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Male-dominated participation in the first two years of medical school: A mismatch between reality and perception Open PDF
(Informa UK Limited, 2026-02-26)
Park, Connor C.
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Brendes, Keith D.
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Lundstrom, Karrie
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O’Neil, Kiley
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Jayaram, Maya A.
Introduction: Although women now comprise most U.S. medical students, male physicians continue to dominate leadership roles, earn higher salaries, and hold more full professorships. These disparities suggest that cultural dynamics contributing to gender inequities may emerge early in medical training. This mixed-methods study investigated gender differences in perceived and actual participation in mandatory educational sessions during the first two years of medical school. Methods: First, a survey assessed student perceptions of gendered participation across mandatory first- and second-year educational sessions. Subsequently, these sessions were observed for eight weeks at a single institution. Observed sessions included full-class Didactic and Social/Ethical sessions (120 students) and smaller Clinical sessions (30 students). For each participation instance (asking or answering a question), the gender of the student and instructor was recorded. Students could opt out. Results: Survey responses indicated that most students perceived no gender-based differences in Social/Ethical or Clinical sessions. Female students, however, reported that men participated more frequently in Didactic sessions, while male students perceived no disparity (p = 0.001). Observational data showed male students accounted for 72.4% of 311 participation events (p < 0.001). Men contributed significantly more in Didactic (81.2%) and Social/Ethical sessions (67.1%; both p < 0.001), with no significant difference in Clinical sessions (54% male; p = 0.19). Male participation decreased in sessions led by female instructors compared with male (p = 0.036) or mixed-gender faculty (p = 0.023). Discussion: Despite objective gender disparities in participation, most first- and second-year students did not perceive differences. Notably, only female students perceived this discrepancy in their pre-observation surveys, and only in the context of didactic sessions. This imbalance may reinforce early professional norms favoring male visibility and engagement, perpetuating gender inequities in academic medicine. Addressing these dynamics is essential for fostering equitable learning environments and promoting diverse leadership in medicine.
Gender in authorship and editorship in medical education journals: A bibliometric review Open PDF
(2021)
Madden, Caoimhe
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O'Malley, Róisín
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O'Connor, Paul
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O'Dowd, Emily
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Byrne, Dara
CONTEXT: Gender bias has been observed in the authorship and editorship of academic literature in varied medical specialties. This is important as peer-reviewed publications, and participation on editorial boards, are closely related to academic productivity and advancement. The aim of this paper was to examine whether gender-based disparities in authorship and editorship exist in leading medical education journals. METHODS: A retrospective bibliometric review was conducted of articles published at eight different time-points across a 49-year time period (specifically: 1970, 1980, 1990, 2000, 2005, 2010, 2015 and 2019) in four leading medical education journals (Academic Medicine, BMC Medical Education, Medical Education and Medical Teacher). First and last (as a proxy for senior) author gender was determined for each article, along with the gender of the 2019 editorial board members of each journal. Chi-square tests for trend were conducted to examine variations in author gender distributions over time, and binomial tests of proportions were conducted to examine gender distributions in authorship and editorship in 2019. Logistic regression analyses were carried out to determine factors that predicted the odds of authorship by women. RESULTS: A total of 5749 articles were included. A significant trend of increased women as first and last authors was observed across all journals. The percentage of women first authors increased from 6.6% in 1970 to 53.7% in 2019 (P < .001), and women last authors increased from 9.5% in 1970 to 46% in 2019 (P < .001). Overall, the distributions of women first authors, last authors and editorial board members in 2019 indicated greater gender parity than many other fields of medicine. CONCLUSIONS: Positive progress towards gender parity has been made in medical education scholarship. However, future research and efforts are needed to ensure the continued participation, and highlighting, of women in medical education scholarship and to address other factors which may hinder academic advancement for women in this field.
When perception is reality: Resident perception of faculty gender parity in a university-based internal medicine residency program. Open PDF
(2019)
Lukela, Jennifer Reilly
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Ramakrishnan, Aditi
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Hadeed, Nicole
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Del Valle, John
INTRODUCTION: Although women have entered medical school and internal medicine residency programs in significant numbers for decades, women faculty remain underrepresented in senior and departmental leadership roles. How residents perceive this gender disparity is unknown. We sought to assess resident perception of gender parity among departmental leadership and teaching faculty in our internal medicine department, and to determine the actual gender distribution of those faculty roles. METHODS: An anonymous cross-sectional survey was distributed to evaluate resident perception of gender representation of various faculty roles. Using conference schedules, resident evaluations, and our department website, we determined the actual representation of women faculty in department leadership roles, and in clinical and educational activities. RESULTS: 88 of 164 residents (54%) responded. Women residents were less likely than men to perceive that women faculty were equally represented in department leadership (45% men agreed vs. 13% women, p < 0.05), clinical teaching roles (55% men agreed vs. 28% women, p < 0.05), or facilitating educational conferences (45% men agreed vs. 28% women, p = 0.074). In 2017, the internal medicine department at our institution comprised 815 faculty members, 473 men (58%) and 342 women (42%). At that time, women faculty held 5% of senior departmental leadership positions and 21% of educational leadership positions. During the year preceding survey distribution, women faculty attended on internal medicine inpatient wards for 33% of the total number of weeks, staffed 20% of morning reports, and facilitated 28% of noon conferences. DISCUSSION: Women residents in our internal medicine training program perceived a gender disparity among faculty in leadership and educational positions to a greater extent than male residents. The perception of women trainees was accurate. In addition to disproportionate underrepresentation in leadership positions, women faculty were underrepresented in prominent educational positions, including attending on inpatient services and serving as discussants at educational conferences.
Gender differences in faculty rank among academic physicians: a systematic review and meta-analysis Open PDF
(2021)
Li, Ben
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Jacob-Brassard, Jean
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Dossa, Fahima
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Salata, Konrad
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Kishibe, Teruko
OBJECTIVE: Many studies have analysed gender bias in academic medicine; however, no comprehensive synthesis of the literature has been performed. We conducted a pooled analysis of the difference in the proportion of men versus women with full professorship among academic physicians. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Education Resources Information Center and PsycINFO were searched from inception to 3 July 2020. STUDY SELECTION: All original studies reporting faculty rank stratified by gender worldwide were included. DATA EXTRACTION AND SYNTHESIS: Study screening, data extraction and quality assessment were performed by two independent reviewers, with a third author resolving discrepancies. Meta-analysis was conducted using random-effects models. RESULTS: Our search yielded 5897 articles. 218 studies were included with 991 207 academic physician data points. Men were 2.77 times more likely to be full professors (182 271/643 790 men vs 30 349/251 501 women, OR 2.77, 95% CI 2.57 to 2.98). Although men practised for longer (median 18 vs 12 years, p<0.00002), the gender gap remained after pooling seven studies that adjusted for factors including time in practice, specialty, publications, h-index, additional PhD and institution (adjusted OR 1.83, 95% CI 1.04 to 3.20). Meta-regression by data collection year demonstrated improvement over time (p=0.0011); however, subgroup analysis showed that gender disparities remain significant in the 2010-2020 decade (OR 2.63, 95% CI 2.48 to 2.80). The gender gap was present across all specialties and both within and outside of North America. Men published more papers (mean difference 17.2, 95% CI 14.7 to 19.7), earned higher salaries (mean difference $33 256, 95% CI $25 969 to $40 542) and were more likely to be departmental chairs (OR 2.61, 95% CI 2.19 to 3.12). CONCLUSIONS: Gender inequity in academic medicine exists across all specialties, geographical regions and multiple measures of success, including academic rank, publications, salary and leadership. Men are more likely than women to be full professors after controlling for experience, academic productivity and specialty. Although there has been some improvement over time, the gender disparity in faculty rank persists. PROSPERO REGISTRATION NUMBER: CRD42020197414.
Gender Disparities in Medical Student Research Awards: A 13-Year Study from the Yale School of Medicine Open PDF
(Lippincott Williams and Wilkins, 2018)
King, J.T.
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Angoff, N.R.
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Forrest, J.N.
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Justice, A.C.
Purpose The Liaison Committee on Medical Education mandates instruction in research conduct, and many U.S. Medical schools require students to complete a research project. All Yale School of Medicine (YSM) graduating students submit a research thesis, and ∼5% are awarded highest honors. Gender disparities exist in areas related to physician research productivity, including academic rank, research funding, and publications. The authors asked whether gender disparities exist for medical student research. Method The authors conducted a retrospective review of 1,120 theses submitted by graduating medical students from 2003 to 2015 at YSM and collected data on gender, mentoring, research type, sponsoring department, and other characteristics. Multivariate logistic regression modeling examined gender differences in medical student research awards. Results Women authored 50.9% of theses, but earned only 30.9% of highest honors awards (OR 0.41; 95% CI: 0.23, 0.74). Among factors associated with increased receipt of highest honors that differed by gender, men were more likely than women to work with a mentor with a history of three or more thesis honorees, take a fifth year of study, secure competitive research funding, undertake an MD-master of health science degree, and conduct laboratory research (all P <.001). After adjustment for these factors, and for underrepresented in medicine status and sponsoring department, women remained less likely to receive highest honors (OR 0.51; 95% CI: 0.27, 0.98). Conclusions Women YSM students were less likely to receive highest honors for medical research. Gender disparities in postgraduate biomedical research success may start during undergraduate medical education. © 2018 by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited.
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.
Global evidence of gender equity in academic health research: a scoping review Open PDF
(2023)
Tricco, AC
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Nincic, V
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Darvesh, N
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Rios, P
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Khan, PA
Objectives To chart the global literature on gender equity in academic health research.Design Scoping review.Participants Quantitative studies were eligible if they examined gender equity within academic institutions including health researchers.Primary and secondary outcome measures Outcomes related to equity across gender and other social identities in academia: (1) faculty workforce: representation of all genders in university/faculty departments, academic rank or position and salary; (2) service: teaching obligations and administrative/non-teaching activities; (3) recruitment and hiring data: number of applicants by gender, interviews and new hires for various rank; (4) promotion: opportunities for promotion and time to progress through academic ranks; (5) academic leadership: type of leadership positions, opportunities for leadership promotion or training, opportunities to supervise/mentor and support for leadership bids; (6) scholarly output or productivity: number/type of publications and presentations, position of authorship, number/value of grants or awards and intellectual property ownership; (7) contextual factors of universities; (8) infrastructure; (9) knowledge and technology translation activities; (10) availability of maternity/paternity/parental/family leave; (11) collaboration activities/opportunities for collaboration; (12) qualitative considerations: perceptions around promotion, finances and support.Results Literature search yielded 94 798 citations; 4753 full-text articles were screened, and 562 studies were included. Most studies originated from North America (462/562, 82.2%). Few studies (27/562, 4.8%) reported race and fewer reported sex/gender (which were used interchangeably in most studies) other than male/female (11/562, 2.0%). Only one study provided data on religion. No other PROGRESS-PLUS variables were reported. A total of 2996 outcomes were reported, with most studies examining academic output (371/562, 66.0%).Conclusions Reviewed literature suggest a lack in analytic approaches that consider genders beyond the binary categories of man and woman, additional social identities (race, religion, social capital and disability) and an intersectionality lens examining the interconnection of multiple social identities in understanding discrimination and disadvantage. All of these are necessary to tailor strategies that promote gender equity.
How Women in Biomedical PhD Programs Manage Gender Consciousness as They Persist Toward Academic Research Careers Open PDF
(2016)
Remich, Robin
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Jones, Remi
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Wood, Christine V.
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Campbell, Patricia B.
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McGee, Richard
PURPOSE: Women remain underrepresented as biomedical faculty and are more likely than white and Asian men to lose interest in faculty careers in graduate school. However, some women maintain interest in academic research careers during PhD training and are the most likely candidates for faculty positions. This study explored how these women described and interpreted gender issues at early stages in their training. METHOD: Annual interviews from 2009 to 2014 with 22 female PhD students aspiring to research faculty careers were analyzed using an iterative, content analysis approach rooted in the interview data. Focusing on career intentions and experiences with gender, race, and ethnicity, authors arrived at 11 themes which describe a range of gendered experiences and strategies. RESULTS: Of the 22 women, 19 (86%) acknowl edged systemic gender inequities in science and/or reported instances of bias, while 15 of them also said they had not yet experienced unequal treatment. All 22 described using at least one "gender-explicit strategy," where they based decisions on gender or in response to perceived biases. "Gender-agnostic strategies" emerged for 12 (55%) who doubted that gender will affect their career. CONCLUSIONS: Findings show that women biomedical PhD students continue to face conditions that can lead to unequal treatment; gender biases continue to persist. Students displayed a range of perceptions and strategies in response to these conditions at this early training stage. Following these students over time will determine whether these or other strategies are required and sufficient to enable persistence toward academic careers.
Analysis of Sex Diversity Trends Among Ophthalmology Match Applicants, Residents, and Clinical Faculty Open PDF
(2021)
Aguwa, Ugochi T.
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Srikumaran, Divya
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Green, Laura K.
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Potts, John R.
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Canner, Joseph
IMPORTANCE: The proportion of women in the field of ophthalmology in the US trails the proportion of women in the general population. Sex diversity trends have been studied in other specialties, but there is a dearth of such literature in ophthalmology. OBJECTIVE: To investigate trends in the proportion of female ophthalmology match applicants, residents, and clinical faculty. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study examined data from the San Francisco Match, the Association of University Professors of Ophthalmology, Accreditation Council for Graduate Medical Education, Association of American Medical Colleges, and American Academy of Ophthalmology (AAO) from January 1, 2011, to December 31, 2019. Data from ophthalmology match applicants, residents, clinical faculty at US medical schools, and AAO members were collected. MAIN OUTCOMES AND MEASURES: The proportion of female applicants, residents, and medical school clinical faculty in ophthalmology. RESULTS: Data were obtained from a total of 2807 ophthalmology applicants (35.3% female), 1 004 563 residents (43.8% female), 463 079 clinical faculty members (42.5% female), and 78 968 AAO members (26.1% female). Male ophthalmology residency applicants outnumbered female applicants by a ratio of 1.6:1 from 2016 to 2019. The percentage of female matched applicants in 2016 (41% [168/406]) and 2019 (42% [184/436]) differed by 1% (percent change, 0.99; 95% CI, -1.12 to 3.1; P = .36). There was a 2.3% increase (percent change, 0.34; 95% CI, 0.24-0.43; P < .001) in the percentage of female residents across all surgical specialties from 2011 (39.7% [8710/21 985]) to 2019 (42% [10 951/26 082]) but a 2.5% decrease (percent change, -0.45; 95% CI, -0.84 to -0.06; P = .02) in the percentage of female residents in ophthalmology from 2011 (41.5% [589/1419]) to 2019 (39% [575/1473]). The percentage of female ophthalmology clinical faculty differed by 2% (percent change, 1.02; 95% CI, -0.21 to 2.24; P = .10) from 2017 (38% [1179/3102]) to 2019 (40% [1225/3060]). From 2016 to 2019, male practicing ophthalmologists in the AAO outnumbered female practicing ophthalmologists by a ratio of 3:1. CONCLUSIONS AND RELEVANCE: This study found that the percentage of women in the field of ophthalmology remains lower than percentages in other specialties, and the percentage of female ophthalmology residents has decreased in recent years. More efforts are needed to improve female representation in ophthalmology.

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