Female Editorial Authorship Trends in High-Impact Ophthalmology Journals

Gender Disparities in Mentorship and Career Outcomes in Ophthalmology

Background: Gender disparities in the field of ophthalmology have been increasingly recognized. Although mentorship has been proposed as a contributing factor, there are limited data on the differences in mentorship experiences by gender among ophthalmologists. Objective: The purpose of this study was to evaluate gender disparities in mentorship experiences among ophthalmologists, and the impact of mentorship disparities on career outcomes. Design: Prospective, cross-sectional study. Setting: Web-based survey distributed through ophthalmology listservs. Participants: Ophthalmologists and ophthalmologists-in-training who completed the survey. Exposure: Training and practicing in the field of ophthalmology. Main Outcome Measures: Mentorship score based on 10 items from a previously published scale of mentorship quality and self-reported career outcomes (income, job satisfaction, achievement of career goals, and support to achieve future career goals). Results: We received survey responses from 202 male and 245 female ophthalmologists. Female ophthalmologists reported significantly lower mentorship satisfaction and worse quality of mentorship (p < 0.03). Female ophthalmologists also reported significantly lower income, worse job satisfaction, and lower rates of goal achievement and support to achieve future goals; all of these career outcomes, except income level, were partly mediated by mentorship score (mediation effect ranged from 29% to 68%, p < 0.014). Conclusions and Relevance: Gender-based inequities in achievement of career goals and job satisfaction are partly mediated by disparities in mentorship. Therefore, focused mentorship of women in ophthalmology at all career stages is imperative to reduce these inequities.

Disparity in Medicare Reimbursement Between Female and Male Vitreoretinal Surgeons

Purpose: To quantify the Medicare reimbursement disparity between female and male vitreoretinal surgeons. Methods: Reimbursement reports were obtained from the US Center for Medicare and Medicaid Services from 2013 through 2020, which detail all Medicare Part B services. A vitreoretinal surgeon was defined as any provider with at least 10 charges of a Healthcare Common Procedure Coding System code related to vitrectomy or retinal detachment repair. Providers were grouped by sex, and the average total reimbursement rate and additional secondary statistics to quantify the reimbursement disparity were identified. Results: On average, female vitreoretinal surgeons were reimbursed 65% that of their male counterparts in 2020, $1.66 million to $2.56 million. The percentage of the average male vitreoretinal specialist's total reimbursement that the average female vitreoretinal specialist received decreased 8.8% from 2013 to 2020, from 73.8% to 65.0%. Conclusions: The reimbursement that the average female vitreoretinal surgeon receives from Medicare is only two thirds that of the average male vitreoretinal surgeon. In addition, there was no identifiable improvement in this disparity over the study period. Further efforts must be taken to establish concerted efforts to improve the reimbursement disparity and to identify the systematic inequities that led to its presence in the first place.

Demographic Trends at the American Academy of Ophthalmology Annual Cornea Subspecialty Day

PURPOSE

The purpose of this study was to identify trends in female representation and years since training completion among speakers and moderators at the American Academy of Ophthalmology (AAO) Annual Cornea Subspecialty Day between 2007 and 2022.

METHODS

Speakers and moderators at each AAO Cornea Subspecialty Day from 2007 to 2022 were sorted by sex and year of training completion. Sex and time from training completion were identified based on the individual's institutional profile or publicly available databases.

RESULTS

Five hundred eighty-three speakers and 48 moderators were identified from the AAO Cornea Subspecialty Day meeting archives over 15 years. Overall, women represented 199 (34.1%) speakers and 19 (39.6%) moderators. The proportion of female speakers increased from 10.0% in 2007 to 54.8% in 2022 (P < 0.001). The ratio of female moderators increased from 4 of 21 (19.0%) in 2007 to 2014 to 15 of 27 (55.6%) in 2015 to 2022 (P = 0.017). In years where there were less than 50% female moderators, women represented 26.3% of speakers versus 44.4% of speakers in years with greater than 50% female moderators (P = 0.014). Female speakers were overall earlier in practice than male speakers, with fewer average years since training completion (16.4 ± 1.8 vs. 22.3 ± 2.1 years; P < 0.001).

CONCLUSIONS

Female representation among speakers and moderators at AAO's Cornea Subspecialty Day increased between 2007 and 2022. Sessions with a majority of female moderators were associated with a higher number of female speakers. Female speakers were generally earlier in their career than male speakers. These trends highlight the overall increases in female representation in academic ophthalmology.

The status of women in academic ophthalmology: Authorship of papers, presentations, and academic promotions

As the field of ophthalmology has evolved in the last several decades, so has the gender distribution of ophthalmologists. We conducted a narrative review to further characterise the status of women in the realm of publication, presentations, editorial positions, grants, academic promotion, and financial compensation. While the proportion of women publishing, presenting, and filling academic and editorial roles has increased over time, it still does not match that of men. Women are more likely to be first authors instead of senior authors, have lower average h-indices, and are awarded fewer grants. The magnitude of some of these differences is smaller when adjusted for women's shorter career duration on average. Despite increased representation of women in ophthalmology, women continue to receive less compensation for the same work. This review highlights that more can be done to improve gender parity in ophthalmology.

Female Representation in Pediatric Ophthalmology at the American Academy of Ophthalmology Annual Meeting From 2018 to 2022

PURPOSE

To identify trends in female pediatric ophthalmologist authorship and representation at the American Academy of Ophthalmology (AAO) Annual Meeting from 2018 to 2022.

METHODS

Participant data from 2018 to 2022 were collected from the AAO website, organized by conference activity (papers, posters, instruction courses, videos, symposia, subspecialty day, and awards), and analyzed by sex using an online tool. Chi-squared and odds ratio analyses were performed to determine trends in authorship sex and associations between the sex of paper and poster authors in each category.

RESULTS

Of 923 pediatric ophthalmology presentations from 2018 to 2022, 46.2% (426 of 923) of presenters and 46.6% (281 of 603) of unique individual participants were women. Overall, 48% (174 of 362) of first and senior authors of papers and posters were women. No significant difference or association between female first and senior authors was observed (52% vs 44%, P = .14; odds ratio 1.59, P = .13). There was no significant change in the proportion of total female presenters from 2018 to 2019 (-3.09%, P = .53), 2019 to 2020 (0.76%, P = .88), 2020 to 2021 (9.09%, P = .09), 2021 to 2022 (-5.68%, P = .30), or 2018 to 2022 (1.08%, P = .84).

CONCLUSIONS

Since 2018, female representation at the AAO Annual Meeting has remained consistent and nears 50%. The lack of a significant difference between the proportion of female first and senior authors suggests that junior female pediatric ophthalmologists are climbing the ranks and more broadly engaging in mentorship roles. Considering the increasing proportion of female pediatric ophthalmologists, the absence of corollary, statistically significant increases in female participation may be of concern. [J Pediatr Ophthalmol Strabismus. 2024;61(1):6-13.].

Female Authorship and Ophthalmology Journal Editorial Board Membership Trends Over the Last Decade, 2012-2021

PURPOSE

To study the relationship between female authorship and editorial board membership in 3 ophthalmology journals from 2012 to 2021.

DESIGN

Cross-sectional and trend study.

METHODS

The prevalence of female first, senior authorship, and editorial board members were examined in Ophthalmology, JAMA Ophthalmology, and American Journal of Ophthalmology. Gender-API assigned gender to authors based on name and country. Editorial board (EB) information was manually extracted and grouped for comparison among leadership positions. Gender data collected on authorship and EB membership were compared. The proportion of women in EB positions was identified: editor-in-chief, mid-level editors, and consulting editors. Relationship between female authorship and editorial board membership was analyzed.

RESULTS

Women published fewer articles as first (1547/4267) and senior (1165/4267) authors than did men. The proportion of women in senior authorship significantly increased from 2012 to 2021 (23.4% to 30.5%, P = .0046). Across EB, a significant increase in female members (13.9% to 34.6%, P = .0006) was observed. There was a significant correlation (P < .0001) between female EB members and female authors (r = 0.74, 95% CI = 0.51-0.87) for all journals. The odds of female first authorships were 1.89 (95% CI = 1.65-2.17) times higher for articles with female senior authors than for male senior authors (P < .0001).

CONCLUSION

Female senior authorship significantly increased over the last decade. Journals with a higher representation of female EB members also had a higher representation of female authorship. This study found a positive association between first and senior female authorship; however, the gender gap persists. Continued efforts to reach equity in publications and EB representation are necessary.

Gender balance in infectious diseases and hospital epidemiology journals

Objective

Diversity is recognized as a driver of excellence and innovation. Women represent a significant part of the infectious diseases (ID) and hospital epidemiology (HE) workforce. We aimed to assess gender representation among editors of top ID and HE journals and explore potential correlations with the gender of first and last authors in published articles.

Methods

Using Scimago Journal & Country Rank, we identified 40 ID and 4 HE high-ranking journals. Editorial members were categorized by decision-making influence (levels I-III). We retrieved names of first and corresponding authors from 12 ID-focused journals' 2019 research articles. Gender assignment for editors, first authors, and last authors utilized digital galleries and manual searches.

Results

Among 2,797 editors from 44 journals, 33% were women. Female representation varied across editorial levels: 26% at level I, 36% at level II, and 31% at level III. Gender balance disparities existed among journals. Female first authors accounted for 50%, and female last authors accounted for 36% of the 2,725 published articles. We found weak but significant correlations between the editors' gender and the gender of the first and last authors.

Conclusion

Gender representation among ID and HE journal editors displayed unevenness, but no overt vertical segregation was observed. A generational transition among authors may be underway. Our findings suggest that a generational transition may be occurring among authors.

Gender representation in rheumatology journals: an assessment of editors, editorial boards, and authors

Diversity is widely recognized as a driver of excellence and innovation. In recent years, women have become an increasingly significant part of the rheumatology workforce. We aimed to assess the gender representation of the leading rheumatology journals' editors and to explore whether editors' gender correlates with the gender of the first and last authors of published articles. We conducted a cross-sectional study and extracted editorial members of rheumatology journals in quartiles 1 to 3 (Clarivate Analytics) from each journal's website. We categorized editorial positions according to the level of influence in manuscript acceptance decision-making (levels I to III). The gender of editors and of the first and last authors in all 2019 original articles published in a sample of 15 rheumatology journals was assigned using a combination of digital gallery and manual searches. There were 2242 editors' names retrieved from 43 journals, 24 (26%) of the 94 editors at level I, 139 (36%) of 385 editors at level II, and 469 (27%) of 1763 at level III were female. The imbalance between journals was heterogeneous. Females were the first authors in 1342 (48%) and the last authors in 969 (35%) of the 2797 published articles. However, we found no significant correlation between editors' and authors' gender. Our data showed uneven gender representation on the editorial boards of most rheumatology journals, but we did not find any apparent vertical segregation or influence on publishing by gender. Our findings suggest that a generational transition may be occurring among authors.

Female authorship trends in the field of colorectal surgery: A retrospective bibliometric study

Background

Gender disparity and hidden discrimination remained in the surgical subspecialties. This study aimed to explore the authorship gender composition in four high-impact colorectal surgery journals over the past two decades.

Method

This cross-sectional study queried the Web of Science Core Collection database and PubMed (MEDLINE) for articles published in four high-impact colorectal surgery specialty journals between 2000 and 2021 (Database accessed at July 2022). Extracted data included authors' full names, institutions, year of publication and total citation numbers. Authors' genders were assigned via gendrize.io, a third-party name predictor tool.

Results

100,325 authorship records were included in the final analysis. 21.8% of writers were identified as female, an increase from 11.4% (95% CI, 9.4%-13.3%) in 2000 to 26.5% (95% CI, 25.6%-27.4%) in 2021. Female authorship has risen in all authorship types, but women physicians were less likely to be the last authors than the first (OR, 0.63; 95%CI, 0.6-0.67) or middle authors (OR, 0.57; 95%CI, 0.55-0.60). Female authorship has also increased substantially in different document types, but female authorships were less likely in editorials than original articles (OR, 0.76; 95%CI, 0.7-0.83) and reviews (OR, 0.83; 95%CI, 0.74-0.94). Compared with male physicians, females were more likely to author in publications with reportable funding, either as first authors (OR, 1.46; 95%CI, 1.12-1.78) or last authors (OR, 1.51; 95%CI, 1.22-1.89). Authorship varied geographically, and countries with the highest female authorship percentage were mainly in Europe and North America.

Conclusion

Female authorship has grown substantially in colorectal surgery literature. However, female physicians were still underrepresented and less likely to assume senior or leading authorship roles.

Female authorship trends and the effect of COVID-19 on cataract and refractive surgery literature

PURPOSE

To evaluate whether gender barriers persist specifically in the cataract and refractive surgery (CRS) literature. In addition, no literature exists investigating the long-term effect of COVID-19 on female authorship in ophthalmology past 2020.

SETTING

Scopus 2015 to 2022.

DESIGN

Retrospective data review.

METHODS

Articles published in the Journal of Refractive Surgery and the Journal of Cataract & Refractive Surgery were recorded from January 2015 to February 2022 from Scopus. Articles with only 1 author or where gender could not be identified were excluded. The first author (FA) gender, senior author (SA) gender, affiliated country, type of literature, and number of citations were collected. Pearson chi-squared tests with phi coefficients and multivariate logistic regression were performed.

RESULTS

3153 articles were included in analysis. There were 910 works with female FAs and 648 with female SAs. Gender did not predict publishing in one journal over the other (P > .050). Women made up less than 30% of authorship of all types of literature, except for prospective/observational studies as FA (31.3%). Compared with before 2020, female FAs from 2020 onward were associated with increased retrospective analysis (phi = 0.072, P = .030) and letters/editorials (phi = 0.134, P < .001) but decreased case reports (phi = 0.087, P = .009) and "others" (phi = -0.164, P < .001). Similar associations were observed for female SAs. Females were more likely to publish in Asian countries. Female SAs predicted an increased likelihood of female FAs (odds ratio, 1.401, 95% CI, 1.165-1.684, P < .001).

CONCLUSIONS

Gender disparities exist in authorship of the CRS literature. COVID-19 has altered the types of literature published by women, but men still publish most of all types of CRS research.

Leadership in Ophthalmology Professional Organizations: A Descriptive Analysis and Trends, 2002-2022

PURPOSE

To describe characteristics and trends in appointed leaders of ophthalmology professional organizations between 2002 and 2022.

DESIGN

Trend study.

METHODS

This study used a Web-based search and data collection. Data were collected on 232 individuals appointed to leadership positions of ophthalmology professional organizations. Main outcome measures were demographic and publication data.

RESULTS

Of the 232 ophthalmology leaders appointed between 2002 and 2022, 22.8% were female. Most leaders had subspecialty training (92.9%), practiced in the South (32.6%, P = .001), and practiced at academic institutions (64.8%). Leaders were appointed 32.7 ± 7.3 years after graduation from medical school. Significant variation existed in the number of publications (98.3 ± 104.0) and research productivity scores (29.2 ± 19.5) at the time of appointment. The number of female leaders doubled in 2012-2021 as compared to 2002-2011 (2002-2011: 14.5% female vs 2012-2021: 29.6% female; P = .01). Female leaders were generally appointed earlier in their careers as compared to male leaders (P = .005, male vs female in 2002-2011; P = .02 male vs female in 2012-2021). There were no statistically significant differences in the number of publications or research productivity scores among female vs male leaders.

CONCLUSIONS

Leaders of ophthalmology professional organizations are largely fellowship-trained subspecialists practicing at academic institutions. Although the number of female leaders of ophthalmology professional organizations has grown over time, most leaders are male. Female leaders tend to be earlier in their careers than male leaders; however, there is no statistically significant difference in research productivity scores among female vs male leaders.

Gender disparity among ophthalmologists awarded Canadian institute of health research grants

Despite efforts toward equity, diversity, and inclusion in academic ophthalmology faculties, gender disparity continues to exist. Current evidence indicates that female ophthalmologists consistently hold lower academic ranks and receive less funding from the National Institutes of Health compared to their male colleagues. The extent of this disparity is unknown in the Canadian context. We sought to characterize the gender gap in Canadian Institutes of Health Research funding among ophthalmologists. From inception, funding decision data were collected from the official Canadian Institutes of Health Research website database hosted by the Government of Canada. Measures including gender, number of grants held over the study period, number of simultaneous grants, and total funding were collected. Female ophthalmologists were consistently awarded fewer grants (21.43 percent) compared to male counterparts and were less likely to hold multiple grants since 2008. An over five-fold disparity was found in total funding for female compared to male ophthalmologists. As well, females were less likely than males to hold a grant in each particular year except in 2020. Female ophthalmologists continue to face barriers to attaining academic support from Canadian Institute of Health Research funds. Continued action to mitigate this gender gap may improve gender-based parity in federal research funding.

Enhancing Mentorship Networks through the Experiences of Women Professors of Ophthalmology

Purpose  The aim of this study is to identify and characterize women professors in ophthalmology to enhance professional development and equity of women in academic ophthalmology. Design  Cross-sectional descriptive survey study. Participants  Participants in the survey were women in ophthalmology departments who have obtained full professor rank at their respective institutions. Methods  A cross-sectional study was conducted using data from an electronic survey of women ophthalmologists and researchers who had obtained full professorship rank in ophthalmology. The survey included questions about degree obtained, training path, fellowship, length and trajectory of academic career, family or medical leave participation, previous positions, and mentorship involvement. Statistical comparisons were made based on response. Main Outcome Measures  Survey responses to questions pertaining to three domains: education and training, academic career, and mentorship. Results  Women that obtained the professor title within ophthalmology largely held Doctor of Medicine/Doctor of Osteopathic Medicine degrees, were more likely to have completed fellowship training, and on average took 11 to 15 years to obtain the full professor title. The participants held a variety of other positions and titles throughout their academic careers. The vast majority of women reported having between 1 and 3 mentors during their careers with the majority also noting they currently participate in mentoring programs. Surveys were completed by 62 (30% response rate) women full professors of ophthalmology. Conclusion  The experiences women have along the academic path to professorship are described in this survey and can help to inform junior faculty. Literature review highlights the importance of mentorship for work productivity, retention, and promotion within academic medicine which is an element seen in the vast majority of our participants' career paths. Guided by the identification of women professors within departments of ophthalmology and characterization of their experiences, a new initiative called Women Professors of Ophthalmology was formed under the Association of University Professors of Ophthalmology's organizational structure in 2021. This group that is tailored for women professors of ophthalmology to foster peer mentorship and guidance is poised to increase the retention and promotion of women in academic ophthalmology.

Sex Differences in Salaries of Academic Ophthalmologists in the United States

Importance

Representation of women in medicine and ophthalmology has increased in recent years. However, substantial inequities still exist between salaries for male and female physicians.

Objectives

To evaluate the status of disparities in compensation among US academic ophthalmologists and compare compensation across specialties.

Design, Setting, and Participants

This cross-sectional study analyzed data for full-time academic physicians practicing in 154 accredited US medical schools. Data from the Association of American Medical Colleges Faculty Salary Report for fiscal year 2019-2020 were used to evaluate disparities in total compensation for female and male academic ophthalmologists.

Main Outcomes and Measures

Median total compensation for female and male ophthalmologists in fiscal year 2019-2020.

Results

Female academic ophthalmologists were paid a mean of $50 300 (95% CI, $4600-$96 000) less than their male counterparts. This trend was present across other specialties with women earning less than men by amounts ranging between $25 100 (95% CI, $1000-$49 300) in nonsurgical specialties and $104 400 (95% CI, $62 800-$146 600) in general surgery. Including all academic ranks, women's total compensation was between 75% (general surgery) and 82% (nonsurgical specialties) of men's compensation.

Conclusions and Relevance

These findings indicate that female academic ophthalmologists are paid less than their male counterparts. Future research and efforts to increase awareness and close the pay gaps seem warranted to encourage more women to pursue careers in ophthalmology and to achieve parity in the field.

Representation of women on editorial boards of ophthalmology journals: protocol for a cross-sectional study

INTRODUCTION

There is a notable under-representation of women in leadership positions in ophthalmology despite the increasing number of women as ophthalmologists. Gender inequality in editorial boards of ophthalmology journals has not been investigated on a global scale. This study will aim to evaluate the representation of women as editorial board members in ophthalmology journals across different regions, journal subspecialties and impact factors.

METHODS AND ANALYSIS

This will be a cross-sectional study describing the gender composition of editorial boards in ophthalmology journals globally. Ulrich's Periodicals Directory and SCImago Journal & Country Rank will be used to comprehensively identify journals indexed with the keyword, 'ophthalmology'. All journals with active websites and lists of editorial boards will be included. Journals will be categorised according to the World Bank's 2021 classification of countries by income and region, and classified into ophthalmology subspecialties based on publication scope. Impact factors will be obtained from Journal Citation Reports. The gender and academic degrees of each editorial board member will be determined based on journal profiles, institutional websites or name query feature on an online interface. The research impact of each editorial board member will be ascertained from the author records on Web of Science. The gender proportion will be presented for all journals combined, and then for journals grouped by regions, subspecialties and impact factors. Editorial board member characteristics including academic degrees and research productivity measures will be compared between men and women. These comparisons will be made using the χ² test for categorical variables and the independent samples t-test for continuous variables.

ETHICS AND DISSEMINATION

This study did not require research ethics approval given the use of publicly available data and lack of human subjects. The results will be presented at scientific meetings and published in peer-reviewed journals.