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Shattering the Glass Scalpel: Analyzing Female Representation in Orthopedic Surgery Across the United States Open PDF
(Springer Science and Business Media LLC, 2025-03-05)
Loyst, Rachel A
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Hidalgo Perea, Sofia
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Vanhelmond, Taylor
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Patterson, Diana
Background Orthopedic surgery has historically been a male-dominated field, with slower growth in female participation compared to other surgical specialties. The present study aims to assess the extent of this influence, examine whether the dynamic is changing, and further analyze female participation trends, focusing on various regions of the United States and including analyses of female residents. Methodology Orthopedic surgery residency programs were surveyed online. A list of 200 programs was sourced from the Association of American Medical Colleges, which provided details including the program names, cities, states, regions, and website links. The homepages of the residency program as well as the department of orthopedic surgery were surveyed for any mention of women or female in orthopedics, number of female residents, total number of residents (class of 2025-2029), number of female faculty operative orthopedic faculty, total number of operative orthopedic faculty physicians, specialty of the female orthopedic faculty, program director gender, assistant program director gender, and chair of the program gender. Data analyses were performed using SPSS Software version 28.0 (IBM Corp., Armonk, NY, USA) and Rstudio version 1.4.1106 (Boston, MA, USA). Results In total, 55 Midwest (28%), 53 Northeast (27%), 63 South (32%), and 27 West (14%) orthopedic surgery residency programs were included. Female orthopedic surgery residents comprised 23.7% of all orthopedic residents across the United States. When analyzed by geographic region, female residents comprised 22.7% of all residents in the Midwest, 24.3% in the Northeast, 22.5% in the South, and 27.0% in the West. In the Northeast region, there was a notable upward trend in the percentage of female residents across PGY5 to PGY1 years (τ = 1, p = 0.027). A total of 25 (12.6%) programs had a section in their residency program or orthopedic department website homepage that mentioned and/or was dedicated to women or females. There was a significant association between region and homepage mention of women (χ² (8, N = 198) = 105.7; p < 0.001). A total of 12.9% of all orthopedic residency program directors were female, while 21.2% of all associate program directors were female. Conclusions These findings underscore the importance of monitoring and addressing regional disparities in gender representation within orthopedic surgery residency programs. By identifying trends and disparities, healthcare institutions and policymakers can implement targeted interventions to promote gender equity and cultivate a diverse and inclusive workforce.
Academic Surgical Oncologists’ Productivity Correlates with Gender, Grant Funding, and Institutional NCI Comprehensive Cancer Center Affiliation Open PDF
(2018)
Nguyen, V.
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Marmor, R.A.
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Ramamoorthy, S.L.
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Blair, S.L.
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Clary, B.M.
Background: A scholar’s h-index is defined as the number of h papers published, each of which has been cited at least h times. We hypothesized that the h-index strongly correlates with the academic rank of surgical oncologists. Methods: We utilized the National Cancer Institute (NCI) website to identify NCI-designated Comprehensive Cancer Centers (CCC) and Doximity to identify the 50 highest-ranked general surgery residency programs with surgical oncology divisions. Demographic data of respective academic surgical oncologists were collected from departmental websites and Grantome. Bibliometric data were obtained from Web of Science. Results: We identified 544 surgical oncologists from 64 programs. Increased h-index was associated with academic rank (p < 0.001), male gender (p < 0.001), number of National Institutes of Health (NIH) grants (p < 0.001), and affiliation with an NCI CCC (p = 0.018) but not number of additional degrees (p = 0.661) or Doximity ranking (p = 0.102). H-index was a stronger predictor of academic rank (r = 0.648) than total publications (r = 0.585) or citations (r = 0.450). Conclusions: This is the first report to assess the h-index within academic surgical oncology. H-index is a bibliometric predictor of academic rank that correlates with NIH grant funding and NCI CCC affiliation. We also highlight a previously unexpected and unappreciated gender disparity in the academic productivity of US surgical oncologists. When academic rank was accounted for, female surgical oncologists had lower h-indices compared with their male colleagues. Evaluation of the etiologies of this gender disparity is needed to address barriers to academic productivity faced by female surgical oncologists as they progress through their careers. © 2018, Society of Surgical Oncology.
A Systematic Review of Gender-Based Differences in Hirsch Index Among Academic Surgeons Open PDF
(2019)
Myers, S.P.
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Reitz, K.M.
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Wessel, C.B.
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Neal, M.D.
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Corbelli, J.A.
Background: The h-index is a commonly used bibliometric in academic medicine which enumerates the number of publications (h) that have been cited h times. Recent investigations have suggested that gender-based differences in h-index may exist among academic physicians. We systematically reviewed studies of academic surgeons’ h-index, hypothesizing that a significant difference would exist between the h-index of men and women at all academic ranks. Methods: Peer-reviewed journal articles authored by academic surgeons of any subspecialization in the United States between January 1, 2006, and November 20, 2017, were reviewed. We excluded studies of trainees or gender-based differences in funding without mention of h-index. Two reviewers assessed article quality using the Newcastle-Ottawa criteria. Pooled estimates of standard mean differences (SMD) in h-index between genders were calculated using random-effects meta-analyses. A subgroup analysis based on the academic rank was performed. Heterogeneity was assessed using the I 2 statistic. Sensitivity analyses determined the effect of study on h-index. Meta-regression identified whether surgical specialty contributed to heterogeneity. Results: Twelve articles comparing h-index between genders were selected from 7950. Men possessed higher h-indices than women (SMD, 0.547; P < 0.001; I 2 = 89.5%). Men exhibited higher h-indices at the assistant rank (SMD, 0.12; 95% confidence interval [CI], 0.01-0.24; P = 0.039) but not at the associate (SMD, 0.14; 95% CI, −0.06 to 0.33; P = 0.165) or full professor (SMD, 0.12; 95% CI, −0.08 to −0.31; P = 0.25) ranks. Conclusions: The h-index is higher for men than that for women in academic surgery overall but not at individual ranks. Further investigations are necessary to address limitations in h-index and to further characterize the relationship between h-index, gender, and promotion. © 2018 Elsevier Inc.
Author-Reviewer Homophily in Peer Review
(bioRxiv, 2019)
Murray, Dakota
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Siler, Kyle
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Larivière, Vincent
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Chan, Wei Mun
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Collings, Andrew M.
The fairness of scholarly peer review has been challenged by evidence of disparities in publication outcomes based on author demographic characteristics. To assess this, we conducted an exploratory analysis of peer review outcomes of 23,876 initial submissions and 7,192 full submissions that were submitted to the biosciences journal eLife between 2012 and 2017. Women and authors from nations outside of North America and Europe were underrepresented both as gatekeepers (editors and peer reviewers) and authors. We found evidence of a homophilic relationship between the demographics of the gatekeepers and authors and the outcome of peer review; that is, there were higher rates of acceptance in the case of gender and country homophily. The acceptance rate for manuscripts with male last authors was seven percent, or 3.5 percentage points, greater than for female last authors (95% CI = [0.5, 6.4]); this gender inequity was greatest, at nine percent or about 4.8 percentage points (95% CI = [0.3, 9.1]), when the team of reviewers was all male; this difference was smaller and not significantly different for mixed-gender reviewer teams. Homogeny between countries of the gatekeeper and the corresponding author was also associated with higher acceptance rates for many countries. To test for the persistence of these effects after controlling for potentially confounding variables, we conducted a logistic regression including document and author metadata. Disparities in acceptance rates associated with gender and country of affiliation and the homophilic associations remained. We conclude with a discussion of mechanisms that could contribute to this effect, directions for future research, and policy implications. Code and anonymized data have been made available at https://github.com/murrayds/elife-analysis Author summary Peer review, the primary method by which scientific work is evaluated, is ideally a fair and equitable process in which scientific work is judged solely on its own merit. However, the integrity of peer review has been called into question based on evidence that outcomes often differ between male and female authors, and for authors in different countries. We investigated such disparities at the biosciences journal eLife by analyzing the demographics of authors and gatekeepers (editors and peer reviewers), and peer review outcomes of all submissions between 2012 and 2017. Outcomes were more favorable for male authors and those affiliated with institutions in North America and Europe; these groups were also over-represented among gatekeepers. There was evidence that peer review outcomes were influenced by homophily —a preference of gatekeepers for manuscripts from authors with shared characteristics. We discuss mechanisms that could contribute to this effect, directions for future research, and policy implications.
Research Conducted in Women Was Deemed More Impactful but Less Publishable than the Same Research Conducted in Men Open PDF
(Mary Ann Liebert, Inc., publishers, 2021)
Murrar, Sohad
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Johnson, Paula A.
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Lee, You-Geon
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Carnes, Molly
Background: Female scientists, who are more likely than their male counterparts to study women and report findings by sex/gender, fare worse in the article peer review process. It is unknown whether the gender of research participants influences the recommendation to publish an article describing the study. Materials and Methods: Reviewers were randomly assigned to evaluate one of three versions of an article abstract describing a clinical study conducted in men, women, or individuals. Reviewers assessed the study's scientific rigor, its level of contribution to medical science, and whether they would recommend publishing the full article. Responses were analyzed with logistic regression controlling for reviewer background variables, including sex and experience level. Results: There was no significant difference in perceived research rigor by abstract condition; contribution to medical science was perceived to be greater for research conducted in women than men (odds ratio = 1.7; p = 0.030). Nevertheless, reviewers were almost twice as likely to recommend publication for research conducted in men than the same research conducted in women (predicted probability 0.606 vs. 0.322; p = 0.000). Conclusions: These results are consistent with abundant data from multiple sources showing a lower societal value placed on women than men. Because female investigators are more likely than male investigators to study women, our findings suggest a previously unrecognized bias that could contribute to gender asymmetries in the publication outcomes of peer review. This pro-male publication bias could be an additional barrier to leadership attainment for women in academic medicine and the advancement of women's health.
An International Survey of Female Dental Students' Perceptions About Gender Bias and Sexual Misconduct at Four Dental Schools. Open PDF
(2018)
Ivanoff, Chris S.
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Luan, Diana M.
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Hottel, Timothy L.
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Andonov, Bogomil
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Ricci Volpato, Luiz Evaristo
As women enter the dental profession in increasing numbers in North America and around the world, the questions of how they perceive their environment and what kind of barriers they face are important subjects to be addressed. The aim of this study was to assess and compare women dental students' perceptions of bias in their environment and experiences of sexual misconduct at one dental school in each of four countries. In spring 2017, 1,293 female students at four dental schools in the U.S., Bulgaria, Brazil, and India were invited to participate in a 24-item survey developed by researchers from the four countries; 990 students responded (response rate 76.6%). The overall majority of the respondents reported thinking the admissions process at their school was fair (79.7%); but a fifth of U.S. and Brazilian students perceived their school was not fully embracing of females, with most Bulgarian students agreeing (87.2%) and all Indian students disagreeing. Most respondents overall perceived that male faculty members did not favor male students (79.5%) and did not think there was discrimination against female students by faculty (87.1%), but half of the U.S. respondents reported feeling discriminated against by both male faculty and male students. When the responses "I've been verbally harassed" and "I've been somewhat verbally harassed" were combined, 10.1% of the U.S. respondents reported verbal harassment, compared to 20% of Brazilian, 15% of Bulgarian, and 2% of Indian respondents. When the responses "I've been sexually assaulted" and "I've been somewhat sexually assaulted" were combined, 6% of U.S. respondents reported being sexually assaulted, compared to 6.2% of Brazilian, 2.5% of Bulgarian, and none of the Indian respondents. Almost half (46.9%) of these students overall perceived their school was not or only somewhat vigilant about issues of sexual misconduct, and only 54% said they would feel comfortable or very comfortable reporting misconduct. These results suggest that academic dental institutions in all four countries need improvements to make their environments more equitable and free of bias and sexual misconduct.
Gender and racial/ethnic disparities in rates of publishing and inclusion in scientific-review processes. Open PDF
(Educational Publishing Foundation, 2021)
Willis, Malachi
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Bridges, Ana J.
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Jozkowski, Kristen N.
Sexism and racism in academia have contributed to women and people of color being underrepresented at increasing levels of the academic hierarchy. We investigated whether people with socially marginalized identities experience disparities regarding rates of publishing and inclusion in the scientific-review process. Using a sample of academics in psychology departments at research-focused universities in the United States (<i>n</i> = 885), we found gender disparities for PhD holders and racial/ethnic disparities for graduate students. Specifically, female PhD holders and graduate students of color reported fewer publications and were less likely to be included in the scientific-review process compared with male PhD holders and White graduate students, respectively. Differences in research activity by gender and race/ethnicity in a contemporary sample of psychologists reflected a 'leaky pipeline' that persists in psychology departments. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
The Role of Gender in Publication in The Journal of Pediatrics 2015-2016: Equal Reviews, Unequal Opportunities Open PDF
(2018)
Williams, Wadsworth A.
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Garvey, Katherine L.
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Goodman, Denise M.
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Lauderdale, Diane S.
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Ross, Lainie Friedman
OBJECTIVES: To examine whether the gender of corresponding authors, reviewers, and editors led to differential publication recommendations and outcomes for original research articles and invited editorials submitted to The Journal of Pediatrics in 2015 and 2016. STUDY DESIGN: Names of corresponding authors, reviewers, editors, and editorial writers in The Journal of Pediatrics databases for 2015-2016 were analyzed to determine gender using computer algorithms and Internet searches. Reviewer recommendations and final editor dispositions were stratified by their gender and the gender of the corresponding authors. RESULTS: Of 3729 original manuscripts, 54.3% had female corresponding authors. Women were the associate editor (40.2% of submissions), guest editor (34.8%), or primary reviewer (37.4%), with no gender difference in editor or reviewer assignments for submissions by female vs male corresponding authors. There were no outcome differences by author gender for manuscripts overseen by female (P = .71) or male (P = .62) editors nor recommendation differences by female (P = .18) or male (P = .71) reviewers. Female editors had a lower acceptance rate overall than male editors (20.1% vs 25.6%; P < .001). Women were statistically less likely to accept and complete the invitation to peer review original articles (34.0%; 2295 of 6743) compared with men (40.0%; 3930 of 9823; P < .001). Women wrote 33 of 107 editorials (30.8%). CONCLUSIONS: There were no differences in reviewer recommendations or editor decisions for original research articles based on corresponding author gender. However, women had fewer opportunities to serve as peer reviewers and editorial writers than would be expected given their representation as academic pediatric faculty.
Woman authorship in pre-print versus peerreviewed oral health-related publications: A two-year observational study Open PDF
(2021)
Rajendran, L.
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Khandelwal, N.
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Feine, J.
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Ioannidou, E.
Objectives Women in oral health science face similar societal issues and challenges as those in other STEMM careers, and gender disparities continue to exist as evidenced by fewer women represented as first and last authors in scientific publications. Pre-prints may serve as a conduit to immediately disseminating one's work, bypassing the arduous peer review process and its associated inherent biases. Therefore, the purpose of this study was to 1] compare the gender of first and last authors in pre-print versus peer reviewed publications, 2] examine the composition of first and last author pairs as stratified by publication type, and 3] examine the correlation between woman authorship and institutional geographic location and publication metrics stratified by publication type. Methods The keyword "oral health"was used to search for publications in BioRxiv and Pubmed in the years 2018 and 2019. Gender of first and last authors were determined, and its frequency was considered as the primary outcome. Additionally, the geographic location of the author's associated institution and publication metrics measured by Altmetrics score were extracted. Data was descriptively summarized by frequencies and percentages. Chi-square analysis was conducted for categorical variables which included the relationship between gender and publication type as well as gender and region of author's associated institution. Binomial regression analysis was conducted to analyze the relationship between gender and Altmetrics. Results Woman first authors comprised 40.3% of pre-prints and 64.5% of peer reviewed publications [p<0.05]. Woman last authors comprised 31.3% of pre-prints and 61.5% of peer reviewed publications [p<0.05]. When analyzing the relationships between first and last author, the Man-Man pairing represented 47.7% of the pre-print publications and the Woman-Woman pairing comprised a majority of the of the peer review publications at 47.5%. All results were statistically significant with a p-value <0.05. No significant correlation was found between region of institution or Altmetrics and gender of first or last authors [p>0.05]. Conclusion For the first time in oral health science, it was found that women show higher representation as first and last author positions in peer reviewed publications versus pre-prints. © 2021 Rajendran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
An advisor like me? Advisor gender and post-graduate careers in science Open PDF
(2018)
Gaule, P.
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Piacentini, M.
We investigate whether having an advisor of the same gender is correlated with the productivity of PhD science students and their propensity to stay in academic science. Our analysis is based an original dataset – combined from dissertation abstracts, faculty directories and bibliometric data – covering nearly 20,000 PhD graduates and their advisors from U.S. chemistry departments. We find that students working with advisors of the same gender tend to be more productive during the PhD; and that female students working with female advisors are considerably more likely to become faculty themselves. We suggest that the under-representation of women in science and engineering faculty positions may perpetuate itself through the lower availability of same-gender advisors for female students. © 2018 Elsevier B.V.

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