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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.
The gender and geography of publishing: a review of sex/gender reporting and author representation in leading general medical and global health journals Open PDF
(2021)
Merriman, Rebekah
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Galizia, Ilaria
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Tanaka, Sonja
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Sheffel, Ashley
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Buse, Kent
INTRODUCTION: Diverse gender and geographical representation matters in research. We aimed to review medical and global health journals' sex/gender reporting, and the gender and geography of authorship. METHODS: 542 research and non-research articles from 14 selected journals were reviewed using a retrospective survey design. Paper screening and systematic data extraction was conducted with descriptive statistics and regression analyses calculated from the coded data. Outcome measures were journal characteristics, the extent to which published articles met sex/gender reporting guidelines, plus author gender and location of their affiliated institution. RESULTS: Five of the fourteen journals explicitly encourage sex/gender analysis in their author instructions, but this did not lead to increased sex/gender reporting beyond the gender of study participants (OR=3.69; p=0.000 (CI 1.79 to 7.60)). Just over half of research articles presented some level of sex/gender analysis, while 40% mentioned sex/gender in their discussion. Articles with women first and last authors were 2.4 times more likely to discuss sex/gender than articles with men in those positions (p=0.035 (CI 1.062 to 5.348)). First and last authors from high-income countries (HICs) were 19 times as prevalent as authors from low-income countries; and women from low-income and middle-income countries were at a disadvantage in terms of the impact factor of the journals they published in. CONCLUSION: Global health and medical research fails to consistently apply a sex/gender lens and remains largely the preserve of authors in HIC. Collaborative partnerships and funding support are needed to promote gender-sensitive research and dismantle historical power dynamics in authorship.
Gender differences in the publication rate among breast imaging radiologists in the United States and Canada Open PDF
(2018)
Khurshid, K.
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Shah, S.
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Ahmadi, M.
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Jalal, S.
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Carlos, R.
OBJECTIVE. The purpose of this study is to determine whether academic achievement differs by gender among breast imaging radiologists. MATERIALS AND METHODS. We examined the gender disparity in academic breast radiology using several parameters, including the h-index, the number of publications, and the number of citations. We also inspected gender disparity in academic ranks and leadership ranks. RESULTS. The research productivity of female breast imagers was found to be significantly lower than that of male colleagues across all academic ranks (p < 0.001). In addition, no correlation was noted between female gender and leadership positions (p = 0.57), despite the fact that women dominate the specialty of breast imaging. CONCLUSION. The number of publications by female radiologists has risen steadily over time; however, a significant gender disparity is seen in scholarly productivity. �© American Roentgen Ray Society.
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.
Gender differences in representation, citations, and h-index: An empirical examination of the field of communication across the ten most productive countries Open PDF
(2024)
Goyanes, Manuel
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Herrero, Esperanza
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de-Marcos, Luis
Women researchers have been shown to be underrepresented in science, especially among the most productive scholars. This is especially relevant in the social sciences and humanities fields, where gender parity is closer, but disparities among top scholars are still pronounced. The gender gap in the field of communication has been explored from several approaches, but studies focusing on gender differences in representation, citations, and h-index are rather scarce. Drawing upon data retrieved from SciVal, we conducted a comparative study of the top 500 and top 100 most productive scholars (N = 5000) for each of the ten most productive countries in communication research in the 2019-2022 period: the United States, the United Kingdom, China, Spain, Germany, India, Australia, Canada, Italy, and the Netherlands. The results indicate a consistent underrepresentation of women, particularly among the top 500, across countries. Despite women being cited more frequently than men in some countries over shorter time frames, a gender bias persists favoring men, particularly when considering the h-index. All in all, our study shows that, despite hints of gender equality in citation patterns, the gender gap still constitutes a structural part of the field of communication when addressing gender representation in research productivity and long-term dynamics of research impact.
Trial characteristics associated with under-enrolment of females in randomized controlled trials of heart failure with reduced ejection fraction: a systematic review Open PDF
(2021)
Whitelaw, Sera
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Sullivan, Kristen
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Eliya, Yousif
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Alruwayeh, Mohammad
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Thabane, Lehana
AIMS: To evaluate temporal trends in the enrolment of females in randomized controlled trials (RCTs) of heart failure with reduced ejection fraction (HFrEF) published in high-impact journals, and assess RCT characteristics associated with under-enrolment. METHODS AND RESULTS: We searched MEDLINE, EMBASE and CINAHL for studies published from January 2000 to May 2019 in journals with impact factor ≥10. We included RCTs that recruited adults with HFrEF. We used a 20% threshold below the sex distribution of HFrEF to define under-enrolment. We used multivariable logistic regression to assess trial characteristics independently associated with under-enrolment. We included 317 RCTs. Among the 183 097 participants, mean (standard deviation) age was 63.0 (7.0) years and 25.5% were female. Females were under-enrolled in 71.6% [95% confidence interval (CI) 66.6-76.6%] of the RCTs; enrolment did not increase significantly between 2000-2019. Sex-related eligibility criteria [odds ratio (OR) 2.05, 95% CI 1.01-4.16; P = 0.046]; recruitment in ambulatory settings (OR 2.56, 95% CI 1.37-4.81; P = 0.003); trial coordination in North America (OR 4.44, 95% CI 1.09-18.07; P = 0.037), Europe (OR 6.79, 95% CI 1.63-27.39; P = 0.018) and Asia (OR 9.33, 95% CI 1.40-12.40; P = 0.033); drug (OR 1.76, 95% CI 1.96-7.36; P < 0.001) and device/surgical interventions (OR 1.69, 95% CI 1.16-9.43; P = 0.002); and men in first and last authorship position (OR 1.32, 95% CI 1.12-3.54; P = 0.047) were associated with under-enrolment of females. CONCLUSIONS: Females were under-enrolled relative to disease distribution in a majority of high-impact HFrEF RCTs, with no change in temporal trends between 2000 and 2019. Trial characteristics and gender of trial leaders were associated with under-enrolment.
Towards gender equity in emergency medicine: a position statement from the CAEP Women in Emergency Medicine committee Open PDF
(2021)
Sheppard, Gillian
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Pham, Chau
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Nowacki, Anna
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Bischoff, Taylor
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Snider, Carolyn
As of January 2019, over half of all doctors working in Canada under the age of 40 were women. Despite equal representation in the profession of medicine, women still experience harassment, discrimination, and pay inequity when compared to their male colleagues. Gender discrimination is present at all levels of medical training and negatively impacts women who want to become emergency physicians. The right to gender equity is part of the Canadian Charter of Rights and Freedoms. The World Health Organization states that "gender inequities are socially generated and, therefore, can be changed." CAEP recognizes that gender equity is important to its members and that it intersects with inequities experienced by other minority groups. This position statement from the committee for Women in Emergency Medicine (EM) is intended to support women and those who identify as women who have chosen EM as their career. Furthermore, it is meant to inform and support policy makers as they consider the unique challenges that women face in their pursuit of excellence in EM.
Women in Academic Medicine Leadership: Has Anything Changed in 25 Years? Open PDF
(2016)
Rochon, Paula A.
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Davidoff, Frank
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Levinson, Wendy
Over the past 25 years, the number of women graduating from medical schools in the United States and Canada has increased dramatically to the point where roughly equal numbers of men and women are graduating each year. Despite this growth, women continue to face challenges in moving into academic leadership positions. In this Commentary, the authors share lessons learned from their own careers relevant to women's careers in academic medicine, including aspects of leadership, recruitment, editorship, promotion, and work-life balance. They provide brief synopses of current literature on the personal and social forces that affect women's participation in academic leadership roles. They are persuaded that a deeper understanding of these realities can help create an environment in academic medicine that is generally more supportive of women's participation, and that specifically encourages women in medicine to take on academic leadership positions.
h-Index and Academic Rank by Gender Among Breast Surgery Fellowship Faculty Open PDF
(2022)
Radford, Diane M.
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Parangi, Sareh
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Tu, Chao
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Silver, Julie K.
Background: Gender disparities in academic promotion and leadership are well documented. Scholarly impact is essential for promotion. The Hirsch-index (h-index) is a measure of impact using number of publications and citations. We sought to (i) evaluate breast surgery fellowship faculty in North America by academic rank and research impact using the h-index, (ii) determine whether there is a gender difference in scholarly productivity, and (iii) determine the relationship between academic rank, h-index, and gender. Materials and Methods: A retrospective cross-sectional study of h-index and academic rank disparity in breast surgery faculty by gender was performed. We reviewed the faculty of Society of Surgical Oncology-accredited breast surgery fellowships in February 2019. Rank, gender, academic appointment, years in practice, program directorship, National Cancer Institute-designated cancer center association, size of the program, and h-index (via Scopus) were recorded. Univariate and multiple linear regression analyses were performed. Results: Fifty-two programs were identified, and 209 faculty had an h-index. Of them, 69.9% were women and 30.1% were men. h-index increased with academic rank although there was considerable overlap between ranks. Women were underrepresented at the professor level (46.4%), but accounted for the majority of assistant professors (91.5%, p < 0.001), and program directors (70.7%). Men professors had a significantly higher mean h-index than women professors, p < 0.001. However, women associate professors had a higher mean h-index than men, but this did not reach significance. Conclusions: Mean h-index increased with increasing rank among breast surgery faculty for both genders. Average h-index was significantly higher for men professors compared to women professors. No significant gender difference in h-index was found for assistant professors. For associate professors, h-index for women was higher than for men. Women are underrepresented at higher academic ranks despite forming the majority of breast surgical teaching faculty.
Gender Disparity Among Leaders of Canadian Academic Radiology Departments Open PDF
(2020)
Qamar, Sadia Raheez
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Khurshid, Kiran
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Jalal, Sabeena
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McInnes, Matthew D. F.
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Probyn, Linda
OBJECTIVE. Underrepresentation of women in the top hierarchy of academic medicine exists despite women comprising more than half of the medical school graduates and residency positions. The purpose of this study is to analyze and quantify the relationship of gender, research productivity, and career advancement in Canadian academic radiology departments. MATERIALS AND METHODS. Seventeen academic radiology departments with affiliated residency programs in Canada were searched for publicly available data on faculty to generate a database for gender and academic profiles of the radiologists. Bibliometric data were collected using Scopus archives. The associations of gender, academic ranks, and leadership positions were assessed, and a p value of ≤ 0.05 was defined as significant. Significant variables were analyzed using a multivariate linear regression model. RESULTS. Of 1266 faculty members, gender information and academic rank were available for 932 faculty members: 597 (64.05%) were men and 335 (35.95%) were women (χ2 = 21.82; p < 0.0001). Of a total of 563 assistant professors, 331 (58.79%) were men and 232 (41.21%) were women; of 258 associate professors, 177 (68.60%) were men and 81 (31.40%) were women; and of 111 professors, 89 (80.18%) were men and 22 (19.82%) were women. The gender gap widens at higher academic ranks, displaying a threefold drop in the ratio of women holding the rank of full professor (6.57%) compared with 14.91% male professors; 29.55% of women radiologists have first-in-command leadership positions compared with 70.45% of men. A comparable or higher h-index is noted for women Canadian radiologists after adjusting for number of citations, number of publications, and years of active research. CONCLUSION. Canadian academic radiology departments have fewer women radiologists in senior faculty and leadership positions. Our study results show that Canadian female radiologists at the professor level have more publications than their male counterparts.

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