Gender disparities in research productivity among 9952 academic physicians

Gender Disparity in Academic Trauma Surgery: The Current State of Affairs

INTRODUCTION

Despite the increasing number of female surgeons in general surgery programs, women are still inadequately represented in leadership positions. This study aims to investigate the magnitude of gender bias in university-based trauma surgery fellowship programs and leadership positions in the United States of America.

MATERIAL AND METHODS

FRIEDA was used to identify trauma surgery programs. A thorough website review of each program obtained further information on faculty members, including their name, age, gender, and faculty rank. Trauma surgeons with an MD or DO qualification and a faculty rank of Professor, Associate Professor, or Assistant Professor were selected for inclusion in this study. SCOPUS was used to assess the H-index and the number of publications and citations of surgeons.

RESULTS

The total number of programs included was 136, consisting of 715 faculty members. Less than a quarter (n = 166; 23.2%) comprised females and less than one-fifth (n = 30; 19%) of female surgeons were Professors. The difference in the research productivity of male and female trauma surgeons was statistically significant (P < .05), with the average H-index being 10 vs 7.5, respectively, amongst the top 50 surgeons of both genders. Based on a multiple regression analysis, academic rank was significantly associated (P < .05), and gender was not significantly associated (P > .05) with H-index.

CONCLUSION

Gender disparity exists in the field of trauma surgery, as noted in senior faculty ranks and leadership positions. Female-inclusive state policies, appropriate mentorship, and supportive institutions can help to bridge this gap.

Factors Associated with Research Productivity and National Institutes of Health Funding in Academic Otology

OBJECTIVES

Bibliometrics, such as the Hirsch index (h-index) and the more recently developed relative citation ratio (RCR), are utilized to evaluate research productivity. Our study evaluates demographics, research productivity, and National Institutes of Health (NIH) funding in academic otology.

METHODS

Academic otologists were identified, and their demographics were collected using institutional faculty profiles (N = 265). Funding data were obtained using the NIH Research Portfolio Online Reporting Tools Expenditures and Reports Database. The h-index was calculated using Scopus and mean (m-RCR) and weighted RCR (w-RCR) were calculated using the NIH iCite tool.

RESULTS

H-index (aOR 1.18, 95% CI 1.10-1.27, p < 0.001), but not m-RCR (aOR 1.50, 95% CI 0.97-2.31, p = 0.069) or w-RCR (aOR 1.00, 95% CI 0.99-1.00, p = 0.231), was associated with receiving NIH funding. Men had greater h-index (16 vs. 9, p < 0.001) and w-RCR (51.8 vs. 23.0, p < 0.001), but not m-RCR (1.3 vs. 1.3, p = 0.269) than women. Higher academic rank was associated with greater h-index and w-RCR (p < 0.001). Among assistant professors, men had greater h-index than women (9.0 vs. 8.0, p = 0.025). At career duration 11-20 years, men had greater h-index (14.0 vs. 8.0, p = 0.009) and w-RCR (52.7 vs. 25.8, p = 0.022) than women.

CONCLUSION

The h-index has a strong relationship with NIH funding in academic otology. Similar h-index, m-RCR, and w-RCR between men and women across most academic ranks and career durations suggests production of similarly impactful research. The m-RCR may correct some deficiencies of time-dependent bibliometrics and its consideration in academic promotion and research funding allocation may promote representation of women in otology.

LEVEL OF EVIDENCE

N/A Laryngoscope, 134:3786-3794, 2024.

Gender diversity in pediatric surgery: academic ranks and scholarly productivity amongst pediatric surgeons

Purpose

Despite a growing number of women entering medical school, a small proportion of women pursue surgical specialties, including pediatric surgery. This multi-center study assesses gender-based differences in measures of scholarly productivity and distribution of faculty positions.

Methods

This is a retrospective web-based study of all pediatric surgeons at twelve large institutions across the United States. Data published by the American Association of Medical Colleges was compiled and analyzed to understand the gender distributions of medical students, general surgery residents, and pediatric surgery fellows. P-values were calculated using two-sided Student's independent t-tests and chi-squared tests.

Results

There have been a growing number of women applying into pediatric surgery, but the proportion of women matriculating into these fellowships is not concordant. Women are still underrepresented (28%) amongst the pediatric surgeon workforce. A total of 111 pediatric surgeons were identified for this study, which included 31 women (28%) and 80 males (72%). There was a significant difference in the distribution across academic ranks between genders (p < 0.001). Women had significantly fewer publications per year after residency, fewer total publications, and a lower h-index in comparison to men (p < .001, p = .005, p = .002, respectively).

Conclusions

Women are not only underrepresented in pediatric surgery, but there are also significant differences in the distribution of faculty positions and scholarly productivity when comparing men and women. There is a pressing need to improve gender diversity and identify barriers that may prevent women from advancing to leadership positions and achieving professional success.

Demographics and Research Activity Among 2023 Academic Glaucoma Specialists

PURPOSE

To characterize demographics, academic characteristics, and research activity of academic glaucoma specialists.

METHODS

Faculty demographic and academic data were recorded for glaucoma specialist faculty from 99 United States ophthalmology residency programs using institutional websites, Doximity, and LinkedIn. H-index was calculated using Scopus. Mean and weighted relative citation ratio (RCR), measuring research impact and productivity, respectively, was determined with the National Institute of Health iCite tool.

RESULTS

Most academic glaucoma specialists were men (0.61), located in the Southern United States (0.316), and in practice for less than or equal to 10 years in 2023 (0.324). Twenty-six percent had additional professional degrees, and 11% completed fellowship training in addition to clinical glaucoma. Assistant professor was the most common academic appointment (0.479), and almost a quarter (0.23) had additional positions. Mean h-index (13.3), mean-RCR (1.76), and weighted-RCR (84.0) were consistent with high research productivity and impact. Gender comparison found that men had significantly higher h-index (p < .001), m-RCR (p = .007), w-RCR (p < .001) as compared to women. H-index (p < .001; p < .001; p < .001), m-RCR (p = .006; p < .001; p < .001), and w-RCR (p < .001; p < .001; p < .001) also increased with career duration, academic position, and additional academic appointments, respectively. Additional training was associated with higher h-index (p = .023) and w-RCR (p = .012), but not m-RCR (p = .699).

CONCLUSION

Higher research activity is significantly associated with higher departmental positions and additional academic appointments. This illustrates the importance of research contributions for academic promotion. Variations in research activity by gender distribution may therefore affect opportunities for career advancement.

Representation of Women Authorship in the Top 5 Transplantation Journals in the United States

BACKGROUND

In the United States, only 13% of transplant surgeons are women. We evaluated gender distribution and trends of American authorship over the past 10 y in high-impact solid organ transplantation journals to gain insight into the current status of women authorship in transplantation.

METHODS

Original articles from 2012 to 2021 from the 5 highest-impact solid organ transplantation journals were extracted from Scopus. First and last author's gender was predicted using Genderize.io. Data of first and last authors, article type and topic, location, citation, and funding metrics were analyzed. Chi-square, logistic regression, and trend tests were performed where appropriate. Statistical significance was set at <0.05.

RESULTS

Women's first and last authorship increased over time among all journals. There was an increase in women first authors in the American Journal of Transplantation and in senior women authors in Liver Transplantation and Transplantation . Significant differences in gender authorship in lung, intestine, pancreas, general, and islet cell transplantation were found. Women's last authorship was associated with 1.69 higher odds of having a woman first author when adjusting for year and journal. There was an increase in the rate of women's first and last author collaborations over the years. Women last authors had 1.5 higher odds of being funded by the National Institutes of Health over the years.

CONCLUSIONS

Despite an increase in women transplant surgeons and physicians, the gap in women authorship in transplantation persists. Women's last authorship was associated with higher odds of having a woman first author, pointing to the importance of mentorship for women joining the transplant academia.

The Relative Citation Ratio: An Impartial Assessment of Productivity in Academic Otolaryngologists

OBJECTIVES

Quantification of academic productivity relies on bibliometric measurements, such as the Hirsch index (h-index). The National Institutes of Health (NIH) recently developed the relative citation ratio (RCR), an article-level, citation-driven metric that compares researchers with others within their respective fields. Our study is the first to compare the usage of RCR in academic otolaryngology.

STUDY DESIGN

Retrospective Database Review.

METHODS

Academic otolaryngology residency programs were identified using the 2022 Fellowship and Residency Electronic Interactive Database. Demographic and training data were collected for surgeons using institutional websites. RCR was calculated using the NIH iCite tool, and h-index was calculated using Scopus. Mean RCR (m-RCR) is the average score of the author's articles. Weighted RCR (w-RCR) is the sum of all article scores. These derivatives are a measure of impact and output, respectively. The career duration of a physician was categorized into the following cohorts: 0-10, 11-20, 21-30, and 31+ years.

RESULTS

A total of 1949 academic otolaryngologists were identified. Men had higher h-indices and w-RCRs than women (both p less than 0.001). m-RCR was not different between genders (p = 0.083). There was a difference in h-index and w-RCR (both p less than 0.001) among the career duration cohorts, but there was no difference in m-RCR among the cohorts (p = 0.416). The faculty rank professor was the greatest for all metrics (p < 0.001).

CONCLUSION

Critics of the h-index argue that it is reflective of the time a researcher has spent in the field, instead of impact. The RCR may reduce historic bias against women and younger otolaryngologists.

LEVEL OF EVIDENCE

NA Laryngoscope, 134:592-599, 2024.

Gender and Pathways to Leadership in Academic Anesthesiology: A Qualitative Content Analysis of US Chairpersons' Curricula Vitae

BACKGROUND

Women are underrepresented in medicine and academic anesthesiology, and especially in leadership positions. We sought to characterize career achievement milestones of female versus male academic anesthesiology chairs to understand possible gender-related differences in pathways to leadership.

METHODS

We conducted a retrospective observational cross-sectional analysis. In November 2019, curricula vitae (CVs) were requested from then-current members of the US Association of Academic Anesthesiology Chairs. Data reflecting accomplishments up to the time of chair appointment were systematically extracted from CVs and analyzed using a mixed methods approach with qualitative content analysis supplemented by descriptive statistics and bivariate statistical testing. Missing data were not imputed.

RESULTS

Seventy-two CVs were received from eligible individuals (response rate 67.3%). The respondent sample was 12.5% women (n = 9), 87.5% men (n = 63), and no transgender or nonbinary people; this is similar to the known gender balance in anesthesiology chairs in the United States. No statistically significant differences in objective markers of academic achievement at the time of chair appointment were evident for female versus male chairs, including time elapsed between the first faculty appointment and assumption of the chair role (median 25 vs 18 years, P = .06), number of publications at the time the chair was assumed (101 vs 69, P = .28), or proportion who had ever held a National Institutes of Health (NIH) grant as principal investigator (44.4% vs 25.4%, 0.25). Four phenotypes of career paths were discernible in the data: the clinician-administrator, the educator, the investigator, and the well-rounded scholar; these did not differ by gender.

CONCLUSIONS

Female chairpersons who were members of the Association of Academic Anesthesiology Chairs in the United States demonstrated similar patterns of academic achievement as compared to male chairpersons at the time the position of chair was assumed, suggesting that they were equally qualified for the role as compared to men. Four patterns of career achievements were evident in the chairperson group, suggesting multiple viable pathways to this leadership position.

Gender Differences in North American and International Otolaryngology Clinical Practice Guideline Authorship: A 17-Year Analysis

OBJECTIVE

To analyze gender differences in authorship of North American (Canadian and American) and international published otolaryngology-head and neck surgery (OHNS) clinical practice guidelines (CPG) over a 17-year period.

METHODS

Clinical practice guidelines published between 2005 and 2022 were identified through the Canadian Agency for Drugs and Technology in Health (CADTH) search strategy in MEDLINE and EMBASE. Studies were included if they were original studies, published in the English language, and encompassed Canadian, American, or international OHNS clinical practice guidelines.

RESULTS

A total of 145 guidelines were identified, encompassing 661 female authors (27.4%) and 1756 male authors (72.7%). Among OHNS authors, women and men accounted for 21.2% and 78.8% of authors, respectively. Women who were involved in guideline authorship were 31.0% less likely to be an otolaryngologist compared to men. There were no gender differences across first or senior author and by subspeciality. Female otolaryngologist representation was the greatest in rhinology (28.3%) and pediatrics (26.7%). American guidelines had the greatest proportion of female authors per guideline (34.1%) and the greatest number of unique female authors (33.2%).

CONCLUSION

Despite the increasing representation of women in OHNS, gender gaps exist with regards to authorship within clinical practice guidelines. Greater gender diversity and transparency is required within guideline authorship to help achieve equitable gender representation and the development of balanced guidelines with a variety of viewpoints.

World Workshop on Oral Medicine VIII: Barriers to research in oral medicine: results from a global survey

OBJECTIVES

To explore factors influencing research interest and productivity and perceived barriers to conducting research in Oral Medicine (OM).

METHODS

Invitations to participate in an online survey were e-mailed to a network of international OM practitioners and related professional organizations. Questions captured respondents' demographic/professional variables and gauged research interest, productivity, and perceived barriers to conducting research specifically in OM. Statistical analysis was conducted via descriptive, logistic regression, and multivariate modeling.

RESULTS

Five hundred and ninety-three OM practitioners from 55 countries completed the survey, with 54%, 25%, and 21% practicing in high, upper-middle, and lower-middle-income countries, respectively. Eighty-six percent of respondents were interested in conducting research. Age (less interest with an increase in age), working in academia, and practicing in a lower-middle vs high-income country were significant predictors of research interest. Self-reported research productivity was significantly greater among males, those working in academia, and those who graduated from programs that mandated research presentation/publication. Obtaining research funding was a significant barrier among respondents from lower and upper-middle-income countries, whereas finding time for research was a reported barrier by respondents from high-income countries.

CONCLUSION

The results of this survey identified perceived barriers to conducting research in OM and highlighted solutions to address such barriers.

Gender imbalances among top-cited scientists across scientific disciplines over time through the analysis of nearly 5.8 million authors

We evaluated how the gender composition of top-cited authors within different subfields of research has evolved over time. We considered 9,071,122 authors with at least 5 full papers in Scopus as of September 1, 2022. Using a previously validated composite citation indicator, we identified the 2% top-cited authors for each of 174 science subfields (Science-Metrix classification) in 4 separate publication age cohorts (first publication pre-1992, 1992 to 2001, 2002 to 2011, and post-2011). Using NamSor, we assigned 3,784,507 authors as men and 2,011,616 as women (for 36.1% gender assignment uncertain). Men outnumbered women 1.88-fold among all authors, decreasing from 3.93-fold to 1.36-fold over time. Men outnumbered women 3.21-fold among top-cited authors, decreasing from 6.41-fold to 2.28-fold over time. In the youngest (post-2011) cohort, 32/174 (18%) subfields had > = 50% women, 97/174 (56%) subfields had > = 30% women, and 3 subfields had = <10% women among the top-cited authors. Gender imbalances in author numbers decreased sharply over time in both high-income countries (including the United States of America) and other countries, but the latter had little improvement in gender imbalances for top-cited authors. In random samples of 100 women and 100 men from the youngest (post-2011) cohort, in-depth assessment showed that most were currently (April 2023) working in academic environments. 32 women and 44 men had some faculty appointment, but only 2 women and 2 men were full professors. Our analysis shows large heterogeneity across scientific disciplines in the amelioration of gender imbalances with more prominent imbalances persisting among top-cited authors and slow promotion pathways even for the most-cited young scientists.

Analysis of Publication Productivity and Academic Rank of Ophthalmology Residency Program Directors in the United States

PURPOSE

Female ophthalmologists are underrepresented in the field of ophthalmology. This study aimed to analyze the gender differences among ophthalmology residency program directors (PDs) in the United States with respect to academic rank, number of publications, and h-index.

METHODS

This cross-sectional study evaluated 120 ophthalmology residency PDs from 120 ophthalmology residency programs during the 2022 San Francisco Match. The gender information was collected from institutional websites. The information regarding the state of each institute, academic rank, degree (MD or DO), age, and publication productivity was also recorded.

RESULTS

From the 120 residency programs, 120 ophthalmology residency PDs were identified. Most PDs had an MD degree (118 out of 120, 98.3%), while only a few had a DO degree (2 out of 120, 1.7%). Only 31 (25.8%) out of 120 residency PDs were female. There was a statistically significant difference between female residency PDs and male residency PDs (p<0.0001). Male PDs had a higher h-index (15.2 ± 1.2) compared to their female counterparts (11.9 ± 0.97) (p=0.003). Regarding academic rank, male PD number was higher in each category, including assistant professor, associate professor, and full professor.

CONCLUSIONS

United States ophthalmology residency programs have a smaller portion of females compared to male PDs. Furthermore, full professors are more likely to be male, and males have higher publication productivity in terms of h-index. To promote equality among ophthalmologists, future initiatives should focus on addressing the gender disparities in ophthalmology residency programs and the selection of residency PDs.

Gender Disparities Among Academic Vitreoretinal Specialists in the United States With Regard to Scholarly Impact and Academic Rank

Background and objective While men outnumber women in the specialty of ophthalmology in general, the subspecialty of vitreoretinal surgery in particular has the highest percentage of men across all ophthalmic subspecialties. This study aimed to analyze the gender disparities regarding the publication productivity and academic rank of academic vitreoretinal specialists in the United States (US). Methods This cross-sectional study evaluated 116 ophthalmology residency programs in the US participating in the 2022 San Francisco Match. The academic vitreoretinal faculty from each ophthalmology residency program was included. The information on gender, academic rank, and publication activity in terms of the h-index were collected from institutional websites, the Scopus database, and the National Library of Medicine PubMed website. Results A total of 467 academic vitreoretinal specialists were identified. Among them, 345 (73.9%) were men, and 122 (26.1%) were women (p<0.001). When the academic ranks were analyzed, a higher number of men (43.8%) were found to hold the rank of full professor as compared to women. Furthermore, a higher number of women (47.5%) were found to hold the rank of assistant professor as compared to their male colleagues. Regarding the number of publications, in all academic rank categories, women had a significantly lower number of publications compared to men (p<0.001). Men also had a higher publication productivity or scholarly impact [h-index=15.2 ± 0.82 standard error of the mean (SEM)] compared to women (h-index=12.8 ± 0.99 SEM) (p=0.0004). Higher h-index correlated with higher academic rank, from assistant professor through full professor (p<0.001). Conclusion The field of vitreoretinal surgery has significantly fewer women compared to men, with women producing fewer publications and having less scholarly impact. H-index and total number of publications are also associated with a higher academic rank. Furthermore, full professors are more likely to be men, while assistant professors are more likely to be women. Future efforts should be aimed at reducing the gender disparity in vitreoretinal surgery.

Gender gaps in Australian research publishing, citation and co-authorship

Despite improvement in gender inequality in Australian science, the problem has not been fully addressed yet. To better understand the nature of gender inequality in Australian science, all gendered Australian first authored articles published between 2010 and 2020 and indexed in the Dimensions database were analysed. Field of Research (FoR) was used as the subject classification of articles and Field Citation Ratio (FCR) was used for citation comparison. Overall, the ratio of female to male first authored articles increased over the years, and this was true for all FoRs except for information and computing sciences. The ratio of single-authored articles by females was also improved over the study period. Females appeared to have a citation advantage, using Field Citation Ratio, over males in a few FoRs including mathematical sciences, chemical sciences, technology, built environment and design, studies in human society, law and legal studies, and studies in creative arts and writing. The average FCR for female first authored articles was greater than the average FCR for male first authored articles, including in a few fields such mathematical sciences where male authors outperformed females in terms of the number of articles.

Exploring female otolaryngologists' experiences with gender bias and microaggressions: a cross sectional Canadian survey

BACKGROUND

Gender bias is behavior that shows favoritism towards one gender over another. Microaggressions are defined as subtle, often unconscious, discriminatory, or insulting actions that communicate demeaning or negative attitudes. Our objective was to explore how female otolaryngologists experience gender bias and microaggressions in the workplace.

METHODS

Anonymous web-based cross-sectional Canadian survey was distributed to all female otolaryngologists (attendings and trainees) using the Dillman's Tailored Design Method from July to August of 2021. Quantitative survey included demographic data, validated 44-item Sexist Microaggressions Experiences and Stress Scale (MESS) and validated 10-item General Self-efficacy scale (GSES). Statistical analysis included descriptive and bivariate analysis.

RESULTS

Sixty out of 200 participants (30% response rate) completed the survey (mean age 37 ± 8.3 years, 55.0% white, 41.7% trainee, 50% fellowship-trained, 50% with children, mean 9.2 ± 7.4 years of practice). Participants scored mild to moderate on the Sexist MESS-Frequency (mean ± standard deviation) 55.8 ± 24.2 (42.3% ± 18.3%), Severity 46.0 ± 23.9 (34.8% ± 18.1%), Total 104.5 ± 43.7 (39.6% ± 16.6%) and high on GSES (32.7 ± 5.7). Sexist MESS score was not associated with age, ethnicity, fellowship-training, having children, years of practice, or GSES. In the sexual objectification domain, trainees had higher frequency (p = 0.04), severity (p = 0.02) and total MESS (p = 0.02) scores than attendings.

CONCLUSIONS

This was the first multicenter, Canada-wide study exploring how female otolaryngologists experience gender bias and microaggressions in the workplace. Female otolaryngologists experience mild to moderate gender bias, but have high self-efficacy to manage this issue. Trainees had more severe and frequent microaggressions than attendings in the sexual objectification domain. Future efforts should help develop strategies for all otolaryngologists to manage these experiences, and thereby improve the culture of inclusiveness and diversity in our specialty.

Gender differences in publication rates at Canadian Society of Otolaryngology-Head and Neck Surgery annual meetings: an 11-year analysis

BACKGROUND

Evaluating gender differences in publication rates after conference presentations is an avenue to assess women's contributions to academic medicine. The objective of this study was to assess gender differences in publication rates, time to publication, and subspeciality of publication of abstracts presented at Canadian otolaryngology conferences over an 11-year period.

METHODS

Cross-sectional data was obtained from online conference schedules of annual Canadian Society of Otolaryngology-Head and Neck Surgery national meetings between 2009 and 2020. A total of 2111 abstract titles were searched in MedLine via PubMed. Gender of the first and senior author, publication status of presented work, and subspeciality of publication were extracted.

RESULTS

Of 2111 scientific abstracts presented between 2009 and 2020, female first and senior authors accounted for 29.0% and 12.8% of published abstracts, respectively. There was a significant difference in the publication rate of senior authors by gender (p < 0.01). Male senior authors had a 9.70% higher rate of publication compared to female senior authors. Posters with a female first author were 33.0% (OR: 0.67; 95% CI 0.49-0.91) less likely to be published compared to posters with a male first author. Similarly, posters with a female senior author were 34.0% (OR: 0.66; 95% CI 0.45-0.96) less likely to be published. There was a significant difference in discipline of publication by gender of the senior author (p < 0.001). Male senior authors were more likely to supervise projects in otology while female senior authors were more likely to supervise projects in education and pediatrics. The time to publication and impact factor of the journal of publication did not differ by gender.

CONCLUSION

Gender disparities exist in the publication rates of first and senior authors at Canadian otolaryngology meetings. Female senior authors have significantly lower publication rates compared to their male colleagues and differences exist in publication rates after poster presentations. Investigation of gender gaps in academic medicine, research productivity, and publications is essential for development of a diverse, equitable, and inclusive workforce in otolaryngology.

Thinking like a Lawyer-Human Rights and Their Association with the Plastic Surgeon of Today

Plastic surgeons are trained to perform a wide repertoire of surgeries-ranging from standard local procedures to highly specialized operations. Therefore, plastic surgeons treat a plethora of clinical presentations and address multiple patient needs. Their daily workflow is increasingly entwined with legal topics. The concrete legal interpretation falls within the remit of legal experts. However, by understanding the legal basics of selected surgical procedures, plastic surgeons may generate synergies in patient care and clinical practice. The legal situation is to be elucidated based on the German Basic Law (GBL) and the European Convention on Human Rights (ECHR). LEVEL OF EVIDENCE V: "This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."

Gender differences in academic productivity, educational positions, and leadership appointments of physicians in the U.S

BACKGROUND

Promotions in academic medicine are frequently based on number of publications and leadership positions held. While prior study has established women publish less than men, many evaluations are limited to individual specialties and do not evaluate involvement with educational activities.

OBJECTIVE

To compare gender differences in academic output, intramural leadership positions, and educational leadership positions of academic physicians.

METHODS

The curriculum vitae and de-identified demographic data of all permanent physicians employed at a multi-site academic medical center were reviewed from April to May 2020. Multivariable logistic and Poisson regressions evaluated leadership positions and number of publications.

RESULTS

Of 3,359 physicians in the demographic database, 32.3% (n = 1,087) were women and 72.5% were white (n = 2,510). Of the 3,015 physicians in the curriculum vitae database, 32% (n = 962) were women. Women were more likely (p < 0.001) to be assistant professor (54% vs. 42.7%) and less likely to be associate (18.1% vs. 20.3%) or full professor (14.6% vs. 29.1%). Women assistant professors published 22% fewer articles (ratio estimate = 0.78, p < 0.001), associate professors 18% less (coefficient = 0.82, p < 0.001), and full professors 23% less (coefficient = 0.77, p < 0.001). Fewer women were program directors for residencies (1.6% vs. 2.9%, p = 0.02) or fellowships (5.4% vs. 7.4%, p = 0.04), and held fewer division or department leadership positions (OR 0.8, 95% CI as [0.6, 1.0], p = 0.03).

CONCLUSION

Women physicians do not outperform men across any education, leadership, or publication category. A cultural shift is needed to redefine traditional metrics for leadership appointments if academic medicine hopes to achieve equity.

Descriptive analysis of cornea and anterior segment fellowship program directors in 2020

PURPOSE

To investigate demographic characteristics, educational backgrounds, and academic achievements among program directors (PDs) of cornea and external disease and anterior segment fellowships in the United States in 2020.

SETTING

Database study of U.S. fellowship programs.

DESIGN

Cross-sectional study.

METHODS

PDs of cornea and external disease and anterior segment fellowships were identified using the San Francisco Match website. Fellowship program features reviewed included academic or private practice type, number of cornea faculty, and sex of chairperson. PD demographic characteristics, educational and training background, and academic productivity were analyzed using publicly available profiles and databases.

RESULTS

76 cornea and external disease and 10 anterior segment fellowships were reviewed. Of 86 reviewed programs, 55 (64.0%) were considered academic, 30 (34.9%) were private practice, and 1 (1.2%) was hybrid. 76 cornea and external disease PDs and 12 anterior segment PDs were identified. Overall, 21 (23.9%) of PDs were women, and the mean age for all PDs was 52.6 ± 11.5 years. Of the 88 PDs, the average number of publications was 45.1 ± 55.9. The mean h-index was 16.7 ± 15.4 and was higher among cornea and external disease than anterior segment PDs (18.2 ± 15.5 vs 7.1 ± 11.4, P = .008) and also higher among academic than private practice PDs (19.9 ± 15.1 vs 11.2 ± 14.7, P = .011). More female PDs were in departments with a female chairperson compared with male PDs (6 [28.6%] vs 4 [6.0%], P = .011).

CONCLUSIONS

Cornea and external disease and anterior segment fellowship PDs represent a wide array of backgrounds and scholarly achievements. Female PDs remain in the minority and are more common in departments with female chairpersons.

Gender analysis of Journal of Perinatology authorship during COVID-19

OBJECTIVE

To examine authorship gender distributions before and during COVID-19 in the Journal of Perinatology.

STUDY DESIGN

We collected data from the Journal of Perinatology website. The author gender was determined using Genderize.io or a systematic internet search. Our primary outcome was the difference between the number of published articles authored by women during the pandemic period (March 2020-May 2021, period two), compared with the preceding 15-month period (period one). We analyzed the data using chi-square tests.

RESULTS

Publications increased from period one to two by 8.9%. There were slightly more female than male first (62%) and overall (53%) authors, but fewer last authors (43%) for the combined time periods. Female authorship distribution was not different between periods.

CONCLUSIONS

Though publications increased overall, authorship gender distribution did not change significantly during the COVID-19 pandemic. Women authors remain underrepresented overall and specifically as last author, considering the majority of neonatologists are women.

Gender Differences in National Institutes of Health Grant Submissions Before and During the COVID-19 Pandemic

Introduction: Emerging data suggest that the COVID-19 pandemic has disproportionately impacted women in academic medicine, potentially eliminating recent gains that have been made toward gender equity. This study examined possible pandemic-related gender disparities in research grant submissions, one of the most important criteria for academic promotion and tenure evaluations. Methods: Data were collected from two major academic institutions (one private and one public) on the gender and academic rank of faculty principal investigators who submitted new grants to the National Institutes of Health (NIH) during COVID-19 (March 1st, 2020, through August 31, 2020) compared with a matched period in 2019 (March 1st, 2019, through August 31, 2019). t-Tests and chi-square analyses compared the gender distribution of individuals who submitted grants during the two periods of examination. Results: In 2019 (prepandemic), there was no significant difference in the average number of grants submitted by women compared with men faculty. In contrast, women faculty submitted significantly fewer grants in 2020 (during the pandemic) than men. Men were also significantly more likely than women to submit grants in both 2019 and 2020 compared with submitting in 2019 only, suggesting men faculty may have been more likely than their women colleagues to sustain their productivity in grant submissions during the pandemic. Discussion: Women's loss of extramural funding may compound over time, as it impedes new data collection, research progress, and academic advancement. Efforts to support women's research productivity and career trajectories are urgently needed in the following years of pandemic recovery.

The Extent of Gender Gap in Citations in Ophthalmology Literature

Purpose

To investigate the severity and causes of gender imbalance in the counts of ophthalmology citations.

Methods

The PubMed database was searched to identify cited papers that were published in four journals (Prog Retin Eye Res, Ophthalmology, JAMA Ophthalmol, and Invest Ophthalmol Vis Sci) between August 2015 and July 2020, and those that referenced these cited papers by 2021 July (i.e., citing papers). The gender category of a given paper is defined by the gender of the first and last author (MM, FM, MF, and FF; M means male and F means female). A generalized additive model to predict the expected proportion was fitted. The difference between the observed proportion and expected proportion of citations of a paper’s gender category was the primary outcome.

Results

The proportion of female-led (MF and FF) papers slightly increased from 27% in 2015 to 30% in 2020. MM, FM, MF, and FF papers were cited as −9.3, −1.5, 13.0, and 23.9% more than expected, respectively. MM papers cited 13.9% more male-led (MM and FM) papers than female-led papers, and FF papers cited 33.5% fewer male-led papers than female-led papers. The difference between the observed proportion and expected proportion of MM citing papers within male-led and female-led cited papers grew at a rate of 0.13 and 0.67% per year.

Conclusion

The high frequency of citations of female-led papers might narrow the gender gap in the citation count within ophthalmology. These findings show that papers by female-led are less common, so the gender gap might still exist even with their high citation count.

Benchmarking Surgeons’ Gender and Year of Medical School Graduation Associated With Monthly Operative Workdays for Multispecialty Groups

Background

Female surgeons reportedly receive less surgical block time and fewer procedural referrals than male surgeons. In this study, we compared operative days between female and male surgeons throughout Florida. Our objective was to facilitate benchmarking by multispecialty groups, both the endpoint to use for statistically reliable results and expected differences.

Methodology

The historical cohort study included all 4,060,070 ambulatory procedural encounters and inpatient elective surgical states performed between January 2017 and December 2019 by 8,472 surgeons at 609 facilities. Surgeons’ gender, year of medical school graduation, and surgical specialty were obtained from their National Provider Identifiers.

Results

Female surgeons operated an average of 1.0 fewer days per month than matched male surgeons (99% confidence interval 0.8 to 1.2 fewer days, P < 0.0001). The mean differences were 0.8 to 1.4 fewer days per month among each of the five quintiles of years of graduation from medical school (all P ≤ 0.0050). Results were comparable when repeated using the number of monthly cases the surgeons performed.

Conclusions

An average difference of ≤1.4 days per month is a conservative estimate for the current status quo of the workload difference in Florida. Suppose that a group’s female surgeons average more than two fewer operative days per month than the group’s male surgeons of the same specialty. Such a large average difference would call for investigation of what might reflect systematic bias. While such a difference may reflect good flexibility of the organization, it may show a lack of responsiveness (e.g., fewer referrals of procedural patients to female surgeons or bias when apportioning allocated operating room time).

Family Supportive Supervisor Behaviors Moderate Associations between Work Stress and Exhaustion: Testing the Job Demands-Resources Model in Academic Staff at an Austrian Medical University

The time-intensive work of publishing in scientific journals is an important indicator of job performance that is given much weight during promotion procedures for academic positions. The current study applied the job demands–resources model and analyzed whether family supportive supervisor behaviors (FSSB) moderated associations between work stress and feelings of exhaustion as a job resource and whether feelings of exhaustion ultimately mediated the link between work stress and academic employees’ publication activity. The current online cross-sectional questionnaire study was conducted in 133 academic employees (65.4% women, 34.6% men; M_age = 41.9, SD = 10.1) at an Austrian medical university and assessed employees’ numbers of publications, H-index, work stress, feelings of exhaustion, FSSB, and work–family services used. Manifest path models revealed that FSSB moderated the link between experiencing high levels of work stress and strong feelings of exhaustion, especially in employees who had at least one child below the age of 18. Part-time employment was most strongly linked with lower numbers of publications and lower H-index levels. The finding that FSSB acted as a job resource mostly for employees with at least one child below 18 underlines the fact that FSSB is different from other forms of supervisor support. The current study supports recommendations to increase the amount of work–family services and to change organizational norms to be supportive of the successful management of family and work obligations.

Academic Radiology in the United States: Defining Gender Disparities in Faculty Leadership and Academic Rank

RATIONALE AND OBJECTIVES

Female physicians in academic medicine have faced barriers that potentially affect representation in different fields and delay promotion. Little is known about gender representation differences in United States academic radiology departments, particularly within the most pursued subspecialties.

PURPOSE

To determine whether gender differences exist in United States academic radiology departments across seven subspecialties with respect to academic ranks, departmental leadership positions, experience, and scholarly metrics.

MATERIALS AND METHODS

In this cross-sectional study from November 2018 to June 2020, a database of United States academic radiologists at 129 academic departments in seven subspecialties was created. Each radiologist's academic rank, departmental leadership position (executive-level - Chair, Director, Chief, and Department or Division Head vs vice-level - vice, assistant, or associate positions of executive level), self-identified gender, years in practice, and measures of scholarly productivity (number of publications, citations, and h-index) were compiled from institutional websites, Doximity, LinkedIn, Scopus, and official NPI profiles. The primary outcome, gender composition differences in these cohorts, was analyzed using Chi² while continuous data were analyzed using Kruskal-Wallis rank sum test. The adjusted gender difference for all factors was determined using a multivariate logistic regression model.

RESULTS

Overall, 5086 academic radiologists (34.7% women) with a median 14 years of practice (YOP) were identified and indexed. There were 919 full professors (26.1% women, p < 0.01) and 1055 executive-level leadership faculty (30.6% women, p < 0.01). Within all subspecialties except breast imaging, women were in the minority (35.4% abdominal, 79.1% breast, 12.1% interventional, 27.5% musculoskeletal, 22.8% neuroradiology, 45.1% pediatric, and 19.5% nuclear; p < 0.01). Relative to subspecialty gender composition, women full professors were underrepresented in abdominal, pediatric, and nuclear radiology (p < 0.05) and women in any executive-level leadership were underrepresented in abdominal and nuclear radiology (p < 0.05). However, after adjusting for h-index and YOP, gender did not influence rates of professorship or executive leadership. The strongest single predictors for professorship or executive leadership were h-index and YOP.

CONCLUSION

Women academic radiologists in the United States are underrepresented among senior faculty members despite having similar levels of experience as men. Gender disparities regarding the expected number of women senior faculty members relative to individual subspecialty gender composition were more pronounced in abdominal and nuclear radiology, and less pronounced in breast and neuroradiology. Overall, h-index and YOP were the strongest predictors for full-professorship and executive leadership among faculty.

KEY RESULTS

● Though women comprise 34.7% of all academic radiologists, women are underrepresented among senior faculty members (26.1% of full professors and 30.6% of executive leadership) ● Women in junior faculty positions had higher median years of practice than their male counterparts (10 vs 8 for assistant professors, 21 vs 13 for vice leadership) ● Years of practice and h-index were the strongest predictors for full professorship and executive leadership.

Gender-based salary differences in academic medicine: a retrospective review of data from six public medical centers in the Western USA

OBJECTIVES

We assessed the effect of gender, rank and research productivity on compensation for faculty at academic medical centres.

DESIGN

A web-based retrospective review of salary for professors in 2016.

SETTING

Faculty from six state-run, publicly funded academic medical centres in the Western USA.

PARTICIPANTS

799 faculty members, 225 assistant (51% women), 200 associate (40% women) and 374 full professors (32% women) from general surgery (26% women), obstetrics and gynaecology (70% women) and radiology (34% women).

METHODS

Archived online faculty profiles were reviewed for gender, rank and compensation (total, baseline and supplemental). Total compensation was defined as baseline compensation plus supplemental income. Baseline compensation was defined as base salary minus reductions due to participation in the voluntary Employee Reduction in Time and phased retirement programmes. Supplemental income was defined as additional salary for clinical care and research (eg, grants). Elsevier's Scopus was used to collect data on h-index, a measure of research productivity. Linear regression models were estimated to determine the relationship between these factors and salary.

RESULTS

Total compensation was significantly higher for men across all professorial ranks in both general surgery [Formula: see text] and obstetrics and gynaecology [Formula: see text]. Women faculty members within these departments earned almost US$75 000 less than their men colleagues. The disparity in salary originates from gaps in supplemental income, as baseline compensation was not significantly different between men and women. No significant gender difference in total compensation for radiology was found [Formula: see text]. Higher h-index was associated with higher baseline compensation across all departments as well as with supplemental income for general surgery. Higher h-index was related to lower supplemental income for radiology and was not related to supplemental income for obstetrics and gynaecology.

CONCLUSIONS

Further investigations should focus on discrepancies in supplemental income, which may preferentially benefit men.

Effect of Coronavirus Disease-2019 on the Workload of Neonatologists

OBJECTIVE

To describe the impact of coronavirus disease-2019 (COVID-19) on the neonatology workforce, focusing on professional and domestic workloads.

STUDY DESIGN

We surveyed US neonatologists in December 2020 regarding the impact of COVID-19 on professional and domestic work during the pandemic. We estimated associations between changes in time spent on types of professional and domestic work and demographic variables with multivariable logistic regression analyses.

RESULTS

Two-thirds (67.6%) of the 758 participants were women. Higher proportions of women than men were in the younger age group (63.3% vs 29.3%), held no leadership position (61.4% vs 46.3%), had dependents at home (68.8% vs 56.3%), did not have a partner or other adult at home (10.6% vs 3.2%), and had an employed partner (88.1% vs 64.6%) (P < .01 for all). A higher proportion of women than men reported a decrease in time spent on scholarly work (35.0% vs 29.0%; P = .02) and career development (44.2% vs 34.9%; P < .01). A higher proportion of women than men reported spending more time caring for children (74.2% vs 55.8%; P < .01). Reduced time spent on career development was associated with younger age (aOR, 2.21; 95% CI, 1.20-4.08) and number of dependents (aOR, 1.21; 95% CI, 1.01-1.45). Women were more likely to report an increase in time spent time doing domestic work (aOR, 1.53; 95% CI, 1.07-2.19) and a reduction in time on self-care (aOR, 0.49; 95% CI, 0.29-0.81).

CONCLUSIONS

COVID-19 significantly impacts the neonatology workforce, disproportionately affecting younger, parent, and women physicians. Targeted interventions are needed to support postpandemic career recovery and advance physician contributions to the field.

Impact of Mentoring on Academic Career Success for Women in Medicine: A Systematic Review

PURPOSE

Research has shown that barriers to career success in academic medicine disproportionately affect women. These barriers include inadequate mentoring, which may perpetuate the underrepresentation of women in senior leadership positions. The purpose of this review was to summarize the qualitative and quantitative evidence of the impact of mentoring on women's career outcomes and to inform future interventions to support the promotion and retention of women in academic medicine.

METHOD

The authors conducted a systematic review of original research published in English-language, peer-reviewed journals through March 20, 2020. Search terms related to mentorship, women, and academic medicine. The authors searched MEDLINE, Embase, Scopus, Current Contents Connect via Web of Science, Cochrane Library, and PsycINFO. They excluded studies not specifically addressing women and those without gender-stratified outcomes. They extracted and analyzed the following data: study design, population, sample size, response rate, participant age, percentage of women, mentoring prevalence, and outcomes.

RESULTS

Of 2,439 citations identified, 91 studies met the inclusion criteria, including 65 quantitative and 26 qualitative studies. Mentoring was associated with objective and subjective measures of career success. Women perceived mentorship to be more valuable to their career development yet were more likely to report having no mentor. Additionally, women were more likely to report lower levels of research productivity, less career satisfaction, and greater barriers to promotion. Qualitative results indicated that women had less access to informal mentoring and family responsibilities had a greater effect on their career outcomes. Professional networking, female mentors, and relational aspects of mentoring were common themes.

CONCLUSIONS

This review examined gender disparities in mentoring and the impact on research productivity, promotion success, and career satisfaction for women in academic medicine. Institution-supported mentoring programs are needed to facilitate identification of appropriate mentors and promotion of a more equitable academic career environment for women.

Gender Disparity in Academic Gastroenterology: Beginning of the End of the Underrepresentation of Women?

BACKGROUND

Though there are an increasing number of female medical graduates, women remain underrepresented in academic medicine. There have been several reasons to explain this gender disparity, including marital status, number of children, number of hours worked, job flexibility, perceptions of women as inferior leaders, gender bias, sexual harassment, and unsupportive academic climates.

AIMS

This study aimed to investigate the relationship between scholarly productivity and the representation of female gastroenterologists in academia. Specifically, scholarly productivity measured by the h-index and academic rank were explored to determine if there were gender disparities in academic productivity and rank in gastroenterology.

METHODS

Gastroenterology departmental listings were obtained from the Fellowship and Residency Interactive Database of the American Medical Association. The Scopus database was used to record each physician's h-index. Statistical analyses were conducted with Wilcoxon rank-sum test, which compared matched samples by academic rank, and ANOVA tests, which compared multiple academic ranks.

RESULTS

Out of 1703 academic gastroenterologists, women account for 25% of academic physicians. Women have statistically lower h-indices at the level of Assistant Professor (p = 0.0012), and at the level of Chair (p = 0.01). There was no difference in h-indices between male and female at the rank of Associate Professor and Professor.

CONCLUSIONS

While these results mirror patterns appreciated in other fields of medicine, the results at the rank of Chair may suggest that despite the lower h-index compared to their male counterparts, females are perceived as having strong inherent leadership skills outside of academic productivity that are also conducive to leading a department and may be contributing to their rise to Chair.

An analysis of publication trends of orthopedic surgery residency graduates in relation to academic achievement

CONTEXT

Traditionally, the Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to implement research and other scholarly activities into their training curriculum. Encouraging residents to publish during residency is believed to promote research throughout their careers; however, no study has attempted to quantify research productivity among orthopedic surgery residents before, during, and after residency.

OBJECTIVES

To determine whether publishing in peer-reviewed journals during orthopedic residencies was an indicator of continued academic achievement after graduation.

METHODS

This study was observational in nature and employed a cross-sectional design. We examined whether research outcomes during orthopedic residency was associated with academic advancement or continued research involvement after residency. We identified 201 orthopedic residency programs on the Doximity website and randomly selected 50 to include in our sample. Of these programs, graduate rosters for 31 programs were located and subsequently included. Of the 341 graduates identified, we recorded the number of peer-reviewed publications, H-indices, fellowships, and whether the graduate pursued a career in private practice or academia.

RESULTS

Orthopedic residency graduates from 31 programs published a total of 1923 peer-reviewed manuscripts. On average, residents had a total of 5.6 publications and an h-index of 3.2. Residents entering academia and pursuing fellowships had a significantly higher total number of publications, higher number of first-author publications, and greater H-indices compared to those who did not enter academia or pursue a fellowship.

CONCLUSIONS

Increased research productivity was associated with continued academic pursuits and an increased likelihood of pursuing fellowship training after residency.

Do Attitudes towards Work or Work Motivation Affect Productivity Loss among Academic Employees?

Work motivation and job attitudes are important for productivity levels among academic employees. In situations where employees perceive problems, for example, health-related and work environment-related problems, the ability to perform at work could be affected, which may result in fewer publications, reduced quality and less research funding. Few studies, however, have paid attention to productivity loss among academic employees in order to understand how, or if, the perceived loss is affected by the reported problems, either alone or in combination with work motivation and job attitudes. To evaluate whether attitudes towards work—measured as job satisfaction, organisational commitment and work motivation—are associated with productivity loss in the workplace, a cross-sectional study was conducted. This type of design is required as performance is highly variable and is affected by changes in health and work status. This study includes employees who reported either health-related problems, work environment problems or a combination of both (n = 1475). Linear regression analyses were used to answer the hypotheses. Higher levels of motivation, job satisfaction and organisational commitment were associated with lower levels of productivity loss among employees who experienced either health-related or work environment problems. High work motivation and high commitment were significantly associated with lower levels of productivity loss among employees who experienced a combination of problems. In summary, productivity loss among academic employees is not only affected by health-related problems or problems in the work environment but also by work motivation, job satisfaction and organisational commitment; i.e., these factors seem to buffer, or moderate, the reduction in performance levels for this group of employees.

Gender, Productivity, and Philanthropic Fundraising in Academic Oncology

BACKGROUND

Philanthropic donations are important funding sources in academic oncology but may be vulnerable to implicit or explicit biases toward women. However, the influence of gender on donations has not been assessed quantitatively.

METHODS

We queried a large academic cancer center's development database for donations over 10 years to the sundry funds of medical and radiation oncologists. Types of donations and total amounts for medical oncologists and radiation oncologists hired prior to April 1, 2018 (allowing ≥2 years on faculty prior to query), were obtained. We also obtained publicly available data on physician/academic rank, gender, specialty, disease site, and Hirsch-index (h-index), a metric of productivity.

RESULTS

We identified 127 physicians: 64% men and 36% women. Median h-index was higher for men (31; range, 1-100) than women (17; range, 3-77; P=.003). Men were also more likely to have spent more time at the institution (median, 15 years; range, 2-43 years) than women (median, 12.5 years; range, 3-22 years; P=.025). Those receiving donations were significantly more likely to be men (70% vs 30%; P=.034). Men received significantly higher median amounts ($259,474; range, $0-$29,507,784) versus women ($37,485; range, $0-$7,483,726; P=.019). On multivariable analysis, only h-index and senior academic rank were associated with donation receipt, and only h-index with donation amount.

CONCLUSIONS

We found significant gender disparities in receipt of philanthropic donations on unadjusted analyses. However, on multivariable analyses, only productivity and rank were significantly associated with donations, suggesting gender disparities in productivity and promotions may contribute to these differences.

Sex Disparities in Productivity among Oculoplastic Surgeons

Purpose The aim of the study is to investigate sex differences in academic rank, publication productivity, and National Institute of Health (NIH) funding among oculoplastic surgeons and whether there is an association between American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) membership and scholarly output.

Methods Sex, residency graduation year, and academic rank were obtained from institutional websites of 113 U.S. ophthalmology programs. H-indices and m-quotients were obtained from the Scopus database. NIH funding information was obtained from the NIH Research Portfolio Online Reporting Tool.

Results Of the 272 surgeons, 74 (30.2%) were females. When adjusted for career duration, differences in female to male proportions were only significant at the rank of assistant professor (assistant: 74.3 vs. 48.5%, p = 0.047; associate: 18.9 vs. 24.6%, p = 0.243; full professor: 13.0 vs. 37.2%, p = 0.114). Women had a shorter career duration than men [10.0 (interquartile range or IQR 12.0) vs. 21.0 (IQR 20.0) years; p < 0.001] and a lower h-index [4.0 (IQR 5.0) vs. 7.0 (IQR 10.0); p < 0.001], but similar m-quotients [0.4 (IQR 0.4) vs. 0.4 (IQR 0.4); p = 0.9890]. Among ASOPRS members, females had a lower h-index than males [5.0 (IQR 6.0) vs. 9.0 (IQR 10.0); p < 0.001] due to career length differences. No difference in productivity between sexes was found among non-ASOPRS members. ASOPRS members from both sexes had higher scholarly output than their non-ASOPRS counterparts. Just 2.7% (2/74) of females compared with 5.3% (9/171) of males received NIH funding (p = 0.681).

Conclusion Sex differences in academic ranks and h-indices are likely due to the smaller proportion of females with long career durations. ASOPRS membership may confer opportunities for increased scholarly output.

Making a Major Change: Changing Your Practice Setting, Retirement, and Locums

The goal of this article is to discuss factors associated with career change and give data and recommendations of how to prepare for a career change in regards to early, mid, and late career.

Scholarly Productivity Among Academic Foot and Ankle Surgeons Affiliated With US Podiatric Medicine and Surgery Residency and Fellowship Training Programs

Foot and ankle surgeons practicing within academic medicine balance clinical or surgical training, course instruction, administrative duties, and research. Along with clinical skills and patient volume, promotion within academia often relies on scholarly productivity. Previous research across specialties described this productivity using variables including publications, citations, and the h-index, a scale that quantifies the productivity and citation impact of published works, among academic ranks. As no studies examine the scholarly impact of foot and ankle surgeons with academic appointments, this study aimed to analyze the productivity and gender differences present in this specialty. A systematic review of academic-affiliated foot and ankle surgery residencies and fellowships was performed; and faculty members were screened for sex, academic rank, publication history, citations, h-index, and years in practice. Among 234 programs reviewed, 44 programs allowed for the analysis of 106 practitioners with an academic rank eligible for analysis. Overall, 78.3% of practitioners were male with the most common rank being assistant professor. Men published more documents and maintained higher citations as well as longer years in practice, and this was significant (p < .05). A significant difference was exhibited among all academic ranks (p ≤ .001). Multivariate regression revealed the publication history and years in practice are strongly correlated with the h-index of providers (p ≤ .001). Foot and ankle surgeons practicing in an academic setting may use the results of this study to gauge their productivity and identify benchmarks that similar providers have met at varying academic ranks.

Initial impact of the COVID-19 pandemic on time Japanese nursing faculty devote to research: Cross-sectional survey

Aim

To investigate how nursing faculties' perceived time devoted to research changed during the first wave of the pandemic in Japan (April–June 2020) compared to pre‐pandemic.

Methods

This cross‐sectional study was conducted online from July 1 to August 10, 2020 and involved 1,023 nursing faculties in Japan. Participants were asked to respond to a questionnaire based on their experiences from April to June 2020. We calculated descriptive statistics for several measures and examined associations between professional/personal demographic factors and declines in overall research time.

Results

Of the 1,023 participants, 71.1% were spending less time on overall research activity; 79.6% spent less time attending academic events/conferences, and 77.4% spent less time conducting experiments/surveys. In contrast, 81.2% spent more time teaching, a much greater proportion than the global scientific community in a previous survey. As for work time allocation during the pandemic, teaching was by far the one activity that participants spent the most time on. Logistic regression analysis revealed that declines in overall research time were associated with several professional demographic factors, such as type of university, current academic position, and acquisition status of Japan's major research grant (KAKENHI) (all p < .05).

Conclusions

Nursing faculties in Japan clearly spent less time on research, and more time on teaching during the first wave of the pandemic compared to pre‐pandemic. The initial impact of the pandemic on nursing faculties revealed through this study is an eye‐opener and a start for addressing the long‐term impact on the nursing scientific community.

Gender disparities in gastrointestinal surgery fellowship programs

BACKGROUND

Gender disparities in surgical leadership have come under increased scrutiny, and in order to better understand why these disparities exist, it is important to study the disparities across surgical fellowship programs.

METHODS

Data derived from the Fellowship Council (FC) database for fellows completing training from academic years 2015-2019 were analyzed. Available information included institution, fellowship type, program director (PD), associate program director (APD), faculty, and fellow names for all FC Fellowships. Faculty and fellow gender were determined from personal knowledge or publicly available online biographical information.

RESULTS

A total of 1023 fellows and 221 programs were analyzed. The advanced gastrointestinal (GI)/minimally invasive surgery (MIS) fellowship programs included 321 fellows, with a small increase in the percentage of female fellows from 28 to 31% over 5 years. Advanced GI/MIS/bariatric fellowship programs had a total of 262 fellows, also with a small increase in the percent of female fellows, from 29 to 38% in the study period. The gender of program directors, assistant program directors, and faculty for the fellowship programs studied were analyzed as well. Of the 221 programs in the Fellowship Council data, 13.6% of program directors, 18.3% of associate program directors, and 19.9% of faculty were female. Advanced GI/MIS fellowship programs had the lowest percentage of female PDs, with only 9.3% of the program directors being female. Colorectal surgery fellowships had the highest percentage of female PDs, with 33% being female.

CONCLUSIONS

In conclusion, women are underrepresented in gastrointestinal surgery fellowships among both trainees and educators. It is likely that a significant contributing factor to this underrepresentation of female fellows is the underrepresentation of female program directors and faculty; although neither our study nor any previously published study has proven that statistically.

The Relative Citation Ratio: Examining a Novel Measure of Research Productivity among Southern Academic Ophthalmologists

PurposeTo analyze research productivity, as assessed by the National Institutes of Health-supported relative citation ratio (RCR), for a cohort of Southern academic ophthalmologists.DesignA descriptive and cross-sectional design was used. Data on gender, academic rank (assigned as an assistant professor, associate professor, professor, or "other"), degrees, and career duration were collected using online resources. Research yield was quantified using mean and weighted RCR data queried from the iCite database. Significant between-group differences were calculated using the Mann-Whitney U-test and the Kruskal-Wallis test.SettingsPracticing academic ophthalmologists at Accreditation Council for Graduate Medical Education-accredited ophthalmology programs in the Southern United States (n = 1018).ResultsFor all Southern academic ophthalmologists, median mean RCR was 0.90 (IQR 0.18-1.71) and median weighted RCR was 5.12 (IQR 0.34-33.18). Advanced academic rank and PhD acquisition were significantly associated with increased mean and weighted RCR. After exclusion of faculty within the "other" category, median mean RCR was 1.12 (IQR 0.54-1.80) and median weighted RCR was 11.65 (IQR 2.03-45.58). Furthermore, effects of career duration and gender emerged. Ophthalmologists with longer careers had significantly higher mean and weighted RCR than their younger counterparts. Males had significantly higher mean and weighted RCR than females.ConclusionsAcademic rank and attainment of a PhD degree were correlated with increased research productivity. When analyses focused exclusively on faculty not in the "other" subgroup, male gender, and lengthier career were associated with increased mean and weighted RCR, the former of which potentially highlights differences in professional advancement between genders.

Does Gender Matter in Academic Surgery? Author and Mentor Gender Impact Publication Citations in Surgical Research

OBJECTIVE

To examine female author representation within publications in the field of urology from the United States from 2000-2019.

METHODS

All 25,787 articles with a U.S. correspondence address published in the two largest U.S. headquartered general urology journals, Urology and Journal of Urology, were analyzed from 2000-2019. Gender was assigned to each first and last author based on the author's first name. First names were matched to a database of U.S. Social Security Administration data to determine gender.

RESULTS

Overall female authorship, female senior authorship, and female first authorship exhibited a significant upward trend from 2000 to 2019 (P <0.001, P <0.001, P = 0.002). As the number of female last authors increased, female last authors were significantly more likely to publish with female first authors, and significantly less likely publish with male first authors (P <0.001, P <0.001). Furthermore, we found a significant difference for female authors being less likely to get cited than male authors (p = 0.02), despite the greater proportion of females that authored research articles with higher citation counts compared to males (P <0.05).

CONCLUSION

Despite the significant progress in female representation within urological publications, female-authored publications continue to constitute a smaller proportion of the urological literature and are less likely to be cited. Our study provides the first evidence on the current status of female underrepresentation within academic urology and literature productivity at this watershed moment. As the number of female urologists evolves, these findings will be of significant impact in the advancement of female investigators in urology.

Diversifying Researchers and Funding in Otolaryngology

Research productivity is a key metric used in evaluation for advancement and promotion in academic medicine. There are known gender, race, and ethnicity disparities in otolaryngology research and funding. Female academic otolaryngologists have been shown to lag in scholarly productivity, representation at national meetings, leadership positions on journal editorial boards, and National Institutes of Health and industry funding. Underrepresented minorities have been shown to be less successful at obtaining Centralized Otolaryngology Research Efforts grant funding. Directed approaches, such as research funding for women and minorities or targeted recruitment and retention of underrepresented faculty, may move the field toward parity.

Research Output by Medical Doctors After PhD Graduation in Radiology: 17-Year Experience From the Netherlands

RATIONALE AND OBJECTIVES

To determine the frequency and predictors of lack of research output by medical doctors after PhD graduation in radiology.

MATERIALS AND METHODS

This study included all 272 PhD theses by medical doctors in the Netherlands between 2000 and 2016, with radiology as the field of research of the primary doctoral supervisor. Post-PhD research output was considered lacking if no original research, systematic review, or meta-analysis was published as first, second, or last author in the post-PhD period.

RESULTS

The percentage of PhD graduates without research output was 41.9% (78/186) at 5 years, 28.6% (24/84) at 10 years, and 16.1% (5/31) at 15 years in the post-PhD period. On univariate Cox regression analysis, only female gender emerged as a significant predictor of a lack of research output in the post-PhD period (odds ratio: 1.456, 95% confidence interval: 1.023-2.073, p = 0.038). PhD student's age, being a radiologist or not before PhD graduation, the radiologic subspecialty topic of the PhD thesis, the H-index of the primary doctoral supervisor, the institution at which the PhD was performed, and the number of publications in the PhD period, were not significantly associated with lack of post-PhD research output.

CONCLUSION

A considerable proportion of medical doctors has no active research output after obtaining a PhD degree in radiology, and this should be taken into account when relying on PhD programs to replenish the physician-scientist workforce. Females appear to be more prone to lack active research output, and this should be addressed by the scientific community and society.

Gender Prevalence and Trends in Otology and Neurotology Publications

OBJECTIVE

To assess otology and neurotology authorship by gender, subject, and country of origin from 2000 to 2019.

STUDY DESIGN

Retrospective review of otology and neurotology publications in 2000, 2005, 2010, 2015, and 2019 from 10 prominent journals within otolaryngology.

MAIN OUTCOME MEASURES

Demographics for first through third and final authors, including gender, degree, coauthorship, as well as number of authors, subject matter, and region of origin for each publication.

RESULTS

A total of 4,411 neurotology articles published in 2000, 2005, 2010, 2015, and 2019 were analyzed. During the study period, the proportion of female authors increased from 22.3% in 2000 to 33.9% in 2019 (p < 0.0001). However, authorship position analysis demonstrated no increase in final female authorship (22.5% in 2019, from 19.4% in 2000, p = 0.112). Geographic region analysis demonstrated a similar overall global trend toward an increase in female authors. When considering author gender by position, North America, the Middle East, and Africa failed to demonstrate significant increasing trends for female final authors. Female final authors were also significantly less likely to have medical degrees than final male authors, (37.4% versus 78.6%, respectfully, p =  < 0.0001). Finally, women published more often within the subjects of pediatrics and audiology (46.5% and 37.3% of final authors, p < 0.0001).

CONCLUSIONS

Female authorship in otology and neurotology has increased globally. With the predominant number of articles originating from North America, and articles originating from North America failing to demonstrate an increase in female final authorship, overall, final female authorship did not change during the study period.

PROFESSIONAL PRACTICE GAP AND EDUCATIONAL NEED

There is no comprehensive study exploring gender distribution within only the specialty of otology and neurotology. While it is known that more women are becoming otolaryngologists, it is unknown if this increase is reflected in otology and neurotology publications, domestically and internationally.

LEARNING OBJECTIVE

To understand if gender biases and/or differences exist within otology and neurotology publications.

DESIRED RESULT

Identify trends in otology and neurotology publications to address particular barriers to female publication within the field.

Gender equality in academic gastroenterology: a review of gastroenterology literature over four decades

BACKGROUND

Historically males have dominated the physician ranks, although in recent years, there has been an increase in the proportion of female doctors to redress this imbalance. With such attention being paid to gender equality in society, this study aimed to characterise the changing prevalence of female authorship of peer-reviewed published research with in the field of gastroenterology.

AIMS

In order to quantitatively assess the growth of female gastroenterologists, we decided to examine the changing face of gender equality within the field of academic gastroenterology from 1971 to 2010.

METHODS

All research published in the January and July issues of Gastroenterology from 1971 to 2010 was reviewed. The gender of the first author and last author (considered the senior author) of each study was recorded. Research was subsequently categorised by type: basic science research, clinical trials, and epidemiologic research. Data was analysed in 5-year time periods.

RESULTS

Author gender could be identified from a total of 865 abstracts from 80 journal issues. In total, there were 120 (13.8%) female first authors and 91 (10.5%) female senior authors. Female first authorship has tripled since 1995, from 11% (1991-1995) to 32% (2006-2010). Female senior authorship has also tripled since 2000, from 7% (1996-2000) to 24% (2006-2010).

DISCUSSION

Results demonstrated that there has been a significant increase in the prevalence of female authorship of published research in Gastroenterology since 1995. The increasing prevalence of females within the field of academic gastroenterology can therefore be extrapolated to demonstrate the growing numbers of female gastroenterologists in the entire field including clinical and academic gastroenterology.

Women remain underrepresented in leadership positions in academic gastroenterology throughout the United States

Background

Publication history is a key factor in securing academic promotion, but historical underrepresentation of women in gastroenterology may be an ongoing obstacle to achieving gender parity in leadership positions.

Methods

We carried out a cross-sectional study of gastroenterology programs in the United States, with data including faculty and trainee names, leadership positions, Hirsch indices, and year of first gastroenterology certification gathered from 1 February 2020 to 1 March 2020. Our outcomes of interest were: 1) sex representation in various leadership positions in academic gastroenterology departments; and 2) mean difference in Hirsch indices between men and women, for which we used univariate and multivariate regression models.

Results

Our cohort included 3655 faculty members and trainees across 163 academic gastroenterology programs in the United States. Women comprised 28.7% (1049/3655) of the cohort, including 713/2657 (26.8%) of faculty and 56/289 (19.4%) of all fellowship program directors and divisional/departmental chairs and chiefs. Male faculty had higher mean Hirsch indices compared to women (11.4 vs. 5.5, P<0.001), and when adjusted for year of first gastroenterology certification, men had a larger Hirsch index by 2.8 (95% confidence interval 1.3-4.1, P<0.001). Women were also underrepresented in various subspecialties of gastroenterology, particularly advanced endoscopy.

Conclusions

Women in academic gastroenterology remain underrepresented in leadership positions and have lower Hirsch indices than men. Our findings may stem not only from differences in mentorship and career goals, but also from underlying structural factors that disadvantage women.

Scholarly Research Productivity among Otolaryngology Residency Graduates and its Relationship to Future Academic Achievement

OBJECTIVE

Scholastic activity through research involvement is a fundamental aspect of a physician's training and may have a significant influence on future academic success. Here, we explore publication rates before, during, and after otolaryngology residency training and whether publication efforts correlate with future academic achievement.

METHODS

This cross-sectional analysis included a random sample of 50 otolaryngology residency programs. From these programs, we assembled a list of residents graduating from the years in 2013, 2014, and 2015. Using SCOPUS, PubMed, and Google Scholar, we compiled the publications for each graduate, and data were extracted in an independent, double-blinded fashion.

RESULTS

We included 32 otolaryngology residency programs representing 249 residents in this analysis. Graduates published a mean of 1.3 (SD = 2.7) articles before residency, 3.5 (SD = 4.3) during residency, and 5.3 (SD = 9.3) after residency. Residents who pursued a fellowship had more total publications (t₂₄₇ = -6.1, P < .001) and more first author publications (t₂₄₇ = -5.4, P < .001) than residents without fellowship training. Graduates who chose a career in academic medicine had a higher number of mean total publications (t₂₄₇ = -8.2, P < .001) and first author publications (t₂₄₇ = -7.9, P < .001) than those who were not in academic medicine. There was a high positive correlation between residency program size and publications during residency (r = 0.76).

CONCLUSION

Research productivity correlated with a number of characteristics such as future fellowship training, the pursuit of an academic career, and overall h-index in this study.

Cross-sectional analysis of women in neurosurgery: a Canadian perspective

OBJECTIVE

Although the past decades have seen a steady increase of women in medicine in general, women continue to represent a minority of the physician-training staff and workforce in neurosurgery in Canada and worldwide. As such, the aim of this study was to analyze the experiences of women faculty practicing neurosurgery across Canada to better understand and address the factors contributing to this disparity.

METHODS

A historical, cross-sectional, and mixed-method analysis of survey responses was performed using survey results obtained from women attending neurosurgeons across Canada. A web-based survey platform was utilized to collect responses. Quantitative analyses were performed on the responses from the study questionnaire, including summary and comparative statistics. Qualitative analyses of free-text responses were performed using axial and open coding.

RESULTS

A total of 19 of 31 respondents (61.3%) completed the survey. Positive enabling factors for career success included supportive colleagues and work environment (52.6%); academic accomplishments, including publications and advanced degrees (36.8%); and advanced fellowship training (47.4%). Perceived barriers reported included inequalities with regard to career advancement opportunities (57.8%), conflicting professional and personal interests (57.8%), and lack of mentorship (36.8%). Quantitative analyses demonstrated emerging themes of an increased need for women mentors as well as support and recognition of the contributions to career advancement of personal and family-related factors.

CONCLUSIONS

This study represents, to the authors' knowledge, the first analysis of factors influencing career success and satisfaction in women neurosurgeons across Canada. This study highlights several key factors contributing to the low representation of women in neurosurgery and identifies specific actionable items that can be addressed by training programs and institutions. In particular, female mentorship, opportunities for career advancement, and increased recognition and integration of personal and professional roles were highlighted as areas for future intervention. These findings will provide a framework for addressing these factors and improving the recruitment and retention of females in this specialty.

Assessment of the NIH-supported relative citation ratio as a measure of research productivity among 1687 academic neurological surgeons

OBJECTIVE

Publication metrics such as the Hirsch index (h-index) are often used to evaluate and compare research productivity in academia. The h-index is not a field-normalized statistic and can therefore be dependent on overall rates of publication and citation within specific fields. Thus, a metric that adjusts for this while measuring individual contributions would be preferable. The National Institutes of Health (NIH) has developed a new, field-normalized, article-level metric called the "relative citation ratio" (RCR) that can be used to more accurately compare author productivity between fields. The mean RCR is calculated as the total number of citations per year of a publication divided by the average field-specific citations per year, whereas the weighted RCR is the sum of all article-level RCR scores over an author's career. The present study was performed to determine how various factors, such as academic rank, career duration, a Doctor of Philosophy (PhD) degree, and sex, impact the RCR to analyze research productivity among academic neurosurgeons.

METHODS

A retrospective data analysis was performed using the iCite database. All physician faculty affiliated with Accreditation Council for Graduate Medical Education (ACGME)-accredited neurological surgery programs were eligible for analysis. Sex, career duration, academic rank, additional degrees, total publications, mean RCR, and weighted RCR were collected for each individual. Mean RCR and weighted RCR were compared between variables to assess patterns of analysis by using SAS software version 9.4.

RESULTS

A total of 1687 neurosurgery faculty members from 125 institutions were included in the analysis. Advanced academic rank, longer career duration, and PhD acquisition were all associated with increased mean and weighted RCRs. Male sex was associated with having an increased weighted RCR but not an increased mean RCR score. Overall, neurological surgeons were highly productive, with a median RCR of 1.37 (IQR 0.93-1.97) and a median weighted RCR of 28.56 (IQR 7.99-85.65).

CONCLUSIONS

The RCR and its derivatives are new metrics that help fill in the gaps of other indices for research output. Here, the authors found that advanced academic rank, longer career duration, and PhD acquisition were all associated with increased mean and weighted RCRs. Male sex was associated with having an increased weighted, but not mean, RCR score, most likely because of historically unequal opportunities for women within the field. Furthermore, the data showed that current academic neurosurgeons are exceptionally productive compared to both physicians in other specialties and the general scientific community.

Association Between Sex Composition and Publication Productivity of Journal Editorial and Professional Society Board Members in Ophthalmology

Importance

Because women remain underrepresented in leadership positions in medicine, including ophthalmology, knowledge of sex composition of ophthalmic journal editorial and professional society boards seems warranted.

Objectives

To investigate the sex composition of ophthalmic journal editorial and professional society boards and compare the publication productivity and number of citations of male vs female board members.

Design, Setting, and Participants

In this cross-sectional study, the SCImago Journal Rank indicator was used to identify the 20 highest-ranked ophthalmology journals. Faculty members from each ophthalmic subspecialty were surveyed within a US academic ophthalmology department to identify 15 influential ophthalmology societies. The 2018 board members of each journal and society were identified from the journals' and societies' official websites, and the sex of each individual was recorded. Information regarding journals and societies was collected from October 1 to December 31, 2018. The Scopus database was accessed in January 2019 and then used to find each member's h-index and m-quotient.

Main Outcomes and Measures

The h-index, defined as the highest number of an author's publications that received at least h number of citations, was calculated for each board member. The m-quotient, which accounts for varying lengths of academic careers, was calculated by dividing the h-index by the number of years since first publication.

Results

Of the 1077 members of ophthalmic journal editorial and society leadership boards, 797 (74.0%) were men and 280 (26.0%) were women. Among the 24 editors in chief of the 20 journals investigated, 23 (95.8%) were male. Thirteen of the 15 professional society presidents (86.7%) were men. Male board members had significantly higher median h-indexes (male vs female journals: 34 [interquartile range {IQR}, 23-47] vs 28 [IQR, 19-40], P < .001; male vs female societies: 27 [IQR, 15-41] vs 17 [IQR, 8-32], P = .006), median publication numbers (male vs female journal board members: 157 [IQR, 88-254] vs 109 [IQR, 66-188], P < .001; male vs female society board members: 109 [IQR, 57-190] vs 58 [IQR, 28-139, P = .001), and median citations (male vs female journal board members: 4027 [IQR, 1897-8005] vs 2871 [IQR, 1344-5852], P < .001; male vs female society board members: 2228 [IQR, 1005-5069] vs 1090 [IQR, 410-2527], P = .003). However, the median m-quotients for male and female board members were comparable (male vs female journal board members: 1.2 [IQR, 0.8-1.6] vs 1.1 [IQR, 0.8-1.5], P = .54; male vs female society board members: 1.0 [IQR, 0.7-1.4] vs 0.9 [IQR, 0.6-1.3], P = .32).

Conclusions and Relevance

The findings suggest that the sex composition on journal editorial and professional society boards in ophthalmology is consistent with the sex composition of ophthalmologists in the US, as reported by the Association of American Colleges, but that editor in chief and society president positions are male dominated despite the apparent equality in academic productivity.