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Fioranelli GA, Lo Y, Jesch AK, Laluzerne MJ, Donnelly D, Lyon SM, Dingle AM. Diversity Drives Representation: An Internal Audit of Gender Representation in Citation Practices of a Single Surgical Laboratory. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5823. [PMID: 38881963 PMCID: PMC11177816 DOI: 10.1097/gox.0000000000005823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/25/2024] [Indexed: 06/18/2024]
Abstract
Background Large-scale retrospective studies have identified implicit gender bias in citation behaviors across multiple medical fields. There are minimal resources to directly assess one's own citation behavior before publication at a laboratory level. In this study, we performed an internal audit of our own citation practices and behavior, looking at the representation of authors by gender in our own bibliographies. Methods Bibliographies were collated from our laboratory's publications between 2015 and 2022 with a single senior author, who was excluded from participating in this study. Bibliographies were run through a simulation originally constructed and used by authors from the University of Pennsylvania that categorized authors of each article by gender: man or woman, according to external database records. Results Of the 1697 citations, the first and last authorship sequences displayed to be 60.8% male/male, 10.1% male/female, 16.3% female/male and 12.8% female/female. Men-led articles within our laboratory cited 67.4% male/male articles in their bibliographies compared with women-led articles citing 53.9%. All laboratory bibliographies consisted of 77.1% male senior authors compared with 22.9% female senior authors. Conclusions Our data confirm that a gender bias in citation practices exists at the laboratory level. Promisingly, these data also indicate that diversity within an individual laboratory group leads to diversity in representation; therefore, diversifying a team of researchers is prone to improve the overall work and success of the laboratory. We encourage laboratory groups to challenge their own biases by replicating their own results and discovering how these biases might be impacting their publications.
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Affiliation(s)
- Gabriela A Fioranelli
- From the Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
| | - Yunee Lo
- From the Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
| | - Anna K Jesch
- From the Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
| | - Matthew J Laluzerne
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisc
| | - D'Andrea Donnelly
- From the Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
| | - Sarah M Lyon
- From the Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
| | - Aaron M Dingle
- From the Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
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Artiga-Solana X, Muñoz-Mahamud E, Combalia A. Trends in authorship in Medicina Clínica: an 11-year analysis of author gender. Med Clin (Barc) 2024:S0025-7753(24)00192-1. [PMID: 38702273 DOI: 10.1016/j.medcli.2024.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Xenia Artiga-Solana
- Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona (UB), Barcelona, España
| | - Ernesto Muñoz-Mahamud
- Departamento de Cirugía y Especialidades Medicoquirúrgicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona (UB), Barcelona, España
| | - Andrés Combalia
- Departamento de Cirugía y Especialidades Medicoquirúrgicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona (UB), Barcelona, España; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, España.
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Hong JP, Hallock GG. Perish or Publish? Arch Plast Surg 2024; 51:265-267. [PMID: 38737850 PMCID: PMC11081728 DOI: 10.1055/a-2283-2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/03/2024] [Indexed: 05/14/2024] Open
Affiliation(s)
- Joon Pio Hong
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Geoffrey G. Hallock
- Division of Plastic Surgery, Sacred Heart Campus, St. Luke's Hospital, Allentown, Pennsylvania
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Swanson E. Diversity, Equity, and Inclusion in Plastic Surgery: A Systematic Review. Ann Plast Surg 2024; 92:353-366. [PMID: 38527336 DOI: 10.1097/sap.0000000000003936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND The number of publications on the subject of diversity, equity, and inclusion has surged in the last 5 years. However, a systematic review of this topic has not been published. METHOD Six top plastic surgery journals were queried from 2018 to 2023 using the search term "diversity." Methods, conclusions, and recommendations were tabulated. RESULTS A total of 138 publications were identified; 68 studies presented data suitable for analysis. All studies were retrospective. Currently, over 40% of plastic surgery residency applicants are women. The proportion of women in integrated plastic surgery residents is now 43%. In 2021 and 2022, the percentage of female first-year residents exceeded men. The percentage of female presenters at meetings (34%) is double the number in the workforce (17%). Twenty-five percent of academic faculty positions and 22% of program director positions are now held by women. Underrepresented minorities account for fewer than 10% of applicants to integrated plastic surgery residencies. DISCUSSION The proportion of Black and Hispanic applicants to integrated plastic surgery residencies (6% and 8%, respectively) mirrors the proportion of Black and Hispanic medical students (7% and 6%, respectively). Numerous recommendations have been made to increase the proportion of underrepresented minorities in plastic surgery programs. CONCLUSIONS The representation of women in plastic surgery has increased dramatically. A lack of Hispanics and Blacks reflects a small pool of applicants, as opposed to a "leaky pipeline."
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Hemal K, Perez-Otero S, Boyd CJ, Weichman KE, Cohen OD, Thanik VD, Ceradini DJ. The Evolving Plastic Surgery Applicant: How Far Have We Come in 30 Years? Ann Plast Surg 2024; 92:S245-S250. [PMID: 38556682 DOI: 10.1097/sap.0000000000003905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Plastic surgery training has undergone tremendous change and transitioned through many models over the years, including independent, combined, and integrated. This study evaluates how these changes and others have affected plastic surgery applicants' demographics and academic qualifications over the last 30 years. METHODS Data on applicant demographics and academic qualifications were extracted from multiple sources including the National Resident Matching Program, the American Association of Medical Colleges, and cross-sectional surveys of plastic surgery applicants for the years 1992, 2005, 2011, and 2022. Data were compared using pairwise χ2 goodness of fit tests. RESULTS The sex distribution of plastic surgery applicants changed significantly over the last 30 years: whereas men predominated in 1992 (86% male vs 14% female), by 2011, the distribution was nearly equal (54% male vs 46% female in both 2011 and 2022, P < 0.001).The racial makeup of applicants also changed over time (P < 0.05). White applicants decreased from 73% in 1992 to 55% in 2011, and 53% in 2022. While there was an increase in Asian (7% to > 17% to > 20%) and other (13% to > 14% to > 21%) applicants over time, whereas the proportion of Black applicants remained stagnant (5% to > 6% to > 8%).Applicants with prior general surgery experience declined precipitously over the years: 96% in 1992, 64% in 2005, 37% in 2011, and 26% in 2022 (P < 0.001). When compared with 1992, Alpha Omega Alpha status increased significantly in 2011 (36% vs 12%, P < 0.05) but did not change considerably in 2005 (22%) and 2022 (23%). Research experience increased dramatically over the years, with the proportion of applicants with at least one publication going from 43% in 1992, to 75% in 2005, to 89% in 2011, and to 99% in 2022 (P < 0.001). Applicant interest in academic plastic surgery did not change considerably over the years at roughly ranging from 30% to 50% of applicants (P = ns). CONCLUSIONS There has been a shift in the demographics and academic qualifications of plastic surgery applicants over the last 3 decades. Understanding this evolution is critical for reviewing and evaluating the makeup of our specialty, and enacting changes to increase representation where necessary.
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Affiliation(s)
- Kshipra Hemal
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Sofia Perez-Otero
- New York University Grossman School of Medicine, NYU Langone Health, New York, NY
| | - Carter J Boyd
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Katie E Weichman
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Oriana D Cohen
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Vishal D Thanik
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Daniel J Ceradini
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
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Hernandez Alvarez A, Valentine L, Bustos VP, Foppiani J, Weidman AA, Foster L, Lee D, Escobar-Domingo MJ, Lee BT, Lin SJ. Racial and ethnic representation in united states plastic surgery clinical trials: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2024; 91:430-437. [PMID: 38484437 DOI: 10.1016/j.bjps.2024.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024]
Abstract
In 1993, the National Institutes of Health Revitalization Act mandated increasing minority and women enrollment in clinical trials (CTs). This study aimed to investigate trends in race and ethnicity enrollment and reporting in US plastic and reconstructive surgery (PRS) CT. METHODS A comprehensive systematic review was performed. All CTs in PRS from 2012 to 2022 were included. To assess racial and ethnic representation within CTs, a random-effects meta-analysis of proportion was conducted to pool the prevalence of the binomial data. RESULTS A total of 3609 studies were initially identified in the search strategy, with 154 later classified as CTs in PRS. Only 36 met the eligibility criteria for reporting race and ethnicity and were included in the analysis. A total of 7281 participants were included: 446 (6.1%) males and 6835 (93.9%) females. From CTs that correctly reported race, the pooled prevalence of races were as follows: Whites 78% (95% confidence interval [CI] 73-82%), Black or African Americans 8% (95% CI 5-11%), Asians 1% (95% CI <1-2%), American Indians <1% (95% CI <1-<1%), and Pacific Islanders <1% (95% CI <1-<1%). From the studies that reported ethnicity correctly, the pooled prevalence of Hispanics was 7% (95% CI 5-9%), and Non-Hispanics was 12% (<1-38%). CONCLUSIONS Disparities in minority representation were present among PRS CTs. This suggests clear limitations in generalizing PRS CT results to the population. Efforts to decrease the gap in minority enrollment and accurately report race and ethnicity are needed in all fields, including plastic surgery.
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Affiliation(s)
| | - Lauren Valentine
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Valeria P Bustos
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jose Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Allan A Weidman
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Lacey Foster
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniela Lee
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Bernard T Lee
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Samuel J Lin
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Adeboye T, Oni G. Gender parity at the podium in UK plastic surgery conferences. J Plast Reconstr Aesthet Surg 2024:S1748-6815(23)00797-0. [PMID: 38296723 DOI: 10.1016/j.bjps.2023.11.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/04/2023] [Accepted: 11/15/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Despite the increase in the proportion of female plastic surgeons in the United Kingdom (UK), all-male panels continue to prevail. This article sought to establish whether the genders of speakers at conferences hosted by leading UK plastic surgery associations, the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), and the British Association of Aesthetic Plastic Surgeons (BAAPS), are representative of the consultant workforce. METHODS Data on the gender distribution of plastic surgeons in the workforce over the last decade were obtained from NHS Digital Workforce Statistics. The demographics of invited speakers were sought from conference agendas for both BAPRAS (from 2012 to 2022) and BAAPS (from 2014 to 2021) posted on their association's websites. RESULTS The proportion of female consultants increased from 16% in 2012 to 22% in 2022. The average proportion of female speakers at BAPRAS conferences was 16% ± 9% SD that was similar to the proportion of female consultants in practice (p = 0.432). In contrast, the average proportion of female speakers at BAAPS conferences was lower than those in practice (7.88% ± 8.29% SD, p = 0.0032). At BAAPS, 43% of speakers were UK plastic surgeons. CONCLUSIONS Although the podium speakers at BAPRAS were reflective of the consultant population, BAAPS had little to no representation of UK based female plastic surgeons. Therefore, the conference organisers need to intentionally ensure that representation at podium is reflective of the workforce.
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Affiliation(s)
- Teniola Adeboye
- Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
| | - Georgette Oni
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; University of Nottingham, Nottingham, United Kingdom
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Smith RM, Rathore S, Donnelly D, Nicksic PJ, Poore SO, Dingle AM. Diversity Drives Innovation: The Impact of Female-Driven Publications. Aesthet Surg J 2022; 42:1470-1481. [PMID: 35640257 DOI: 10.1093/asj/sjac137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Gender disparities are pervasive in academic plastic surgery. Previous research demonstrates articles authored by women receive fewer citations than those written by men, suggesting the presence of implicit gender bias. OBJECTIVES The aim of this study was to describe current citation trends in plastic surgery literature and assess gender bias. The expectation was that women would be cited less frequently than their male peers. METHODS Articles published between 2017 and 2019 were collected from 8 representative plastic surgery journals stratified by impact factor. Names of primary and senior authors of the 50 most cited articles per year per journal were collected and author gender was determined via online database and internet search. The median numbers of citations by primary and senior author gender were compared by Kruskal-Wallis test. RESULTS Among 1167 articles, women wrote 27.3% as primary author and 18% as senior author. Women-authored articles were cited as often as those authored by men (P > 0.05) across all journal tiers. Articles with a female primary and male senior author had significantly more citations than articles with a male primary author (P = 0.038). CONCLUSIONS No implicit gender bias was identified in citation trends, a finding unique to plastic surgery. Women primary authors are cited more often than male primary authors despite women comprising a small fraction of authorship overall. Additionally, variegated authorship pairings outperformed homogeneous ones. Therefore, increasing gender diversity within plastic surgery academia remains critical.
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Affiliation(s)
- Rachel M Smith
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Srishti Rathore
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - D'Andrea Donnelly
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - Peter J Nicksic
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - Samuel O Poore
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - Aaron M Dingle
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
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The Impact of Senior Author Profile on Publication Level of Evidence in Plastic and Reconstructive Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4506. [PMID: 36203739 PMCID: PMC9529031 DOI: 10.1097/gox.0000000000004506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
Abstract
Plastic and Reconstructive Surgery (PRS) incorporated the level of evidence (LOE) pyramid in 2011 to highlight evidence-based medicine in plastic surgery. This study aimed to assess the relationship between the profile of senior authors publishing in PRS and the LOE of publications.
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