Gender Representation Among Presenters in Ophthalmology Subspecialties in 2019: A Retrospective Review

Trends in Immunosuppressive Agent Use for Non-Infectious Uveitis by US Ophthalmologists in Medicare Beneficiaries and Association with Physician-Industry Interactions

PURPOSE

To report the trends of immunosuppressive drug use for non-infectious uveitis and explore their relationship with industry payments.

METHODS

A retrospective review of ophthalmologists reimbursed by Medicare for the administration of adalimumab (ADA), repository corticotropin (RCI), methotrexate (MTX), and mycophenolate mofetil (MMF) between 2014 and 2018.

RESULTS

A total of 316 ophthalmologists were reimbursed by Medicare for 1567 ADA, 465 RCI, 1752 MTX, and 12 333 MMF administrations. The number and dollar amount of industry payments were positively associated with ADA and RCI use (P < 0.001). From 2014 to 2018, there was a positive trend in the proportion of ADA (P = 0.007) and RCI (P = 0.007) used and negative trend in the proportion of MMF (P = 0.025) used.

CONCLUSION

From 2014 to 2018, the use of ADA and RCI increased while MMF decreased and MTX remained stable. There was a positive association between ADA and RCI use and physician-industry interactions. A causal relationship is not determined.

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.

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.

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.