 5.9% for males). CONCLUSION: OB/GYN must become more appealing and attractive to young female and male professionals alike. A better compatibility of career and family should go hand in hand with the implementation of differentiated, (extra) curricular teaching approaches that take the different preferences of female and male students into account.

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