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  • Item type:Publication,
    A longitudinal analysis of gendered career trajectories and academic efficiency in North American MD/PhD faculty Open PDF 
    (Informa UK Limited, 2026-05-28)
    Quon, Stephanie
    ;
    Joseph, Marissa
    ;
    Khosa, Faisal
    Gender disparities in academic medicine persist despite increasing women's representation in higher education. Prior research highlights the underrepresentation of women in senior ranks and leadership roles, yet few studies have assessed these disparities using time-adjusted productivity metrics. This study aims to evaluate gender-based differences in academic rank, scholarly productivity, and leadership representation among MD/PhD faculty in North America, accounting for career length and institutional variability. A secondary analysis was conducted on a dataset of 6,149 MD/PhD faculty from 122 accredited North American medical schools. Time-adjusted measures of productivity, H-index per year and citations per year, were calculated. Gender differences in rank, productivity, and leadership were assessed using Mann-Whitney U tests and descriptive statistics. Institutional-level representation of women in leadership roles was also analyzed. Women held significantly lower academic ranks than males and were underrepresented in departmental leadership roles. Despite achieving assistant and full professorships earlier, women were overall less likely to reach these positions. Males exhibited higher time-adjusted H-index and citation rates (p < .0001), with a compounded 3.5-year publication gap. Institutional analysis revealed stark variability: 38 institutions had no women in MD/PhD leadership roles, while fewer than 20 percent achieved gender parity. Gender disparities in academic medicine cannot be explained by productivity alone. Structural barriers, opaque promotion criteria, and institutional cultures continue to impede women's advancement and leadership. Addressing these inequities requires transparent policies, targeted mentorship, equity audits, and inclusive leadership pathways to support a more equitable academic workforce.
  • Item type:Publication,
    The proportion of male and female editors in women's health journals: A critical analysis and review of the sex gap Open PDF 
    (2020)
    Grinnell, Madison
    ;
    Higgins, Shauna
    ;
    Yost, Kelli
    ;
    Ochuba, Olivia
    ;
    Lobl, Marissa
    BACKGROUND: Historically, women have been underrepresented in leadership positions in medicine. The reasons for this are multifactorial. In recent years, women's representation in medicine has improved. However, inequities in the proportion of men and women in medical leadership remain, especially with regard to editorial journal boards. OBJECTIVE: This study aimed to explore current trends of women in leadership positions on journal editorial boards. METHODS: A comprehensive search for women's health journals was performed in collaboration with university librarians in February 2019 using EMBASE, Scopus, SciFinder, and MEDLINE records for journals with relevance to women's health. Each journal was e-mailed to verify the accuracy of the journal editorial boards listed on their respective webpages. Five categories, as well as the totals for each journal, were analyzed for the proportion of women versus men: editor-in-chief, associate editor, deputy editor, and section editor, and other. RESULTS: Women comprised the minority of positions on women's health editorial boards. Of the total 1440 board members included, 602 members (42%) were women and 838 members (58%) were men. Women occupied 54 of 132 editor-in-chief positions (41%), 257 of 596 associate editor positions (43%), 13 of 42 deputy editor positions (30%), 46 of 120 section editor positions (38%), and 232 of 549 other editor positions (42%). CONCLUSION: Although the sex gap in leadership in medicine is improving, it is still present. Our findings suggest that women are underrepresented as editors at most levels in women's health journals centered on topics such as reproductive health, obstetrics and gynecology, perinatology, gynecological oncology, and breastfeeding. With sponsorship/mentorship for women, flexible scheduling, and considerate thought in leadership appointment, this sex gap will continue to improve.
  • Item type:Publication,
    Race, ethnicity, and gender in academic obstetrics and gynecology: 12-year trends Open PDF 
    (2020)
    Wooding, Denise J.
    ;
    Das, Priya
    ;
    Tiwana, Sabeen
    ;
    Siddiqi, Javed
    ;
    Khosa, Faisal
    Background Diversity among healthcare teams enhances team function and improves the quality of patient care and outcomes. Women and racial minorities are historically underrepresented in medicine. However, the representation of gender and racial or ethnic groups in academic obstetrics and gynecology in the United States has not been described in recent years. Objective This study aimed to describe the recent state and trends in gender and racial or ethnic disparities in academic obstetrics and gynecology. Study Design Data from the Association of American Medical Colleges between 2007 and 2018 were analyzed to describe the trends in the representation of women and racial (white, Asian, black) or ethnic (Hispanic) groups. The 12-year trends in representation by academic ranks (all academic physicians, full professor, associate professor, instructor), leadership positions (chairperson), and tenure (not on track for tenure, on track for tenure, or tenured) were depicted. The 12-year trends were assessed using linear regression to determine whether the slope depicting the change in representation of each group from 2007 to 2018 was significantly nonzero. In addition, average representation of each group across the 12-year period was compared using a Student t test (for gender) or analysis of variance (for race and ethnicity). Results In 2018, there were 152 institutions and 6302 academic physicians included in the data set. On average across the 12-year period, academic physicians in obstetrics and gynecology were 43% male, 57% female, 68% white, 12% Asian, 8% black, and 5% Hispanic. Across the 12-year period, there was an increase in the total number of physicians from 4755 to 6302 (+166 per year; 95% confidence interval, 146–186; P<.0001), a 15% increase in the proportion of women (+1.38% per year; 95% confidence interval, 1.08%–1.68%; P<.0001), and an increase in the proportion of physicians from racial minorities (Asian, +0.11% per year; 95% confidence interval, 0.08–0.15; P<.0001; black, +0.07% per year; 95% confidence interval, 0.04–0.09; P=.0002; Hispanic, +0.06% per year; 95% confidence interval, 0.02–0.1; P=.0039). There was a greater proportion of white physicians in higher academic ranks (eg, full professor), leadership positions (eg, chairperson), and tenure than the proportion of white physicians overall, whereas the opposite was true for black and Hispanic physicians. Although women now make up 64% of all academic physicians in obstetrics and gynecology, there remains a far higher proportion of males in leadership positions (chairperson) and higher academic ranks (full professor). Similarly, a greater proportion of males were tenured than females. Conclusion Across the 12-year period, the representation of women and racial minorities has increased in academic obstetrics and gynecology in the United States. There is now a predominance of women, but there remains a trend for a predominance of white and male physicians in higher academic ranks, leadership positions, and tenure. It will be important to assess how these groups are represented in the coming years as the changing demographics of incoming cohorts progress through their careers to more senior positions. Promoting diversity in medical schools, leadership positions, and higher academic ranks may be an important area of focus.
  • Item type:Publication,
    Small female citation advantages for US journal articles in medicine Open PDF 
    (2022)
    Thelwall, M.
    ;
    Maflahi, N.
    Female under-representation continues in senior roles within academic medicine, potentially influenced by a perception that female research has less citation impact. This article provides systematic evidence of (a) female participation rates from the perspective of published journal articles in 46 Scopus medical subject categories 1996–2018 and (b) gender differences in citation rates 1996–2014. The results show female proportion increases 1996–2018 in all fields and a female majority of first-authored articles in two-fifths of categories, but substantial differences between fields. A paper is 7.3 times more likely to have a female first author in Obstetrics and Gynaecology than in Orthopaedics and Sports Medicine. Only three fields had a female last author majority by 2018, a probable side effect of ongoing problems with appointing female leaders. Female first-authored research tended to be more cited than male first-authored research in most fields (59%), although with a maximum difference of only 5.1% (log-transformed normalised citations). In contrast, male last-authored research tends to be more cited than female last-authored research, perhaps due to cases where a senior male has attracted substantial funding for a project. These differences increase if team sizes are not accounted for in the calculations. Since female first-authored research is cited slightly more than male first-authored research, properly analysed bibliometric data considering career gaps should not disadvantage female candidates for senior roles. © The Author(s) 2020.
  • Item type:Publication,
    Gender Distribution & Rank of Authorship in Surgical Literature Open PDF 
    (SAGE Publications, 2022)
    Selvakumar, Sruthi
    ;
    Zagales, Israel
    ;
    Newsome, Kevin
    ;
    Spardy, Jeffrey
    ;
    Santos, Radleigh
    BackgroundAuthorship of surgical literature is important for the career advancement of surgeons, and gender disparities in authorship may hinder the representation and leadership of women within academic surgery. The aim of this systematic review and meta-analysis was to evaluate the gender distribution of first, senior, and overall authorship in peer-reviewed surgical journal studies across all surgical specialties to determine if disparities exist.MethodsPubMed, EMBASE, and Google Scholar databases were searched for studies investigating the gender distribution of authorship of surgical literature published before December 10th, 2021. Meta-analysis was performed and Cohen?s Q test for heterogenous effects was used to determine whether random or fixed-effects models were appropriate.ResultsFifteen studies investigating gender distribution of authorship met inclusion, which included a total of 136,627 pooled studies. The meta-analysis demonstrated the meta-proportion of first authorship for women to be 20.6% (95% CI: 13.9, 28.2), the meta-proportion of senior authorship for women to be 11.9% (95% CI: 6.6, 18.5), and the meta-proportion of overall authorship for women to be 23% (95% CI: 16.2, 30.7). In addition, the proportion of senior authorship for women was found to be significantly lower than the proportion of overall authorship for women (11.9% versus 23.0%, P = .0106).ConclusionThere is a significantly smaller proportion of women who are first, senior, and overall authors in surgical literature compared to their colleagues who are men. Sustainable and effective solutions aimed at improving the representation of women surgeons in surgical research and research leadership are necessary.
  • Item type:Publication,
    No Room to "Lean In": A Qualitative Study on Gendered Barriers to Promotion and Leadership. Open PDF 
    (2019)
    Ellinas, Elizabeth H.
    ;
    Kaljo, Kristina
    ;
    Patitucci, Teresa N.
    ;
    Novalija, Jutta
    ;
    Byars-Winston, Angela
    INTRODUCTION: The gender gap in professorship and leadership roles persists in academic medicine, whereas reasons for these disparities remain unclear. MATERIALS AND METHODS: Open-ended text responses to a 2013 faculty engagement survey were analyzed by using the grounded theory and consensual qualitative analysis techniques. The authors grouped 491 faculty's text responses into descriptive codes and three themes: (1) No Obstacles, (2) Barriers to Success, and (3) Concerns Regarding Processes. Demographics of codes were compared by using chi-square analysis. RESULTS: Male faculty identified barriers that included negative views of leadership or leaders. Female faculty, especially those in clinical roles, expressed barriers related to role overload, including that the demands of their current positions prevented advancement or addition of further roles, no matter how desirable further roles may be. Women also shared that considerable self-promotion was required to receive acknowledgement of their work and support by leadership. CONCLUSION: A proposed framework depicts male and female faculty's concerns on a continuum. No Obstacle and Process Concerns were relatively gender neutral, whereas large gender disparities occurred within the Barriers to Success theme. Women's barriers largely revolved around internal obstacles (I can't do any more), and men's barriers largely revolved around external factors (leaders are impeding my progress). Resources are needed to mitigate work overload specifically for female faculty, and to ensure that all faculty are both engaged in advanced career opportunities and encouraged to pursue leadership positions.
  • Item type:Publication,
    The role of gender in academic productivity, impact, and leadership among academic spine surgeons Open PDF 
    (2022)
    Agaronnik, Nicole
    ;
    Xiong, Grace X.
    ;
    Uzosike, Akachimere
    ;
    Crawford, Alexander M.
    ;
    Lightsey, Harry M.
    BACKGROUND/CONTEXT: Women represent a small minority of practicing orthopedic surgeons and neurosurgeons, with spine surgery having a disproportionately low representation relative to other subspecialties. Previous efforts have attempted to characterize gender patterns in authorship amongst select spine journals. However, no study to our knowledge has done a comprehensive assessment of the influence of gender on academic productivity, impact, and leadership amongst academic spine faculty. PURPOSE: To evaluate the impact of gender on academic productivity, promotion to leadership positions, and career advancement among academic spine faculty in the United States. STUDY DESIGN: Cross-sectional study. PATIENT SAMPLE: Academic spine faculty associated with orthopedic residency, North American Spine Society spine fellowship programs, and American Association of Neurological Surgeons spine fellowship programs. OUTCOME MEASURES: Academic productivity as measured by publications counts, h-index, authorship ranking as well as academic rank and leadership roles METHODS: We identified all spine faculty across orthopedic residency, orthopedic spine fellowship, and neurosurgical spine fellowship programs in the United States, and abstracted academic performance characteristics, cumulative h-index, and complete publication records for each individual faculty member. Proportions of men and women by specialty, academic rank, and leadership were compared with Fisher's exact testing, and comparison of mean h-index and publication counts compared with Wilcoxon rank-sum testing. Adjusted analyses on publication count and h-index were achieved with poisson regression analysis with gender as the primary predictor adjusting for specialty, degrees, academic rank, and seniority based on time since fellowship completion. RESULTS: The representation of women among spine faculty associated with orthopedic residency and North American Spine Society spine fellowship programs was 5.6%. On average, women had 40% fewer total publications (p=.025), h-indices approximately 5 units lower than men (p=.006), 40% fewer total high-impact publications (p=.030), half the senior author publications (p=.005), and half the high-impact senior author publications (p=.007) compared to men. After adjusting for seniority and academic rank, the number of publications in high impact journals no longer differed between men and women, although differences persisted for total publication count and the h-index. Men were significantly more likely to occupy higher academic ranks, with 25.6% of men and 9.5% of women holding the rank of full professor (p=.031), although there was no significant difference in the rate of appointment to leadership positions. Similar findings were encountered among American Association of Neurological Surgeons spine fellowship faculty. CONCLUSIONS: The present study details the low rate of women in academic spine surgery. Furthermore, gender disparities exist in publication volume, impact, and h-indices. A much lower proportion of women hold higher-ranking academic positions compared to men, though appointment to leadership positions was similar between genders. Differences in seniority and publication metrics may in part be due to the relatively younger cohort of women faculty. These findings underscore the need for active investment in diversity and pipeline efforts that facilitate recruitment and support academic productivity of women in spine surgery.