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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, WeiMason, RobinOBJECTIVES: 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 glass ceiling thickens: the impact of COVID-19 on academic medicine faculty in the United States Open PDF(2022) ;Lufler, Rebecca S.McNulty, Margaret A.The inequities faced by women in academic Medicine before the COVID-19 pandemic are well established. However, there is little formal data regarding exactly how the pandemic has affected faculty. This cross-sectional study investigated the impact of the pandemic on responsibilities at home, work, and mental health according to gender identification, faculty rank, and faculty appointment. In February 2021, an online questionnaire was broadly distributed to academic medicine faculty. Respondents were asked to provide demographic data, answer questions about their responsibilities at home and work, mental health, and how the pandemic has influenced these. Respondents were also asked to document what their institution(s) can do to help faculty through the pandemic. Responses were analyzed via Pearson's chi-square tests and thematic analysis. Women faculty were more likely to be responsible for the care of others (70%, p = 0.014), and the impact was negative, especially for early career faculty (p = 0.019). Productivity in research, teaching, and clinical practice were negatively impacted, with women feeling this in clinical practice (p = 0.005), increased teaching load (p = 0.042), and inadequate work environment (p = 0.013). In the areas of self-care and mental health, women (p < 0.001), early career-faculty (p < 0.001), and clinical faculty (p = 0.029) were more negatively impacted. Early-career women were more likely to fear retribution. Five themes emerged, including Flexible Expectations, Support, Mental Health, Compensation, and Communication. Pre-pandemic stress and burnout were rampant, and this study demonstrates that academic medicine faculty are still suffering. It is the authors' hope that administrations can utilize these data to make informed decisions regarding policies enacted to assist populations who are most vulnerable to the effects of the pandemic.Item type:Publication, Gender Disparity in Non-ACGME (Accreditation Council for Graduate Medical Education) Otolaryngology Fellowship Leadership Open PDF(2024) ;Leyden, Kara ;Soeder, Mason ;Holdaway, Matthew ;Scagnelli, RobertMortensen, MelissaOBJECTIVE: Women are underrepresented among practicing otolaryngology physicians with increasing disparities in leadership roles and higher levels of professional attainment in academic medicine. The purpose of this study is to determine the gender gap among fellowship directors within specific otolaryngology subspecialties, and how this compares to disparities among all academic appointments held by otolaryngologists. Additionally, we seek to better understand how years practiced, H-index, professorship status, and academic productivity differ between men and women in fellowship director roles. DESIGN: Cross-sectional. Publicly available data from non-ACGME accredited otolaryngology fellowships was collected from department websites and Doximity including gender, years of practice, and professor status of fellowship directors. Scopus was used to find H-index for identified fellowship directors. Fisher's Exact tests were used to determine if significant gender disparity existed between each fellowship and academic otolaryngology as whole. H-index and years of practice were plotted for men and women comparing the slope of lines of best fit as a measure of academic productivity. SETTING: Non-ACGME accredited otolaryngology fellowships in the US. PARTICIPANTS: Fellowship directors in non-ACGME accredited otolaryngology fellowships. RESULTS: Among 174 fellowship positions in our analysis, head and neck (17.3% women), laryngology (17.2% women), rhinology (5.7% women), and facial plastics (8.1% women) had significantly lower overall women representation compared to academic otolaryngology (36.6% women) (p < 0.05). As fellowship directors, women were significantly more productive than men given years practiced and H-index (p = 0.008). CONCLUSIONS: Gender disparities among otolaryngologists are amplified in the role of fellowship directors compared to broader academic otolaryngology. This is true despite women in these roles demonstrating higher academic productivity.Item type:Publication, Gender Disparity in the Citation of Surgical Research Open PDF(2022) ;Kane, W.J. ;Hedrick, T.L.Schroen, A.T.BACKGROUND: Women surgeons face numerous barriers to career advancement. Inequitable citation of surgical literature may represent a contributing factor to gender disparities in academic surgery. STUDY DESIGN: This was a cross-sectional analysis of publications from 50 top-ranking surgery journals in 2017 and 2018, as defined by the 2019 InCites Journal Citation Reports. The citation rate of publications by women vs men first authors was compared. Similarly, the citation rate of publications by men vs women last authors was also compared. Adjusted regression analyses of citation rates accounted for the time interval since publication as well as the journal within which the article was published, among other potential confounding factors. RESULTS: A total of 19,084 publications from 48 surgery journals with a median (interquartile range) of 8 (4 to 15) citations contributing to a median (interquartile range) Journal Impact Factor of 4.0 (3.4 to 4.6) were analyzed. Compared with man-first author publications, woman-first author publications demonstrated a 9% lower citation rate (incidence rate ratio 0.91, p < 0.001). Similarly, compared with publications by man-last authors, woman-last author publications demonstrated a 4% lower citation rate (incidence rate ratio 0.96, p = 0.03). These associations persisted after multivariable adjustment for additional confounding factors, however, not on sensitivity analysis of 24 of the highest-ranking journals. CONCLUSIONS: Among top-tier surgical journals, publications by women-first and -last authors were less cited compared with publications by men-first and -last authors, but not among the highest-tier surgical journals. Gender bias may exist in the citation of surgical research, contributing to gender disparities in academic surgery. Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.Item type:Publication, Editorial (Spring) Board? Gender Composition in High-impact General Surgery Journals Over 20 Years Open PDF(2019) ;Harris, Chelsea A. ;Banerjee, Tanima ;Cramer, Monica ;Manz, ShannonWard, Sarah T.Objective: To quantify gender composition of 10 high-impact general surgery journals, delineate how board composition has changed over time, and evaluate qualification metrics by gender. Background: Underrepresentation of women on editorial boards may contribute to the gender-based achievement gap in surgery. Methods: We performed a cross-sectional analysis of the editorial board gender composition among 10 high-impact general surgery journals in 1997, 2007, and 2017. Univariate and multivariate regression analyses were used to assess differences in editors’ H-indices, academic rank, and number of advanced degrees. Differences in editor turnover and multiple board positions were evaluated for each time interval. Results: Over 20 years, the proportion of women on editorial boards increased from 5% to 19%. After controlling for time since board certification, no differences between men and women's number of advanced degrees, H-indices, or academic rank remained significant. Women and men were equally likely to hold multiple board positions (1997 P = 0.74; 2007 P = 0.42; 2017 P = 0.69), but men's editorial board tenure was longer across each time interval (1997–2007 P = 0.003; 2007–2017 P < 0.001; 1997–2017 P = 0.01). Conclusions: Women surgeons have a small but growing presence on surgical editorial boards, and gender-based qualification differences are likely attributable to practice length. Men's longer tenure on editorial boards may drive some of the observed disparity by limiting new appointment opportunities. Strategies such as imposing term limits or instituting merit-based performance reviews may help editorial boards capture the field's changing demographics.Item type:Publication, Academic Radiology in the United States: Defining Gender Disparities in Faculty Leadership and Academic Rank Open PDF(2022) ;Goswami, Abhishek K. ;Kokabi, Nima ;Khaja, Minhaj S. ;Saad, Wael E.Khaja, AkramRATIONALE AND OBJECTIVES: Female physicians in academic medicine have faced barriers that potentially affect representation in different fields and delay promotion. Little is known about gender representation differences in United States academic radiology departments, particularly within the most pursued subspecialties. PURPOSE: To determine whether gender differences exist in United States academic radiology departments across seven subspecialties with respect to academic ranks, departmental leadership positions, experience, and scholarly metrics. MATERIALS AND METHODS: In this cross-sectional study from November 2018 to June 2020, a database of United States academic radiologists at 129 academic departments in seven subspecialties was created. Each radiologist's academic rank, departmental leadership position (executive-level - Chair, Director, Chief, and Department or Division Head vs vice-level - vice, assistant, or associate positions of executive level), self-identified gender, years in practice, and measures of scholarly productivity (number of publications, citations, and h-index) were compiled from institutional websites, Doximity, LinkedIn, Scopus, and official NPI profiles. The primary outcome, gender composition differences in these cohorts, was analyzed using Chi2 while continuous data were analyzed using Kruskal-Wallis rank sum test. The adjusted gender difference for all factors was determined using a multivariate logistic regression model. RESULTS: Overall, 5086 academic radiologists (34.7% women) with a median 14 years of practice (YOP) were identified and indexed. There were 919 full professors (26.1% women, p < 0.01) and 1055 executive-level leadership faculty (30.6% women, p < 0.01). Within all subspecialties except breast imaging, women were in the minority (35.4% abdominal, 79.1% breast, 12.1% interventional, 27.5% musculoskeletal, 22.8% neuroradiology, 45.1% pediatric, and 19.5% nuclear; p < 0.01). Relative to subspecialty gender composition, women full professors were underrepresented in abdominal, pediatric, and nuclear radiology (p < 0.05) and women in any executive-level leadership were underrepresented in abdominal and nuclear radiology (p < 0.05). However, after adjusting for h-index and YOP, gender did not influence rates of professorship or executive leadership. The strongest single predictors for professorship or executive leadership were h-index and YOP. CONCLUSION: Women academic radiologists in the United States are underrepresented among senior faculty members despite having similar levels of experience as men. Gender disparities regarding the expected number of women senior faculty members relative to individual subspecialty gender composition were more pronounced in abdominal and nuclear radiology, and less pronounced in breast and neuroradiology. Overall, h-index and YOP were the strongest predictors for full-professorship and executive leadership among faculty. KEY RESULTS: ● Though women comprise 34.7% of all academic radiologists, women are underrepresented among senior faculty members (26.1% of full professors and 30.6% of executive leadership) ● Women in junior faculty positions had higher median years of practice than their male counterparts (10 vs 8 for assistant professors, 21 vs 13 for vice leadership) ● Years of practice and h-index were the strongest predictors for full professorship and executive leadership.Item type:Publication, Diversification of Academic Surgery, Its Leadership, and the Importance of Intersectionality Open PDF(2021) ;Riner, Andrea N. ;Herremans, Kelly M. ;Neal, Daniel W. ;Johnson-Mann, CrystalHughes, Steven J.Importance: Diversity in academic surgery is lacking, particularly among positions of leadership. Objective: To evaluate trends among racial/ethnical minority groups stratified by gender along the surgical pipeline, as well as in surgical leadership. Design, Setting, and Participants: This cross-sectional and longitudinal analysis assessed US surgical faculty census data obtained from the Association of American Medical Colleges faculty roster in the Faculty Administrative Management Online User System database. Surgical faculty members captured in census data from December 31, 2013, to December 31, 2019, were included in the analysis. Faculty were identified from the surgery category of the faculty roster, which includes general surgeons and subspecialists, neurosurgeons, and urologists. Main Outcomes and Measures: Gender and race/ethnicity were obtained for surgical faculty stratified by rank. Descriptive statistics with annual percentage of change in representation are reported based on faculty rank. Results: A total of 15 653 US surgical faculty, including 3876 women (24.8%), were included in the data set for 2019. Female faculty from racial/ethnic minority groups experienced an increase in representation at instructor and assistant and associate professorship appointments, with a more favorable trajectory than male faculty from racial/ethnic minority groups across nearly all ranks. White faculty maintain most leadership positions as full professors (3105 of 3997 [77.7%]) and chairs (294 of 380 [77.4%]). The greatest magnitude of underrepresentation along the surgical pipeline has been among Black (106 of 3997 [2.7%]) and Hispanic/Latinx (176 of 3997 [4.4%]) full professors. Among full professors, although Black and Hispanic/Latinx male representation increased modestly (annual change, 0.07% and 0.10%, respectively), Black female representation remained constant (annual change, 0.00004%) and Hispanic/Latinx female representation decreased (annual change, -0.16%). Overall Hispanic/Latinx (20 of 380 [5.3%]) and Black (13 of 380 [3.4%]) representation as chairs has not changed, with only 1 Black and 1 Hispanic/Latinx woman ascending to chair from 2013 to 2019. Conclusions and Relevance: A disproportionately small number of faculty from minority groups obtain leadership positions in academic surgery. Intersectionality may leave female members of racial/ethnic minority groups more disadvantaged than their male colleagues in achieving leadership positions. These findings highlight the urgency to diversify surgical leadership.Item type:Publication, h-Index and Academic Rank by Gender Among Breast Surgery Fellowship Faculty Open PDF(2022) ;Radford, Diane M. ;Parangi, Sareh ;Tu, ChaoSilver, 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.Item type:Publication, A gender gap in the dermatology literature? Cross-sectional analysis of manuscript authorship trends in dermatology journals during 3 decades Open PDF(2009) ;Feramisco, J.D. ;Leitenberger, J.J. ;Redfern, S.I. ;Bian, A.Xie, X.-J.Background: Despite a dramatic influx of female dermatologists during the last 30 years, women in academic dermatology departments remain relatively clustered in junior faculty positions. Research in other specialties showing a disparity in the academic productivity of women has led to many hypotheses regarding factors that may place them at a competitive disadvantage. It is unknown, however, whether similar differences in academic productivity might also serve as barriers to advancement in dermatology, or whether any productivity gap actually exists in this specialty that experienced a more substantial entry of women. Objective: Because publication in peer-reviewed journals is one of the core measures of academic productivity used in the promotion process, we evaluated trends in the prevalence of female authorship in top dermatology journals during the last 3 decades. Methods: We conducted an observational study of trends in the sex distribution of US authors in 3 prestigious general dermatology journals (in 1976, 1986, 1996, and 2006) and 3 subspecialty dermatology journals (in 2006 only). Journals were chosen based on published impact factors and citation half-lives. Results: During the last 3 decades, the proportion of women authoring manuscripts in the 3 major general dermatology journals increased from 12% to 48% of US-affiliated first authors (P < .001) and from 6.2% to 31% of US-affiliated senior authors (P < .001). Separate analyses by journal and by article type showed similar increases. The prevalence of female authors in subspecialty journals in 2006 was slightly more variable. Limitations: Although the publications selected for this study capture many of the most respected US journals in dermatology, they may not be representative of all journals in which dermatologists publish. Conclusions: Female dermatologists are authoring publications in growing numbers that match or exceed their prevalence in the academic and overall workforce. This suggests that other factors (differences in productivity outside of the publishing arena, differences in job descriptions or opportunities, differences in career aspirations, a lack of institutional support or flexibility, or gender bias) may be associated with the ongoing reduced advancement of women to senior academic dermatology ranks relative to their male colleagues, and further research is warranted to explore these possibilities. © 2009 American Academy of Dermatology, Inc.Item type:Publication, Despite Growing Number of Women Surgeons, Authorship Gender Disparity in Orthopaedic Literature Persists Over 30 Years Open PDF(2020) ;Brown, Meghan A. ;Erdman, Mary Kate ;Munger, Alana M.Miller, Anna N.BACKGROUND: The most recent demographic data reveal that only 6.5% of practicing orthopaedic surgeons are women, and as far as we know, only two women have held chair positions in academic orthopaedic programs in the United States. Furthermore, orthopaedic surgery is the least gender-diverse speciality recognized by the Accreditation Council for Graduate Medical Education. The factors that contribute to the lack of gender diversity in orthopaedics remain ill-defined. A lag in publication productivity may be a barrier to career advancement for women orthopaedic surgeons, but this has not been well studied. QUESTIONS/PURPOSES: (1) What is the proportion of orthopaedic studies published in six major orthopaedic journals by women first or senior authors from 1987 to 2017? (2) Did men and women orthopaedic surgeons publish in equal proportions during the study period (measured in 5-year intervals)? (3) Are there differences in the characteristics (such as study type or subject focus) of orthopaedic publications authored by women and those authored by men? (4) Has the increased proportion of practicing women orthopaedic surgeons been matched by an equal increase in authorship by women orthopaedic surgeons during the study timeframe? METHODS: A cross-sectional analysis was designed to characterize trends in authorship of orthopaedic studies by women over time. All publications from the first issue of each of six major orthopaedic journals were evaluated at seven time points (1987, 1992, 1997, 2002, 2007, 2012, and 2017). Characteristics of each first and senior author (including gender, academic degree, and specialty), and study category of each publication were collected. Articles for which this information was not available were excluded (35 of 1073, or 3.3% of published studies, no difference in proportion of excluded studies between journals). The proportions of women and men authors were compared at the seven time points and for six study categories (basic science, case report/technique article, clinical medicine, economics/practice management, editorial content [including true editorials, letters to the editor, commentaries, and book reviews] and review/meta-analysis) using a Fisher's exact test or chi-squared analysis. We compared the rates of change of women authorship, practicing women orthopaedic surgeons, and women orthopaedic residents during the study period using an ANOVA and Tukey's honestly significant difference (HSD) post-hoc test with Cohen's D measure of effect size. RESULTS: From 1987 to 2017, only 1.7% (15 of 880) of senior authors and 4.4% (46 of 1038) of first authors of orthopaedic publications were women orthopaedic surgeons. Based on population proportions (that is, percent of practicing women orthopaedic surgeons compared with men), the proportion of women senior authors was less than would be expected at each time point after 1987 compared with men. There were no differences between the types of studies authored by women or men. Finally, during the study period, the rate of growth of women senior authorship was less than the rates of growth of both practicing women orthopaedic surgeons (d = 5.3, 95% CI, 4.8-5.6; p = 0.023) and women first authorship (d = -4.3, 95% CI -4.6 to -3.6, p = 0.030; estimated mean 3.3, p = 0.013). CONCLUSIONS: Women orthopaedic surgeons published a small proportion of academic orthopaedic research from 1987 to 2017, and women senior authors consistently published less than would be expected based on their population proportion compared with men orthopaedic surgeons. Furthermore, the growth of practicing women orthopaedic surgeons has not been matched by growth in senior authorship by women over the same timeframe. CLINICAL RELEVANCE: This discrepancy warrants further exploration because a low rate of publication may negatively impact the career advancement of women orthopaedic surgeons and contribute to the overall lack of gender diversity in orthopaedics. We suggest that journals and publishers review their editorial processes to ensure blinding of author names during peer review and editorial decision-making, and to disclose those review processes to authors. We also suggest that institutions encourage women trainees and junior faculty to participate in mentorship programs and specialty societies that promote academic productivity.