A trend, analysis, and solution on women's representation in diagnostic radiology in North America: a narrative review

Despite the demonstrated benefits of gender diversity in medicine, women in Radiology in North America are still underrepresented. We reviewed the literature to highlight the current status of women in Radiology in North America, identify the underlying causes of the gender gap, and provide potential strategies to close this gap. We conducted a narrative literature review using the terms ("Gender Disparity" OR "Gender Inequality") AND ("Radiology Department" OR "Radiology Residency"), searching data from April 2000 to April 2022 in Ovid Medline, Embase, PubMed, and Scopus. Our results indicate that Radiology in North America lacks gender diversity in its subspecialties, academic leadership, and research productivity, which the COVID-19 pandemic has further exacerbated. Challenges stemming from a dearth of women role models, limited preclinical contact, and a high rate of burnout contribute to the current gender inequality. Several complementary and supplementary steps can enhance gender diversity in Radiology. These include increasing education and exposure to Radiology at earlier stages and optimizing mentorship opportunities to attract a more diverse pool of talent to the discipline. In addition, supporting resident parents and enhancing the residency program's culture can decrease the rate of burnout and encourage women to pursue careers and leadership positions in Radiology.

Authorship gender among articles about artificial intelligence in breast imaging

RATIONALE AND OBJECTIVES

The purpose of this study is to investigate the variance of women authors, specifically first and senior authorship among peer-reviewed artificial intelligence-related articles with a specific focus in breast imaging.

MATERIALS AND METHODS

A strategic search was conducted in July 2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to capture all existing and publicly available peer-reviewed articles intersecting AI and breast imaging. Primary outcomes were first and senior authors' gender, which were assigned with the aid of an emailed self-declaration survey. Secondary outcomes included country of article, journal impact factor, and year of publication. Comparisons were made using logistic regression models and analysis of variances.

RESULTS

115 studies were included in the analysis. Women authors represented 35.7% (41/115) and 37.4% (43/115) of first and senior authors, respectively. Logistic regression modelling showed a significant increase in women senior authors over time but no changes in women first authors. Impact factor was not associated with female authorship and certain countries had women authorship reach over 50%.

CONCLUSION

This study demonstrates that there is a significant authorship gender gap in artificial intelligence breast imaging research. An increasing temporal trend of senior authors in breast imaging AI-related research is a promising prognosis for more women voices in this field. Further study needs to be done to understand the reasons behind this gap and any potential implications.

Gender Differences in Academic Rank, Leadership, and Awards Among NIH Grant Recipients in Diagnostic Radiology

Objective: Females have been traditionally underrepresented in academia across multiple medical specialties, including radiology. The present study investigated primary investigators (PIs) who received National Institutes of Health (NIH) radiology funding between 2016 and 2019 to establish if there was a correlation between NIH grants, gender, academic rank, first and second tier leadership positions, geographic location, and professional awards. Materials and Methods: Funding information was obtained from the NIH Research Portfolio Online Reporting Tools Expenditure and Results (RePORTER) website for 2016-2019. Information for each PI was obtained from academic institutional websites, LinkedIn, and Doximity. Mann-Whitney U tests and chi-square analyses were performed to compare and determine associations between gender and the stated variables of interest. Results: Of the 805 radiology PIs included in this study, 78% were male. There was a significant association of gender with the attainment of the highest academic rank (p = 0.026), with females occupied more of the assistant professor ranks (M:F = 1:1.5) and less of the professor ranks (F:M = 1:1.2). Between genders, there was no significant difference in first and second tier leadership positions (p = 0.497, p = 0.116), and postgraduate honors and awards (p = 0.149). The greatest proportion of grants was awarded in the setting of sole male PIs (55%) and the least proportion of grants were awarded when the contact PI and other project leader were female (1%). Conclusion: Despite having similar academic credentials, including number of leadership positions and postgraduate honors and awards, female radiology PIs who have received NIH grants continue to be underrepresented in higher academic ranks.

Female Authorship Trends Among Articles About Artificial Intelligence in North American Radiology Journals

Purpose: To examine trends in female authorship of peer-reviewed North American radiology articles centred around artificial intelligence (AI). Method: A bibliographic search was conducted for all AI-related articles published in four North American radiology journals. Collected data included the genders of the first and last (senior) authors, year and country. We compared the trends of female authorship using Pearson chi-square, Fisher exact tests and logistic regression models. Results: 453 articles met the inclusion criteria. Among these, 107 (22.3%) had a female first author and 97 (27.3%) had a female senior author. Female first authors were over three times more likely to publish with a female senior author. Among the four journals, the CARJ had the highest proportion of female senior authors at 45.5%. The only significant temporal trend identified was an increase over the years in female senior authors in Radiology. Twenty-four countries contributed to the included articles, with the largest contributors being the United States (n = 290) and Canada (n = 30). Of the countries contributing more than 15 articles, there were none with above 50% female authorship. Conclusions: Female authors are underrepresented in AI-related radiology literature. However, there has been an encouraging recent increase in female authorship in AI-related radiology articles trending towards significance. There is a great opportunity to improve female representation in AI with intentional mentorship and recruitment. We urge more platforms for female voices in radiology as AI becomes increasingly integrated into the radiology community.

The Status of Diversity in Canadian Radiology-Where We Stand and What Can We Do About It

Radiology has been identified as one of the medical specialties with the least gender, racial, and ethnic diversity. Despite the demonstrated benefits of gender and race diversity in medicine and industry, including innovation, empathy and improved patient outcomes, diversity in radiology in Canada is still lacking. In 2019, women represented around 63% of current medical graduates. However, within Canadian radiology practices, only 31.6% of radiologists are women. Women are also underrepresented in academic positions and the widening gender gap is present at higher academic ranks, indicating that women may not advance through academic hierarchies at the same pace as men. Although data on racial diversity in Canadian radiology practices is currently lacking, the representation of visible minorities in the general Canadian population is not reflected across Canadian radiology practices. Similarly, despite the Canadian Truth and Reconciliation Commission calling for action to increase the number of Indigenous healthcare workers, Indigenous people remain underrepresented in medicine and radiology. The importance of increasing diversity in radiology has gained recognition in recent years. Many solutions and strategies for national associations and radiology departments to improve diversity have been proposed. Leadership commitment is required to implement these programs to increase diversity in radiology in Canada with the ultimate goal of improving patient care. We review the current literature and available data on diversity within radiology in Canada, including the status of gender, race/ethnicity, and Indigenous people. We also present potential solutions to increase diversity.