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Interventions to enhance gender equity in academic medicine: a systematic review Open PDF
(BMJ, 2025-10)
Burke, Elaine
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Darker, Catherine
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Godson Treacy, Isabelle Molly
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Kavanagh, Columb
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Mockler, David
Objectives We aimed to describe the current evidence for interventions to enhance gender equality and equity in academic medicine. We also wished to characterise the nature of the interventions, who delivered them and whether they seek to ‘fix the women’, or target issues at organisational and systemic levels. Design We extracted data using a form developed for the study and applied the Template for Intervention Description and Replication (TIDieR) and Morahan frameworks to describe and characterise interventions. We used the Quality Assessment with Diverse Studies (QUADS) tool to critically appraise included studies. Data sources We searched five electronic databases in November 2022 and August 2023 (Medline (OVID), Embase, CINAHL, Web of Science, Google Scholar) and undertook handsearching. Eligibility criteria for selecting studies We included qualitative or quantitative original studies published in full that described any new intervention designed to enhance gender equality/equity in recruitment, retention or promotion in academic medicine. The settings were Schools/Faculties of Medicine in Higher Education Institutions. The population of interest was female clinical academics/physician scientists. Data extraction and synthesis Data were extracted by one researcher using an Excel form specifically designed for this study with a second researcher applying the form to a subset of seven studies; significant agreement was achieved. Four researchers applied the TIDieR framework to the included studies. Due to the small number of studies and significant heterogeneity, it was not possible to perform a meta-analysis. Results The search of electronic databases yielded 1747 studies. A further 62 were identified through handsearching. Following removal of duplicates, 764 articles were screened for eligibility, and 199 full-text articles were screened. Of these, 27 met the inclusion criteria. The most commonly reported interventions were career development or leadership skills programmes, followed by mentorship and multifaceted interventions. Most papers reported positive findings, but many relied on subjective measures. Robustly designed studies often reported mixed findings. The majority of interventions aimed to ‘fix the women’, with few addressing inequality at organisational level. Conclusions Acknowledging the possibility of publication delay, we found that despite strong evidence of the negative effects of the pandemic on women’s research productivity, there were no new interventions designed to mitigate this. Many existing interventions create ‘institutional housekeeping’ by relying on women for their delivery. This can result in failure, especially during a crisis like COVID. Most studies were low to moderate quality. More robust research and a more holistic approach are needed, moving away from ‘fixing the women’ to address the organisational and systemic structures which underpin inequality. PROSPERO registration number CRD42023391086.
The gender gap in academic anesthesiology and critical care medicine: a systematic review Open PDF
(Springer Science and Business Media LLC, 2024-12-20)
De Cassai, Alessandro
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Rubulotta, Francesca
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Zdravkovic, Marko
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Mustaj, Sindi
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Berger-Estilita, Joana
Abstract Purpose Gender disparities in academia are a growing concern, impacting various disciplines, including health care. We aimed to investigate gender-based differences in academic performance, leadership roles, and academic distinction within anesthesiology and critical care medicine. Source We conducted electronic searches for relevant articles published in PubMed, CENTRAL, Scopus, Web of Science, Embase, Education Resources Information Center, PsychINFO, and ProQuest from database inception until 23 June 2024. Three researchers conducted blinded assessments using predefined inclusion and exclusion criteria, with discrepancies resolved through discussion. We reported descriptive statistics for quantitative data from the included research articles. Principal findings Our initial screening identified 37,311 studies, 71 of which met the specified inclusion criteria and were therefore evaluated. Analysis of academic publishing trends revealed a gradual increase in the proportion of women as coauthors, first authors (in anesthesiology, the increase ranged from 7% to 17%, and in critical care medicine the increase was 4%), last authors, and corresponding authors. Despite these improvements, women remain underrepresented on the editorial boards of top journals. Although an increase in the representation of women as abstract presenters at conferences was noted, gender disparities persist in senior authorship roles. Conclusion Gender disparities are evident in academic leadership positions within anesthesiology and critical care medicine, with few women holding editor-in-chief positions and underrepresentation of women on editorial boards. We observed similar gaps in departmental and scientific society leadership roles. The distribution of awards, prizes, and grants remains skewed, indicating persistent gender imbalances in academic distinction. While progress has been made in certain areas, substantial gaps persist in scholarly publishing, leadership, and academic distinction.
Gender Inequity in Institutional Leadership Roles in US Academic Medical Centers Open PDF
(American Medical Association (AMA), 2025-04-04)
Levy, Morgan S.
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Hunt, Kelby N.
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Lindsay, Kara A.
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Mohan, Vikasni
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Mercadel, Alyssa
Importance Academic medical centers have focused their efforts on promoting gender equity in recent years, but the positive outcomes associated with those efforts remain to be seen in recruiting and retaining diverse institutional leadership. Objective To evaluate the current state of gender inequity in institutional leadership roles, such as deans, department chairs, and residency and fellowship program directors, at US academic medical centers. Evidence Review A search for articles published from January 1, 2019, to August 5, 2022, on gender inequity in institutional leadership roles at academic medical centers was performed using the PubMed, CINAHL, and ERIC databases. Studies were screened for inclusion by sets of 2 independent reviewers (with disagreements resolved by a third reviewer) and evaluated for risk of bias. The Methodological Expectations of Cochrane Intervention Reviews Standards were followed for conducting the review, and the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guideline was followed for reporting results. Findings A total of 8120 articles were retrieved, of which 6368 were screened by title and abstract, 6166 were excluded, and 202 underwent full-text review. Ultimately, 94 studies reported on institutional leadership roles, including deans (5 studies [5.3%]), department chairs (39 studies [41.5%]), division chiefs (25 studies [26.6%]), and program directors (67 studies [71.3%]), with some overlap. A total of 678 participants were deans (564 men [80.5%] and 132 women [19.5%]), 8518 were department chairs (7160 men [84.1%] and 1358 women [15.9%]), 3734 division chiefs (2997 men [80.3%] and 737 women [19.7%]), and 9548 program directors (7455 men [78.1%] and 2093 women [21.9%]). Even in specialties with 50% or more female faculty, none had equal representation of women as department chairs and division chiefs. Gender inequities were particularly pronounced in surgical specialties. Conclusions and Relevance This systematic scoping review suggests that even though emphasis has been placed on addressing gender inequities in academic medicine, considerable disparities remain at the leadership level. While certain positions and specialties have been observed to have more female leaders, niches of academic medicine almost or completely exclude women from their leadership ranks. Importantly, even female-dominated specialties, such as obstetrics and gynecology, have substantial inequity in leadership roles. It is past time for organizational and systems-level changes to ensure equitable gender representation in academic leadership.
Gender‐Based Outcomes in Grants, Prizes and Fellowship Success Rates in Clinical Radiology: A 14‐Year Review of Outcomes in Australia and New Zealand Open PDF
(Wiley, 2025-09-24)
Liu, Jack Edward
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Milner, Lisa
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Shaygi, Behnam
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Stewart, Michael
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Yazdabadi, Anousha
ABSTRACT Introduction While gender disparities in the radiology workforce are well‐documented, there has been no analysis of outcomes for competitive awards in Australia and New Zealand. As formal recognition is critical for career progression, this study aimed to investigate gender‐based differences in application and success rates for grants, prizes and educational fellowships within the Australasian context. Methods We retrospectively reviewed applications for Royal Australian and New Zealand College of Radiologists' (RANZCR) Faculty of Clinical Radiology grants, prizes and educational fellowships from 2011 to 2024. Application and success rates were stratified by gender and compared to College membership demographics. Significance was assessed using Fisher's exact test. Results Across 333 total applications, 227 (68.2%) were from males and 106 (31.8%) from females, closely reflecting College membership gender ratios (69.2% male vs. 30.8% female). No significant gender disparity was found in the success rates for grants (40.3% for males vs. 35.0% for females, p = 0.58), prizes (8.8% vs. 11.1%, p = 0.08) or educational fellowships (36.7% vs. 32.1%, p = 0.32). Application rates for each award type also broadly reflected the gender composition of the College membership. Conclusion This study is the first to examine gender differences in clinical radiology grant, prize and educational fellowship outcomes in Australia and New Zealand. We found no significant disparities in success rates, and application rates generally mirrored College membership, suggesting the award process itself is equitable. However, the continued underrepresentation of women in radiology underscores the need to examine broader structural and sociocultural factors that may impact engagement with competitive academic opportunities.
Equity in Access to Arthroplasty from a Gender Perspective: A Narrative Review Open PDF
(Springer Science and Business Media LLC, 2025-06-04)
Patel, Neha
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McDougall, Catherine
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Arif, Azeta
Objective Despite growing gender diversity in medical education, orthopaedic surgery—particularly arthroplasty—remains one of the most male-dominated subspecialties. This review critically evaluates the barriers limiting female surgeons' access to arthroplasty, including disparities in training, mentorship, professional advancement, and leadership roles. In addition it explores the implications of gender disparities on workforce diversity, patient care outcomes, and surgical innovation while identifying strategies to enhance gender equity in the field. Introduction Women remain significantly underrepresented in arthroplasty, comprising a lower percentage of trainees, faculty, and senior consultants as compared to other surgical specialties. Systemic barriers such as implicit bias, limited mentorship, work-life balance challenges, and inequitable leadership opportunities contribute to this underrepresentation. These disparities influence career trajectories, limiting diversity in surgical perspectives and innovation. Addressing these issues is critical to achieving an equitable and inclusive workforce. Methodology A structured narrative review was conducted using peer-reviewed articles, institutional reports, and orthopaedic society publications. The Data were retrieved from PubMed, Scopus, and institutional databases, focusing on gender representation in orthopaedic surgery, mentorship initiatives, workforce statistics, and leadership opportunities in arthroplasty. Comparative analysis was performed across subspecialties and institutions, and recommendations from diversity and inclusion initiatives were evaluated to highlight successful interventions. Conclusion Achieving gender equity in arthroplasty requires systemic changes, including structured mentorship programs, leadership development workshops, and institutional commitments to diversity. Addressing implicit biases, promoting flexible training pathways, and fostering sponsorship programs for female surgeons are essential. A diverse workforce in arthroplasty will not only promote professional equity but also improve patient care and surgical innovation.
Gender Disparity in Full Professor Rank Among Academic Physicians: A Systematic Review and Meta-Analysis Open PDF
(2024)
Marhoffer, Elizabeth A.
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Ein-Alshaeba, Samer
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Grimshaw, Alyssa A.
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Holleck, Jürgen L.
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Rudikoff, Benjamin
PURPOSE: The gender gap in promotion in academic medicine is well established. However, few studies have reported gender differences in promotion adjusted for scholarly production and national or international reputation, namely, career duration, publications, grant funding, and leadership positions. The authors performed a systematic review and meta-analysis of the differences between men and women in achieving benchmarks for promotion and analyze where such differences lie geographically and within specialties. METHOD: A systematic search of Academic Search Premier, Business Source Complete, Cochrane Library, ERIC, GenderWatch, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science was conducted from inception to August 17, 2022. All studies that reported the number of male and female full professors on medical school faculty were included. The primary outcome was the adjusted odds ratio (AOR) for promotion to full professor for women compared with men. RESULTS: Two hundred forty-four studies met the inclusion criteria. The unadjusted OR for promotion to full professor for women was 0.38 (95% confidence interval [CI], 0.36-0.41). Sixteen studies reported an AOR. The pooled AOR of promotion for women to full professor was 0.60 (95% CI, 0.46-0.77). The AOR for promotion to full professor was 0.55 (95% CI, 0.34-0.88) in surgery and 0.80 (95% CI, 0.57-1.11) in internal medicine. Statistical heterogeneity was high ( Q = 66.6, I2 = 79.4%, P < .001). On meta-regression, 77% of the heterogeneity was from studies outside the United States, where more disparity was reported (AOR, 0.29; 95% CI, 0.22-0.38). CONCLUSIONS: Most studies continued to find decreased promotion of women. Gender disparity was particularly notable in surgery and in studies from outside the United States. The results suggest that differences in promotion were due to differences in productivity and leadership and to gender bias.
The impact of double-blind peer review on gender bias in scientific publishing: a systematic review Open PDF
(2022)
Kern-Goldberger, Adina R.
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James, Richard
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Berghella, Vincenzo
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Miller, Emily S.
OBJECTIVE: Gender-based bias during journal peer review can lead to publication biases and perpetuate gender inequality in science. Double-blind peer review, in which the names of authors and reviewers are masked, may present an opportunity for scientific literature to increase equity and reduce gender-based biases. This systematic review of studies evaluates the impact of double-blind vs single-blind peer review on the publication rates by perceived author gender. DATA SOURCES: The PubMed, Embase, Web of Science, and Scopus electronic databases were searched using the terms "blind," "peer review," "gender," "woman," and "author." All published literature in the English language from database inception through 2020 was queried. STUDY ELIGIBILITY CRITERIA: Prospective experimental and observational studies comparing double-blind to single-blind peer review strategies examining impact on publication decisions by author gender were included. STUDY APPRAISAL AND SYNTHESIS METHODS: The extracted data were primarily descriptive and included information on study design, sample size, primary outcome, major findings, and scientific discipline. The studies were characterized on the basis of design and whether the results demonstrated an impact of double-blind peer review on review scores and publication decision by perceived author gender. This study was registered with the International Prospective Register of Systematic Reviews or PROSPERO. RESULTS: In total, 1717 articles were identified, 123 were reviewed, and 8 were included, encompassing 5 prospective experimental studies and 3 observational studies. Four studies demonstrated a difference in the acceptance rate or review score on the basis of perceived author gender, whereas the other 4 studies demonstrated no differences when the author gender was anonymized. CONCLUSION: Studies evaluating the impact of double-blind peer review on author gender demonstrate mixed results, but there is reasonable evidence that gender bias may exist in scientific publishing and that double-blinding can mitigate its impact. Further evaluation of the processes in place to create the body of evidence that clinicians and researchers rely on is essential to reduce bias, particularly in female-majority fields such as obstetrics and gynecology.
Pre- and post-COVID-19 gender trends in authorship for paediatric radiology articles worldwide: a systematic review Open PDF
(2024)
Kamran, Rakhshan
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Jackman, Liam
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Chan, Cynthia
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Lee, Ann C.
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Kamran, Aleeza
BACKGROUND: Gender inequalities in academic medicine persist despite progress over the past decade. Evidence-based targeted interventions are needed to reduce gender inequalities. OBJECTIVE: This systematic review aimed to investigate the impact of COVID-19 on gender trends in authorship of paediatric radiology research worldwide. MATERIALS AND METHODS: This prospectively registered, PRISMA-compliant systematic review searched the following databases: PubMed, MEDLINE, Web of Science, and Scopus from January 1, 2018, to May 29, 2023, with no restrictions on country of origin. Screening and data extraction occurred independently and in duplicate. Gender of first, last, and corresponding authors were determined using an artificial intelligence-powered, validated, multinational database ( www.genderize.io ). Two time periods were categorised according to the Johns Hopkins Center for Systems Science and Engineering: pre-COVID (prior to March 2020) and peak and post-COVID (March 2020 onwards). One-sample binomial testing was used to analyse proportion of authorship based on gender. Categorical variables were described as frequencies and percentages, and compared using testing chi-square or Fisher exact testing, with a threshold of P<0.05 representing statistical significance. RESULTS: In total, 922 articles were included with 39 countries represented. A statistically significant difference in authorship based on gender persisted during the peak and post-COVID time period (March 2020 onwards) where women represented a statistically significant lower proportion of last (35.5%) and corresponding (42.7%) authors (P<0.001, P=0.001, respectively). Statistically significant differences for first authors were not found in either period (P=0.08 and P=0.48). CONCLUSION: This study identifies differences in gender trends for authorship in paediatric radiology research worldwide. Future efforts to increase authorship by women are needed.
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.
Gender Gaps in Science: Systematic Review of the Main Explanations and the Research Agenda
(2021)
Tomassini, C.
Despite improvements in incorporating women in tertiary education and science, several gender gaps persist today in some scientific and technological areas worldwide. Understanding the factors that determine these gaps is essential to incorporating women into knowledge societies on equal terms. The present research sought to explore and systematize the explanations given to this phenomenon by the international literature in the last four decades. The objectives were: (1). Analyze the evolution of the leading research agendas and categorize these into groups (or clusters) of explanations, and (2) discuss the challenges that research agendas face in addressing the phenomenon in a multi-causal way. The data were obtained from the articles contained in the Web of Science (WoS) and were subjected to a systematic review using bibliometric and qualitative techniques. The analysis reveals an essential growth of research in this area within the social sciences, which is grouped into five main types of explanation: (1) student performance in STEM areas, (2) influence of gender stereotypes and models, (3) interests and educational-learning experiences, (4) educational-occupational expectations and choices, and (5) uneven advancement and performance in scientific careers. Evolution shows that explanations about performance and individual choice have diminished noticeably in the present, giving rise to explanations regarding the influence of gender stereotypes and models within educational systems and socialization stages. This study thus contributes to understanding the causal factors that have determined gender gaps in science while identifying some new issues in research agendas. © 2021 Ediciones Universidad de Salamanca. All rights reserved.

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