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  • 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,
    Prevalence of female authors in case reports published in the medical literature Open PDF 
    (2019)
    Hsiehchen, D.
    ;
    Hsieh, A.
    ;
    Espinoza, M.
    IMPORTANCE Underrepresentation of female authors in research publications is prevalent, but it is unclear whether this is attributable to sex disparities in research conduct or authorship practices. Case reports are a poorly understood component of the biomedical corpus, and the production of anecdotal observations is not confounded by factors associated with disparities in female representation in research publications. Whether female authorship disparities exist in nonresearch publications of clinical information is unknown. OBJECTIVES To examine the authorship of case reports and elucidate factors associated with sex disparity. DESIGN AND SETTING Cross-sectional study of all case reports published by US authors in 2014 and 2015 indexed in PubMed performed from July 2015 to July 2018. MAIN OUTCOMES AND MEASURES The primary outcome measure was the proportion of female first authors. The secondary outcome measures were the proportion of female last authors and female authorship representation among different clinical specialties. RESULTS Bibliometric data was abstracted from 20 427 case reports published across 2538 journals. A total of 7252 (36%) and 4825 (25%) case reports had a female first and last author, respectively. In comparison, 44%and 34%of US trainees and physicians, respectively, were female in 2015. Among adult case reports, female authorship was more prevalent in academic environments compared with community settings (34.0%vs 28.2%for female first authors and 23.4%vs 19.7% for female last authors). Across states, the proportions of female first authors and last authors were universally less than the proportions of female trainees and active female physicians, respectively. Female first authorship was associated with larger author teams (odds ratio [OR], 1.02; 95%CI, 1.01-1.03), an academic affiliation (OR, 1.16; 95%CI, 1.06-1.27), and a female last author (OR, 1.58; 95%CI, 1.47-1.70). Relative to general internal medicine, specialties dominated by male clinicians were less frequently associated with female first authors. Several exceptions displaying a relatively equivalent tendency for male and female first authorship included oncology (OR, 0.97; 95%CI, 0.81-1.16), ophthalmology (OR, 0.87; 95%CI, 0.72-1.05), and radiation oncology (OR, 0.94 95%CI, 0.56-1.56). CONCLUSIONS AND RELEVANCE The underrepresentation of women among first and last authors in publications of case reports underscores the pervasiveness of sex disparities in medicine. Collaboration and female mentors may be critical instruments in upsetting longstanding practices associated with sex bias. Not all clinical specialties were associated with lower-than-expected female authorship, and further exploration of specialty-specific norms in publication and mentorship may elucidate specific barriers to female authorship. © 2019 JAMA Network Open.All right reserved.
  • Item type:Publication,
    Physical Medicine and Rehabilitation Faculty Diversity Trends by Sex, Race, and Ethnicity, 2007 to 2018 in the United States Open PDF 
    (2021)
    Zhang, Yanru
    ;
    Silver, Julie K.
    ;
    Tiwana, Sabeen
    ;
    Verduzco-Gutierrez, Monica
    ;
    Siddiqi, Javed
    INTRODUCTION: Sex and race/ethnicity disparities persist in academic Physical Medicine and Rehabilitation (PM&R). This study contributes to the current body of knowledge by demonstrating changes in academic PM&R by sex and race/ethnicity in multiple categories over a 12-year period. OBJECTIVE: To evaluate workforce disparities in academic PM&R by measuring sex and race/ethnicity diversity in academic degree, rank, and tenure status. DESIGN: Surveillance study. SETTING AND METHODS: Self-reported data for PM&R from the Association of American Medical Colleges (AAMC) annual Faculty Roster report from 2007 to 2018. MAIN OUTCOME MEASURES: The 12-year average percentage composition in academic degree, rank, and tenure status was calculated to compare the overall distribution. Counts and proportion changes were plotted to depict the temporal trends. Absolute changes in racial percentage composition were graphed to highlight the progress. RESULTS: From 2007 to 2018, the increase by sex was roughly equal (male = 216; female = 236), whereas most of the increase was in White faculty (207). The representation of female and Underrepresented in Medicine (URiM) faculty decreased as academic level advanced. Instructors is the only category with a higher proportion of female faculty, from 2007 (53%) to 2018 (59.3%), whereas male faculty occupied over 75% of the full professor positions at any time. Among the non-White faculty, Asian faculty had the greatest increase in proportion of full professors (3.7% to 10%) and Hispanic/Latino faculty in associate professors (2% to 7.1%), whereas full professors who were Black/African American decreased from 4 persons (2.5%) to 2 persons (0.8%). CONCLUSION: An increase in total number of female and URiM faculty was observed in academic PM&R over 2007 to 2018, but sex and ethnicity/race disparities persisted, especially in higher ranks and leadership positions. For non-White faculty, greater disparities existed, pointing toward the need to target challenges faced by URiM race/ethnicity status.
  • Item type:Publication,
    Analysis of H-index in Assessing Gender Differences in Academic Rank and Leadership in Physical Medicine and Rehabilitation in the United States and Canada Open PDF 
    (2019)
    Yang, H.Y.
    ;
    Rhee, G.
    ;
    Xuan, L.
    ;
    Silver, J.K.
    ;
    Jalal, S.
    Objectives The aims of the study were (1) to establish potential gender differences in academic physical medicine and rehabilitation faculty across the United States and Canada and (2) to evaluate associations between physician gender, leadership position, and research productivity. Design Physical medicine and rehabilitation programs enlisted in Fellowship and Residency Electronic Interactive Database (n = 72) and Canadian Resident Matching Service (n = 9) were searched for academic faculty with Doctor of Medicine degrees to generate a database of gender and academic profiles. Bibliometric data were collected using Elsevier's Scopus and analyzed by Strata v14.2. Results Of 1045 faculty meeting the inclusion criteria, 653 were men and 392 were women. Men were found in greater numbers across all academic ranks, with professors as most conspicuous (79.14%), and held most (85.54%) leadership positions. The study's prediction model assessed for gender differences in academic rank and leadership roles and found that odds of men having higher h-index as 0.78 (95% confidence interval = 0.24-0.87), indicating that women were not significantly inferior in academic performance. Conclusions A significantly greater number of men make up physical medicine and rehabilitation faculty in all academic ranks and leadership positions. H-index based on gender and adjusted for covariates is comparable between men and women, suggesting that more complex, multifactorial issues are likely influencing the gender differences. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
  • Item type:Publication,
    Do females create higher impact research? Scopus citations and Mendeley readers for articles from five countries Open PDF 
    (2018)
    Thelwall, M.
    There are known gender imbalances in participation in scientific fields, from female dominance of nursing to male dominance of mathematics. It is not clear whether there is also a citation imbalance, with some claiming that male-authored research tends to be more cited. No previous study has assessed gender differences in the readers of academic research on a large scale, however. In response, this article assesses whether there are gender differences in the average citations and/or Mendeley readers of academic publications. Field normalised logged Scopus citations and Mendeley readers from mid-2018 for articles published in 2014 were investigated for articles with first authors from India, Spain, Turkey, the UK and the USA in up to 251 fields with at least 50 male and female authors. Although female-authored research is less cited in Turkey (-4.0%) and India (-3.6%), it is marginally more cited in Spain (0.4%), the UK (0.4%), and the USA (0.2%). Female-authored research has fewer Mendeley readers in India (-1.1%) but more in Spain (1.4%), Turkey (1.1%), the UK (2.7%) and the USA (3.0%). Thus, whilst there may be little practical gender difference in citation impact in countries with mature science systems, the higher female readership impact suggests a wider audience for female-authored research. The results also show that the conclusions from a gender analysis depend on the field normalisation method. A theoretically informed decision must therefore be made about which normalisation to use. The results also suggest that arithmetic mean-based field normalisation is favourable to males. © 2018 Elsevier Ltd. All rights reserved.