The status of academic interventional radiologists in Germany with focus on gender disparity: how can we do better?

PURPOSE

The aim was to characterize the framework conditions in academic interventional radiology (IR) in Germany with focus on differences between genders.

MATERIALS AND METHODS

After IRB approval, all members of The German Society for Interventional Radiology and Minimally Invasive Therapy (n = 1,632) were invited to an online survey on work and research. Statistical comparisons were undertaken with the Fisher's exact test, Wilcoxon rank sum test or Pearson's Chi-squared test.

RESULTS

From 267 available questionnaires (general response rate 16.4%), 200 were fully completed. 40% of these (78/200) were involved in research (71% men vs. 29% women, p < 0.01) and eligible for further analysis. Of these, 6% worked part-time (2% vs. 17%, p < 0.05). 90% of the respondents spent less than 25% of their research during their paid working hours, and 41% performed more than 75% of their research during. leisure time. 28% received exemption for research. 88% were (rather) satisfied with their career. One in two participants successfully applied for funding, with higher success rates among male applicants (90% vs. 75%) and respondents with protected research time (93% vs. 80%). Compared to men, women rated their entrance in research as harder (p < 0.05), their research career as more important (p < 0.05), felt less noticed at congresses (93% vs. 53%, p < 0.01), less confident (98% vs. 71%, p < 0.01), and not well connected (77% vs. 36%, p < 0.01).  CONCLUSION: Women and men did research under the same circumstances; however, women were underrepresented. Future programs should generally focus on protected research time and gather female mentors to advance academic IR in Germany.

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.

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.

Female participation or "feminization" of medicine

More and more women chose medicine as their profession. Female students and graduates outnumber their male colleagues in Austria and the EU. However, the career paths of men and women differ after a certain point, and more and more female talent is lost along the career stages. Women hold only 30% of professor positions at state medical universities in Austria and only 11.9% of all chief physicians are female. Motherhood and related absence is the main career obstacle, but gender bias and missing role models are also factors hindering women to thrive. Improved working conditions would be beneficial for all members of the medical profession. Future generations (Generation Y, Generation Z) will likely expedite changes toward a better work-life balance and claim the right to find fulfillment besides work. Compatibility of family and work and the chance to individualize career paths could be important factors for employers to find and bind their employees. Additionally, (gender) diverse teams improve the group process and collective intelligence. Therefore, patient care and innovation can only benefit from a diverse medical workforce.

Assessing the gender gap in musculoskeletal radiology authorship across three continents: are really the "ladies first"?

AIM

To assess gender-specific authorship trends in musculoskeletal (MSK) radiology in three major radiology journals, Skeletal Radiology (SR), Clinical Radiology (CR) and Indian Journal of Radiology and Imaging (IJRI).

MATERIALS AND METHODS

Retrospective analysis of articles pertaining to MSK radiology was done for the years 2000, 2010, and 2020 for SR and CR and for the years 2010 and 2020 for IJRI. The number and positions of female authors was noted.

RESULTS

Three hundred and twenty-five articles were reviewed after excluding the articles where the gender of one or more authors could not be conclusively determined. In SR, the percentage of female authors increased significantly from 4% in 2000 to 17% in 2010 (p<0.0001) and to 21.9% in 2020 (p<0.0001) with an increase in the percentage of first female authors from 0.8% in 2000 to 4.9% in 2010 and further to 5.4% in 2020. In CR, the percentage of female authors reduced from 13.8% in 2000 to 13.6% in 2010 (p=0.9798 and further reduced to 7% in 2020 (p=0.1592). In IJRI, the percentage of articles with no female authors went down from 36.4% (2010) to 26.7% (2020).

CONCLUSION

There is an upward trend in female authorship in MSK radiology related articles in SR and IJRI with continued under-representation in CR. The first and middle order female authors have shown a significant increase, although the number of last female authors remains very low. Analysis of such trends in academic journals from other subspecialities in medicine needs to be undertaken to confirm or refute the findings of this study.

Sticky Floor and Glass Ceilings in Academic Medicine: Analysis of Race and Gender

Purpose This paper examines the changes in the representation of women and racial minorities in academic medicine, compares the proportion of minorities in medicine and the general United States (US) population, and discusses potential explanations for observed trends. Methods A retrospective cross-sectional analysis of the Association of American Medical Colleges (AAMC) database was done and used to collect data on the gender and race of physicians in academic medicine. Data was collected for instructors, assistant professors, associate professors, full professors, and chairpersons from 2007 to 2018, and trends were presented. Results White physicians represented most academic physicians at every academic level, peaking in proportion at 82.74% of chairpersons and were lowest at the level of instructor at 59.30%. A similar distribution existed when gender was compared, with men comprising 84.67% of chairpersons and forming the majority at levels of full, associate, and assistant professors. However, most physicians at the level of instructors are women at 55.44%. Conclusions Though women and racial minorities have gained greater representation in academic medicine over the past decade, high-level academic positions are not as accessible to them. Existing efforts of advocacy for women and minority races have proven fruitful over the past decade, but much more work needs to be done.

A comprehensive analysis of authorship trends in Skeletal Radiology since inception from 1976 to 2020

OBJECTIVE

The purpose of this study is to explore authorship trends within the musculoskeletal radiology subspecialty-focused journal, Skeletal Radiology, from inception to 2020.

MATERIALS AND METHODS

Skeletal Radiology articles published in 1976, 1986, 1996, 2006, 2016, and 2020 were reviewed. For each article, the number of authors, the number of distinct institutions, the names of first and last authors, the country of the first author, the article length, and the number of article references were recorded.

RESULTS

A total of 885 articles passed the exclusion criteria to be included in the study. Since inception, there has been a significant increase in the number of SR articles published (P = 0.02), the mean number of authors per article (P < 0.01), the mean number of references per article (P < 0.01), the mean number of distinct institutions per article (P = 0.02), and the mean number of pages per article (P < 0.01). The proportion of female first and last authors significantly increased (P = 0.02, P = 0.02). There was a significant increase in the proportion of articles published from Asia (P = 0.04). However, no significant changes in the proportion of articles published from other regions were observed.

CONCLUSION

Similar to authorship trends in other medical journals, Skeletal Radiology demonstrated upward trends in authorship count, distinct institutional count, and article length. A rise in first and last female authorship was observed. Finally, an increase in the proportion of authors from Asia was observed while no significant changes in the proportion of authors from other regions were demonstrated.

Examining the Gender Gap in Emergency Medicine Research Publications

STUDY OBJECTIVE

The objective of this study was to describe the proportion of female authors on original research articles and editorials across 4 emergency medicine journals from 2013 to 2019. A secondary objective was to examine the gender composition of middle authors in relation to the genders of their respective first and last authors.

METHODS

In this observational study, we selected 4 journals in emergency medicine using the Journal of Citation Reports and prior literature to analyze genders of all authors from research articles and editorials published from January 2013 to September 2019. Reviewers identified author genders through web searches with matching academic qualifications or used a gender identification application programming interface to identify likelihood of male or female identity. The primary outcome was the proportion of female authors in each position.

RESULTS

Selected publications included 2,980 original research articles with 18,224 authors (median 6, interquartile range [IQR] 4 to 8) and 433 editorials with 986 authors (median 2, IQR 1 to 2). Women occupied 34.9%, 24.3%, and 36.5% of first, last, and middle author positions on original research articles and 23.8%, 20.5%, and 34.2% of first, last, and middle author positions among editorials, respectively. Publications with female first and last authors (n=340 articles) had a larger proportion of female middle authors (49%, 634/1,290) compared to publications with male first and last authors (n=1667 articles, female middle authors 33% [2,215/6,771]).

CONCLUSION

Over the 7 years examined, female authorship in these emergency medicine journals increased. A more pronounced gender gap exists in editorial authorship compared to research articles. On publications where the first and last author were women, a higher proportion of middle authors were women.

Training Programs for Fundamental and Clinician-Scientists: Balanced Outcomes for Graduates by Gender

Background:

Women scientists are less likely to obtain Assistant Professorship and achieve promotion, and obtain less grant funding than men. Scientist/clinician-scientist training programs which provide salary awards as well as training and mentorship are a potential intervention to improve outcomes among women scientists. We hypothesized whether a programmatic approach to scientist/clinician-scientist training is associated with improved outcomes for women scientists in Canada when compared with salary awards alone. Trainees within the Kidney Research Scientist Core Education and National Training Program (KRESCENT), Canadian Child Health Clinician Scientist Program (CCHCSP), and the Canadian Institutes of Health Research (CIHR) salary award programs were evaluated.

Objective:

To examine whether the structured KRESCENT training program with salary support improves academic success for women scientists relative to salary awards alone.

Design:

Retrospective cohort study.

Setting:

Canadian national research scientist and clinician-scientist training programs and salary awards.

Participants:

KRESCENT cohort (n = 59, 2005-2017), CCHCSP cohort (n = 58, 2002-2015), and CIHR (n = 571, 2005-2015) Salary Awardees for postdoctoral fellows (PDF) and new investigators (NI).

Measurements:

National operating grant funding success, achieving an academic position as an Assistant Professor for PDF, or achieving promotion to Associate Professor for NI.

Methods:

The gender distribution of each cohort was determined using first name and NamepediA and was examined for PDF and NI, followed by a description of trainee outcomes by gender and training level.

Results:

KRESCENT and CIHR PDF were balanced (12/27, 44% men and 55/116, 47% women) while CCHCSP had a higher proportion of women (13/20, 65%). KRESCENT and CCHCSP NI retained women scientists (19/32, 59% and 22/38, 58% women), whereas CIHR NI had fewer women (165/455, 36% women vs 290/455, 64% men, P = 0.01). There was a high rate of NI operating grant success (91%-95%) with no gender differences in each cohort. There was a high proportion of CCHCSP PDF who achieved an Assistant Professorship (18/20, 90%) that may be due in part to a longer follow-up period (9.3 ± 3 years) compared with KRESCENT PDF (7/27, 26%, 0.88 ± 4.5 years), and these data were not available for CIHR PDF. Women KRESCENT NI showed increased promotion to Associate Professor (P = 0.02, 0.25 ± 3.2 years follow-up) and CCHCSP NI had high promotion rates (37/38, 97%, 6.9 ± 3.6 years follow-up) irrespective of gender. There was an overall trend toward more men pursuing biomedical research.

Limitations:

KRESCENT and CCHCSP training program cohort size and heterogeneity; assigning gender by first name may result in misclassification; lack of data on the respective applicant pools; and inability to examine intersectionality with gender, ethnicity, and sexual orientation.

Conclusion:

Overall trainee performance across programs is remarkable by community standards regardless of gender. KRESCENT and CCHCSP training programs demonstrated balanced success in their PDF and NI, whereas the CIHR awardees had reduced representation of women scientists from PDF to NI. This exploratory study highlights the utility of programmatic training approaches like the KRESCENT program as potential tools to support and retain women scientists in the academic pipeline during the challenging PDF to NI transition period.

Impact of COVID-19 on Radiology Faculty - An Exacerbation of Gender Differences in Unpaid Home Duties and Professional Productivity

RATIONALE AND OBJECTIVES

The COVID-19 pandemic stresses the tenuous balance between domestic obligations and academic output for women across professions. Our investigation aims to evaluate the impact of the pandemic on the home duties and workplace productivity of academic radiologists with respect to gender.

MATERIALS AND METHODS

A 49-question survey was distributed to 926 members of Association of University Radiologists in October 2020. Several categories were addressed: demographics; workplace changes; stress levels and personal experiences with illness; time spent on domestic obligations; and perception of productivity during COVID-19. Statistical analyses were performed using SAS version 9.4 software (SAS Institute, Cary, NC).

RESULTS

A total of 96 responses across 30 states, 53.1% male and 46.9% female were received. Women report spending more time on unpaid domestic duties than men prior to COVID-19, with men spending a median of 5-10 h/wk and women spending a median of 10-15 h/wk (p = 0.043). With pandemic onset, both genders reported that women did more of the homecare, when not split equally. Women with young children reported a significant decrease in work-from-home productivity compared to men with young children (p = 0.007). Men reported they had more time to be productive compared to women (p = 0.012).

CONCLUSION

The COVID-19 pandemic threatens to disrupt the advancement of women in radiology leadership roles by creating disparate effects on productivity due to increased workloads at home for women. This could potentially lead to decreases in promotions and research productivity in years to come that far outlast the acute phases of the pandemic.

Author Gender Inequality in Medical Imaging Journals and the COVID-19 Pandemic

Background Early reports show the unequal effect the COVID-19 pandemic might have on men versus women engaged in medical research. Purpose To investigate whether the COVID-19 pandemic has had an impact on scientific publishing by female physicians in medical imaging. Materials and Methods The authors conducted a descriptive bibliometric analysis of the gender of the first and last authors of manuscripts submitted to the top 50 medical imaging journals from March to May 2020 (n = 2480) compared with the same period of the year in 2018 (n = 2238) and 2019 (n = 2355). Manuscript title, date of submission, first and last names of the first and last authors, journal impact factor, and author country of provenance were recorded. The Gender-API software was used to determine author gender. Statistical analysis comprised χ2 tests and multivariable logistic regression. Results Percentages of women listed as first and last authors were 31.6% (1172 of 3711 articles) and 19.3% (717 of 3711 articles), respectively, in 2018-2019 versus 32.3% (725 of 2248 articles) and 20.7% (465 of 2248 articles) in 2020 (P = .61 and P = .21, respectively). For COVID-19-related articles, 35.2% (89 of 253 articles) of first authors and 20.6% (52 of 253 articles) of last authors were women. No associations were found between first- and last-author gender, year of publication, and region of provenance. First and last authorship of high-ranking articles was not in favor of North American women whatever the year (odds ratio [OR], 0.79 [P = .05] and 0.72 [P = .02], respectively). Higher rates of female last authorship of high-ranking articles were observed in Europe (P = .003) and of female first authorship of low-ranking publications in Asia in 2020 (OR, 1.38; 95% CI: 0.98, 1.92; P = .06). Female first and last authorship of COVID-19-related articles was overrepresented for lowest-rank publications (P = .02 and P = .01, respectively). Conclusion One in three first authors and one in five last authors were women in 2018-2019 and 2020, respectively. Although the first 2020 lockdown did not diminish the quantity of women-authored publications, the impact on the quality was variable. ©RSNA, 2021 See also the editorial by Robbins and Khosa in this issue.

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 trends in authorships and publication impact in Academic Radiology-a 10-year perspective

Objectives

To analyze the development of publication numbers of female authors in high-, medium-, and low-impact radiological journals.

Methods

In this bibliometric analysis, gender of the first (FA) and senior author (SA) was assigned to all original research articles and reviews, published in 10 high-, medium-, and low-impact radiological journals in 2007/8 and 2017/18. The adjusted event rate (AER) and adjusted odds ratio (AOR) were calculated using mixed logistic and multinomial logistic regression models to assess and compare female publications according to impact factor, journal, author position, and combination.

Results

The proportion of female FA and female SA in N = 6979 (2007/2008) and N = 7383 (2017/2018) articles increased to 29.1% and 16.1% in 2017/2018, respectively. While most female authorships were continuously observed in medium-impact journals, the strongest increase occurred for both female FA (AOR 2.0; p < .0001) and SA (AOR 2.1; p < .0001) in low-impact journals. Female SA published significantly more often in a low- (AOR 1.5) or medium- (AOR 1.8) than in a high-ranking journal. Among the high-ranking journals, female FA published most frequently in European Radiology (32.4%; 95% CI [29.3–35.8]; p < .0001), female SA in Investigative Radiology (15.9%; 95% CI [13.7–18.4]; p < .0001). Male same-sex authorships decreased (AOR 0.9), but remained at least twice as common as all-female or mixed authorships.

Conclusion

The increase in female authorship is reflected in all impact areas. Female FA and SA increased most in low-ranking journals but are most common in medium-ranking journals. Female SA remain rare, especially in high impact journals.

Key Points

• Compared to the proportion of female radiologists worldwide, female senior authors are underrepresented in all impact areas, in particular in high-impact journals.

• Among the included high-ranking radiological journals, female first authors and senior authors were strongest represented in European Radiology and Investigative Radiology, while across all impact areas they mostly published in medium-ranking journals.

• Female author combinations were more frequent in low- and medium- than in high-ranking journals, whereas male author combinations remained more common than female senior author collaborations in all impact areas.

Is Empowerment of Female Radiologists Still Needed? Findings of a Systematic Review

Considering that radiology is still a male-dominated specialty in which men make up more than two thirds of the workforce, this systematic review aimed to provide a comprehensive overview of the current role of women in radiological imaging, focusing on the main aspects such as career progression, leadership, academic practice, and perceived discrimination. Three electronic databases were searched up to 21 October 2020. To identify additional records, weekly automatic email alerts were set up on PubMed until December 2020 and reference lists of key studies and included papers were screened. Two reviewers independently performed the search, study selection, quality appraisal, data extraction, and formal narrative synthesis. In case of disagreement, a third reviewer was involved. Across the 61 included articles, women worked more often part-time and held fewer positions of power in hospitals, on editorial boards, and at the academic level (associate and full professors). Women were less often in relevant positions in scientific articles, had fewer publications, and had a lower H-index. Discrimination and sexual harassment were experienced by up to 40% and 47% of female radiologists, respectively. Our study highlights that women in radiology are still underrepresented and play a marginal role in the field, struggling to reach top and leading positions.

Gender Differences in First and Corresponding Authorship in Public Health Research Submissions During the COVID-19 Pandemic

Objectives. To investigate the rate of manuscript submission to a major peer-reviewed journal (American Journal of Public Health) by gender, comparing periods before and during the pandemic.Methods. We used data from January 1 to May 12, 2020, and defined the start of the pandemic period by country as the first date of 50 or more confirmed cases. We used an algorithm to classify gender based on first name and nation of origin. We included authors whose gender could be estimated with a certainty of at least 95%.Results. Submission rates were higher overall during the pandemic compared with before. Increases were higher for submissions from men compared with women (41.9% vs 10.9% for corresponding author). For the United States, submissions increased 23.8% for men but only 7.9% for women. Women authored 29.4% of COVID-19-related articles.Conclusions. Our findings suggest that the pandemic exacerbated gender imbalances in scientific research.

Are Women Disadvantaged in Academic Radiology?

RATIONALE AND OBJECTIVES

Women remain underrepresented in leadership positions in radiology. We sought to determine if 1) women are equitably represented in the senior author positions in radiology journals and 2) if women's contributions to the radiology literature and their individual productivity are proportional to their representation at senior academic rank.

MATERIALS AND METHODS

The gender of 3,702 first and last authors listed for manuscripts published in nine high-impact American radiology journals was assessed between 2002-2017. For the same years, the gender composition of academic faculty and ranks based on AAMC data was queried. Statistical tests were employed to detect discrepancies and changes over time.

RESULTS

First authorship by women grew from 26.9% to 37.4% and from 15.7% to 23.9% as senior author between 2002-2017 (P<.0001). Although the index of manuscript productivity rate was nearly equal for men and women over the 16-year study period, women remained under-represented in senior radiology faculty rank over the same period.

CONCLUSIONS

Although women have proportionally increased their contribution to the radiology literature over the years, commensurate increased representation of women in senior authorship and faculty positions was not observed. Despite increased involvement of women in research over time, they remain disproportionately at junior faculty positions.

Does double-blind peer review impact gender authorship trends? An evaluation of two leading neurosurgical journals from 2010 to 2019

OBJECTIVE

Publications are key for advancement within academia. Although women are underrepresented in academic neurosurgery, the rates of women entering residency, achieving board certification, and publishing papers are increasing. The goal of this study was to assess the current status of women in academic neurosurgery publications. Specifically, this study sought to 1) survey female authorship rates in the Journal of Neurosurgery (JNS [not including JNS: Spine or JNS: Pediatrics]) and Neurosurgery from 2010 to 2019; 2) analyze whether double-blind peer review (started in Neurosurgery in 2011) altered female authorship rates relative to single-blind review (JNS); and 3) evaluate how female authorship rates compared with the number of women entering neurosurgery residency and obtaining neurosurgery board certification.

METHODS

Genders of the first and last authors for JNS and Neurosurgery articles from 2010 to 2019 were obtained. Data were also gathered on the number and percentage of women entering neurosurgery residency and women obtaining American Board of Neurological Surgeons (ABNS) certification between 2010 and 2019.

RESULTS

Women accounted for 13.4% (n = 570) of first authors and 6.8% (n = 240) of last authors in JNS and Neurosurgery publications. No difference in rates of women publishing existed between the two journals (first authors: 13.0% JNS vs 13.9% Neurosurgery, p = 0.29; last authors: 7.3% JNS vs 6.0% Neurosurgery, p = 0.25). No difference existed between women first or last authors in Neurosurgery before and after initiation of double-blind review (p = 0.066). Significant concordance existed between the gender of first and last authors: in publications with a woman last author, the odds of the first author being a woman was increased by twofold (OR 2.14 [95% CI 1.43-3.13], p = 0.0001). Women represented a lower proportion of authors of invited papers (8.6% of first authors and 3.1% of last authors were women) compared with noninvited papers (14.1% of first authors and 7.4% of last authors were women) (first authors: OR 0.576 [95% CI 0.410-0.794], p = 0.0004; last authors: OR 0.407 [95% CI 0.198-0.751], p = 0.001). The proportion of women US last authors (7.4%) mirrors the percentage of board-certified women neurosurgeons (5.4% in 2010 and 6.8% in 2019), while the percentage of women US first authors (14.3%) is less than that for women entering neurosurgical residency (11.2% in 2009 and 23.6% in 2018).

CONCLUSIONS

This is the first report of female authorship in the neurosurgical literature. The authors found that single- versus double-blind peer review did not impact female authorship rates at two top neurosurgical journals.

Women in contemporary cancer research

Despite recent advances, gender inequality persists in many scientific fields including medicine. Thus far, no study has extensively analyzed the gender composition of contemporary researchers in the oncology field. We examined 40 oncological journals (Web of Science, Oncology category) with different impact factors (Q1-Q4) and extracted all the articles and reviews published during 2015-2017 in order to identify the gender of their authors. Our data showed that women represent about 38% of all the authorships, both in articles and reviews. In relative terms, women are overrepresented as first authors of articles (43.8%), and clearly underrepresented as last or senior authors (<30%). This double pattern, also observed in other medical fields, suggests that age, or more specifically, seniority, may play some role in the gender composition of cancer researchers. Examining the pattern of collaboration, an interesting finding was observed: the articles signed by a woman in the first or in the last position roughly showed gender parity in the byline. We also found some differences in the content of the articles depending on which gender occupies the first and last positions of the authorships.

Gender Authorship in the Field of Clinical Chemistry

BACKGROUND

Gender underrepresentation has long existed in the science, technology, engineering, and mathematics fields. While there are upward trends in many areas of the life and health sciences, some disciplines are underrepresented in female author numbers, including first and corresponding authors. This study evaluated the participation by women as authors in the field of clinical chemistry.

METHODS

Clinical Chemistry and The Journal of Applied Laboratory Medicine were selected for data collection. Data were classified into four categories: total number of authors for each article, number of female authors for each article, whether the first author was female, and whether the corresponding author was female. From these data, the percentages of female authors, articles with female first authors, articles with female corresponding authors, and articles where a female was either first or corresponding author were calculated.

RESULTS

Both journals had ≥40% total female authorship, ≥45% female first author, and 64% female first or corresponding author. The 40% female author number matched the percentage of female doctoral degree, board certified clinical chemists, and the 39% female PhDs and MDs in academic clinical pathology departments. Compared with a selected group of science or medicine journals and gender reports, Clinical Chemistry and The Journal of Applied Laboratory Medicine exceeded most journals and gender reports in female total authorship, first author, and corresponding author.

CONCLUSIONS

Women are well represented as authors in these two clinical chemistry journals. Both journals compare favorably against other scientific/medical journals. Female authorship in these two journals also parallels gender composition of the field of clinical chemistry.

Women in radiology: why is the pipeline still leaking and how can we plug it?

Today, >50% of medical students are women. This proportion, however, dramatically decreases throughout the higher levels of academia, a phenomenon described as the "leaky pipeline." This gender disparity is particularly pronounced in academic radiology, mirrored by a significant lack of women in editorial board positions, key authorship positions, and conference keynote lectures. The scientific invisibility is not only a key hurdle facing women in radiology, the lack of female role models and mentors in this context might also negatively affect career choices of young female radiologists thereby further widen the existing gender gap. In this article, the origins of the "leaky pipeline," the reasons for women's choice or rejection of careers in academic medicine, as well as solutions as to how the continued loss of a large part of the talent pool can be prevented, are discussed. Active monitoring and intervention are needed to identify problems, plan targeted actions, and evaluate their efficacy. Among those are measures that address a lack of support in the workplace, specific mentoring needs of women, flexible working hours and opportunities to align work and family, financial constraints, and support for returners after career breaks. Cooperative steps of politics and universities need to be taken that ensure a sustainable way forward to enable many talented women in radiology to achieve their full potential.

Women in radiology: gender diversity is not a metric-it is a tool for excellence

Women in Focus: Be Inspired was a unique programme held at the 2019 European Congress of Radiology that was structured to address a range of topics related to gender and healthcare, including leadership, mentoring and the generational progression of women in medicine. In most countries, women constitute substantially fewer than half of radiologists in academia or private practice despite frequently accounting for at least half of medical school enrolees. Furthermore, the proportion of women decreases at higher academic ranks and levels of leadership, a phenomenon which has been referred to as a "leaky pipeline". Gender diversity in the radiologic workplace, including in academic and leadership positions, is important for the present and future success of the field. It is a tool for excellence that helps to optimize patient care and research; moreover, it is essential to overcome the current shortage of radiologists. This article reviews the current state of gender diversity in academic and leadership positions in radiology internationally and explores a wide range of potential reasons for gender disparities, including the lack of role models and mentorship, unconscious bias and generational changes in attitudes about the desirability of leadership positions. Strategies for both individuals and institutions to proactively increase the representation of women in academic and leadership positions are suggested. KEY POINTS: • Gender-diverse teams perform better. Thus, gender diversity throughout the radiologic workplace, including in leadership positions, is important for the current and future success of the field. • Though women now make up roughly half of medical students, they remain underrepresented among radiology trainees, faculty and leaders. • Factors leading to the gender gap in academia and leadership positions in Radiology include a lack of role models and mentors, unconscious biases, other societal barriers and generational changes.

International and Geographic Trends in Gender Authorship within Plastic Surgery

BACKGROUND

Professional advancement in academic plastic surgery may depend on scholarly activity. The authors evaluate gender-based publishing characteristics in three international plastic surgery journals.

METHODS

A retrospective review of all articles published in 2016 in the following journals was undertaken: Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, European Journal of Plastic Surgery, Annals of Surgery, and New England Journal of Medicine. Data were collected on lead author gender (first or senior author) and differences in author gender proportions, by journal, by article topic, and by geographic location were evaluated.

RESULTS

Overall, 2610 articles were retrieved: 34.1 percent were from plastic surgery journals, 12.8 percent were from the Annals of Surgery, and 53.1 percent were from the New England Journal of Medicine. There was a lower proportion of female lead authors among plastic surgery journals compared with the Annals of Surgery and the New England Journal of Medicine (31 percent versus 39 percent versus 39 percent; p = 0.001). There were no differences in female lead author geographic location in the Annals of Surgery or the New England Journal of Medicine; within the plastic surgery journals, there were differences (p = 0.005), including a lower proportion arising from East Asia (15 percent) and a higher proportion arising from Canada (48 percent). Within plastic surgery, Plastic and Reconstructive Surgery had the lowest proportion of female lead author (p < 0.001). The proportion of female lead author varied by article topic (p < 0.001) and was notably higher in breast (45.6 percent) and lower in head and neck/craniofacial-orientated articles (25.0 percent).

CONCLUSIONS

There are gender disparities in three mainstream plastic surgery journals-Plastic and Reconstructive Surgery, the Journal of Plastic, Reconstructive and Aesthetic Surgery, the European Journal of Plastic Surgery-and there are lower proportions of lead female authorship compared with the Annals of Surgery and the New England Journal of Medicine. Further research should focus on understanding any geographic disparities that may exist.

Gender Differences in Article Citations by Authors from American Institutions in Major Radiology Journals

Objective

To investigate gender difference patterns in article citations, by first and last authors, in four radiology journals.

Materials and methods

Articles by authors published in four major radiology journals from 1984, 1994, 2004, and 2014 were categorized into 12 subspecialties. The number of citations, references used, co-authors, and length of the article (number of pages) were documented. The genders of first/last authors were determined. Data were analyzed using chi-square and logistic regression.

Results

The gender of the first author was determined in 2679 articles and that of the last author in 2717 articles. Over the selected years, 1984 to 2014, female first authorship grew from 13.0% to 31.5% (p<0.001), and female last authorship grew from 9.3% to 22.1% (p<0.001). Primary female authorship papers were cited less often as compared to males (OR 0.9972, 95% CI: 0.9948-0.9996, p=0.021), after adjusting for publication year and subspecialty. Across most subspecialties, female first authorship received fewer citations. In 1984, primary female authorship papers received on average 28.9 citations versus males at 39.1; in 1994, 50.4 versus 60.8; in 2004, 41.5 versus 44.4; and in 2014, 7.0 versus 7.8. The mean difference in the number of citations received by male and female first authors decreased from 10.47±6.09 in 1984 and 9.49±7.12 in 1994 to 1.93±5.63 in 2004 and 0.79±0.39 in 2014. However, there was no statistical difference demonstrated in article citations between male and female last authorship (OR 0.9990, 95% CI: 0.9966-1.0013, p=0.392).

Conclusions

Primary female authorship garnered fewer citations than men, despite the increasing frequency of authorships. However, this differential in the number of citations is narrowing.

Women Publishing in American Psychological Association Journals: A Gender Analysis of Six Decades

Despite recent advances, gender inequality persists in many scientific fields, and Psychology is not alien to this phenomenon. This study presents the evolution of gender composition in American Psychological Association publications in the past six decades, from 1963 to 2016. Longitudinal analysis revealed an important change: women rose from a tiny 12% to 14% in the 1960s to almost gender parity in the last decade (2010s). The pattern of collaboration (coauthorship) shows that women tend to be slightly overrepresented as first author and underrepresented as the last or senior author. In the last two decades, women outnumber men as "new" American Psychological Association authors (authors who publish for the first time in an American Psychological Association journal). These features and the fact that men's publications tend to encompass a much wider range of years suggest that age may play a role in the gender composition of American Psychological Association contributors.

Prevalence of Female Authors in Case Reports Published in the Medical Literature

Importance

Underrepresentation of female authors in research publications is prevalent, but it is unclear whether this is attributable to sex disparities in research conduct or authorship practices. Case reports are a poorly understood component of the biomedical corpus, and the production of anecdotal observations is not confounded by factors associated with disparities in female representation in research publications. Whether female authorship disparities exist in nonresearch publications of clinical information is unknown.

Objectives

To examine the authorship of case reports and elucidate factors associated with sex disparity.

Design and Setting

Cross-sectional study of all case reports published by US authors in 2014 and 2015 indexed in PubMed performed from July 2015 to July 2018.

Main Outcomes and Measures

The primary outcome measure was the proportion of female first authors. The secondary outcome measures were the proportion of female last authors and female authorship representation among different clinical specialties.

Results

Bibliometric data was abstracted from 20 427 case reports published across 2538 journals. A total of 7252 (36%) and 4825 (25%) case reports had a female first and last author, respectively. In comparison, 44% and 34% of US trainees and physicians, respectively, were female in 2015. Among adult case reports, female authorship was more prevalent in academic environments compared with community settings (34.0% vs 28.2% for female first authors and 23.4% vs 19.7% for female last authors). Across states, the proportions of female first authors and last authors were universally less than the proportions of female trainees and active female physicians, respectively. Female first authorship was associated with larger author teams (odds ratio [OR], 1.02; 95% CI, 1.01-1.03), an academic affiliation (OR, 1.16; 95% CI, 1.06-1.27), and a female last author (OR, 1.58; 95% CI, 1.47-1.70). Relative to general internal medicine, specialties dominated by male clinicians were less frequently associated with female first authors. Several exceptions displaying a relatively equivalent tendency for male and female first authorship included oncology (OR, 0.97; 95% CI, 0.81-1.16), ophthalmology (OR, 0.87; 95% CI, 0.72-1.05), and radiation oncology (OR, 0.94 95% CI, 0.56-1.56).

Conclusions and Relevance

The underrepresentation of women among first and last authors in publications of case reports underscores the pervasiveness of sex disparities in medicine. Collaboration and female mentors may be critical instruments in upsetting longstanding practices associated with sex bias. Not all clinical specialties were associated with lower-than-expected female authorship, and further exploration of specialty-specific norms in publication and mentorship may elucidate specific barriers to female authorship.

An Analysis of Female Plastic Surgery Authorship: Where Are We Today?

BACKGROUND

Authorship in a peer-reviewed journal is highly regarded in both the academic and private sectors of plastic surgery. Recently, several articles have cited an increased contribution from women in the plastic surgery literature; however, none to date has analyzed the demographic trends of these female authors. The purpose of this study was to conduct an analysis of female authors in three well-known plastic surgery journals.

METHODS

Articles published in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Aesthetic Surgery Journal between January of 2015 and December of 2015 were reviewed. Supplemental journal, review, and CME articles were excluded. First, second, and last authors from the United States were reviewed and stratified by a number of categories, including sex, geographic location, and title.

RESULTS

Two-thousand fifty authors were reviewed. Of these, 20 percent of first authors, 24 percent of second authors, and 15 percent of last authors were women. Female representation was fairly equal among the journals, and 39 percent of women authors were international. Overall, 16 percent of fully trained plastic surgeon authors and 25 percent of resident authors were women, as compared to 15 percent female fully trained plastic surgeons and 36.2 percent female residents represented in the overall community.

CONCLUSIONS

Faculty are on par with national percentages of women plastic surgeons; however, women residents have lower representation in the literature than in the community as a whole. Residents and faculty must promote productivity of the younger generation of women plastic surgeons to continue increasing contributions of women to the specialty.

Promoting Greater Diversity and Inclusion in Radiology Research: A Survey of the American Association for Women Radiologists

OBJECTIVES

To assess perceived challenges to radiology research and publication by female radiologists, as well as possible strategies for overcoming these challenges.

METHODS

An electronic survey was conducted of female nontrainee members of the American Association for Women Radiologists in September and October, 2017. Respondents were recruited by e-mail. Responses were assessed descriptively.

RESULTS

The response rate was 31.8% (89/280). 61.4% of respondents were interested in conducting radiology research. 60.2% were expected by their departments to pursue research versus 80.7% expected to pursue educational activities. 56.8% felt that their research success is valued by their department. 47.7% felt that they receive appropriate credit for their research from their departments. 22.7% felt that they receive sufficient time for research. 23.9% felt that their department makes deliberate efforts to support women's research efforts. 41.6% versus 70.8% ever had a female versus a male research mentor, respectively. Among seven provided options, the three items most commonly selected as being most helpful to enhancing research success were dedicated research time (40.4%), personal research mentors (23.6%), and earlier career training in research methodology (21.3%). Additional relevant themes identified by a free-response survey item included: family/child-care issues (n = 5), unconscious bias at the departmental/chair level (n = 5), exclusion of women from research activities by male researchers (n = 2), and concern of being perceived as "aggressive" (n = 2).

CONCLUSION

Initiatives targeting the identified challenges to radiology research could help promote greater diversity and inclusion among radiologist researchers, which in turn has implications for improving the quality of such research.

Patterns of authorship in ecology and evolution: First, last, and corresponding authorship vary with gender and geography

The position of an author on the byline of a paper affects the inferences readers make about their contributions to the research. We examine gender differences in authorship in the ecology literature using two datasets: submissions to six journals between 2010 and 2015 (regardless of whether they were accepted), and manuscripts published by 151 journals between 2009 and 2015. Women were less likely to be last (i.e., "senior") authors (averaging ~23% across journals, years, and datasets) and sole authors (~24%), but more likely to be first author (~38%), relative to their overall frequency of authorship (~31%). However, the proportion of women in all authorship roles, except sole authorship, has increased year-on-year. Women were less likely to be authors on papers with male last authors, and all-male papers were more abundant than expected given the overall gender ratio. Women were equally well represented on papers published in higher versus lower impact factor journals at all authorship positions. Female first authors were less likely to serve as corresponding author of their papers; this difference increased with the degree of gender inequality in the author's home country, but did not depend on the gender of the last author. First authors from non-English-speaking countries were less likely to serve as corresponding author of their papers, especially if the last author was from an English-speaking country. That women more often delegate corresponding authorship to one of their coauthors may increase the likelihood that readers undervalue their role in the research by shifting credit for their contributions to coauthors. We suggest that author contribution statements be more universally adopted and that these statements declare how and/or why the corresponding author was selected for this role.

Authorship and Impact of Gender-Specific Research in Major Radiology Journals

PURPOSE

The purpose of this study is to quantify the relationship between author gender and publication topic, as well as the impact of gender-related research.

METHODS

We reviewed all original research publications in Radiology, American Journal of Roentgenology, and Academic Radiology from 2011 through 2015. For each article, we recorded the gender of all authors and the last author H-index, years in practice, and academic rank. The total citations and citation rate (citations per year) were calculated for each article. Articles were categorized as gender-neutral, women's health, or men's health.

RESULTS

There were 1,934 publications involving 11,657 authors. Women represented 30% of first, 25% of last, and 28% of all authors. There were 1,596 (83%) gender-neutral, 276 (14%) women's health, and 61 (3%) men's health articles. Women's health articles were associated with a female first (odds ratio [OR] = 5.0, P < .001) and last author (OR = 6.4, P < .001), as well as more female authors (male = 1.4, female = 3.6, P < .001). Men's health articles were associated with a male first (OR = 2.6, P = .004) and last author (OR = 2.2, P = .03). There were significantly more citations for men's (43.5 ± 54.9, P < .001) and women's health (27.6 ± 37.5, P < .008) articles than gender-neutral articles (21.9 ± 28.9). Similarly, the article citation rate was higher for men's (10.6 ± 11.3, P < .001) and women's health (6.8 ± 8.5, P = .004) articles than gender-neutral publications (5.3 ± 7.0).

CONCLUSION

Radiology researchers publish more often on topics related to their own gender. Furthermore, men's and women's health research generates more citations than gender-neutral research.

Collaboration Metrics Among Female and Male Researchers: A 5-Year Review of Publications in Major Radiology Journals

RATIONALE AND OBJECTIVES

Women are under-represented in radiology, but the implications of this under-representation are poorly understood. Therefore, the purpose of this study was to determine if articles published by women in major radiology journals were more collaborative.

MATERIALS AND METHODS

Following an institutional review board exemption, we reviewed all original research articles in Radiology, in the American Journal of Roentgenology, and in Academic Radiology from 2011 to 2015. For each article, the gender of the first and the last authors and proxy measures of collaboration were recorded, including the total number of authors, female authors, departments, and institutions. Nominal logistic regression analysis was used to test for associations while controlling for confounders.

RESULTS

There were 1934 articles analyzed. Female first and last authors represented 30.2% (585 of 1934) and 24.4% (473 of 1934) of the articles, respectively. A female first author was associated with more female last authors (36% vs 20%, P < .001), total female authors (2.9 vs 1.2, P < .001), and departments (3.3 vs 3.0, P < .001). Similarly, a female last author was associated with more female first authors (44% vs 26%, P = .001), total female authors (3.1 vs 1.2, P < .001), departments (3.5 vs 3.0 P < .001), and institutions (2.3 vs 1.9, P = .006). Each additional female author increased the mean number of institutions by 0.33 and departments by 0.46 on linear regression. First- or last-author gender was not associated with total authors (P = .17).

CONCLUSIONS

Original research articles published with a female first or last author were associated with more departments and institutions, but not with the total number of authors, suggesting that women engage in some metrics of more collaborative research.

Patterns of Recent National Institutes of Health (NIH) Funding to Diagnostic Radiology Departments: Analysis Using the NIH RePORTER System

RATIONALE AND OBJECTIVES

This study aimed to characterize recent National Institutes of Health (NIH) funding for diagnostic radiology departments at US medical schools.

MATERIALS AND METHODS

This retrospective study did not use private identifiable information and thus did not constitute human subjects research. The public NIH Research Portfolio Online Reporting Tools Expenditure and Results system was used to extract information regarding 887 NIH awards in 2015 to departments of "Radiation-Diagnostic/Oncology." Internet searches were conducted to identify each primary investigator (PI)'s university web page, which was used to identify the PI's departmental affiliation, gender, degree, and academic rank. A total of 649 awards to diagnostic radiology departments, based on these web searches, were included; awards to radiation oncology departments were excluded. Characteristics were summarized descriptively.

RESULTS

A total of 61 unique institutions received awards. The top five funded institutions represented 33.6% of all funding. The most common institutes administering these awards were the National Cancer Institute (29.0%) and the National Institute of Biomedical Imaging and Bioengineering (21.6%). Women received 15.9% of awards and 13.3% of funding, with average funding per award of $353,512 compared to $434,572 for men. PhDs received 77.7% of all awards, with average funding per award of $457,413 compared to $505,516 for MDs. Full professors received 51.2% of awards (average funding per award of $532,668), compared to assistant professors who received 18.4% of awards ($260,177). Average funding was $499,859 for multiple-PI awards vs. $397,932 for single-PI awards. Common spending categories included "neurosciences," "cancer," "prevention," and "aging."

CONCLUSIONS

NIH funding for diagnostic radiology departments has largely been awarded to senior-ranking male PhD investigators, commonly at large major academic medical centers. Initiatives are warranted to address such disparities and promote greater diversity in NIH funding among diagnostic radiology investigators.

Contemporary psychology and women: A gender analysis of the scientific production

Despite important advances made in recent decades, women are still underrepresented in science (less than 30% of authorships). This study presents a bibliometric analysis of all the Psychology articles published in 2009 included in the Web of Science database (Thomson Reuters) in order to examine the contribution of women in contemporary Psychology, their pattern of research collaboration, the scientific content and the scientific impact from a gender perspective. From a total of 90,067 authorships, gender could be identified in 74,413 (82.6%) of them, being 40,782 (54.8%) male authorships and 33,631 (45.2%) female authorships. These data corresponded to 24,477 (49.9%) individual men and 24,553 (50.1%) women, respectively. Therefore, Psychology presents gender parity in the number of authors, and a gender asymmetry in the number of authorships that it is much lower than in science in general and other specific scientific fields. In relative terms, women tend to be concentrated in the first position of the authorship by-line and much less in the last (senior) position. This double pattern suggests that age probably plays a role in (partly) explaining the slight gender disparity of authorships.

Gender Differences in Academic Rank of Radiologists in U.S. Medical Schools

Purpose To determine whether there were gender differences in full professorship after accounting for factors known to influence academic advancement. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant study, with waiver of informed consent. In this cross-sectional study, the authors used a comprehensive 2014 physician database (5089 academic radiologists, inclusive of all U.S. academic radiologists in 2014; 11.3% of all U.S. radiologists) containing information on physician age, years since residency, National Institutes of Health funding, scientific publications (first or last author and total), clinical trial investigation, and clinical volume measured according to 2013 Medicare reimbursement. Primary outcome of gender differences in full professorship was estimated by using a multilevel logistic regression model adjusting for these factors. Results Among 5089 academic radiologists, 3638 (71.5%) were men. The average age for male and female radiologists was 52 and 49 years, respectively. Overall, 239 women (16.5%) and 948 (26.1%) men were full professors (P < .001). Women had fewer total and first or last author publications than men (total, 12.2 vs 17.6; first or last, 6.8 vs 10.7; P < .001 for both comparisons). Women were less likely than men to have National Institutes of Health funding (2.0% vs 3.6%; P = .004) and generated less annual Medicare revenue ($63 346 vs $75 854; P = .001). After multivariate adjustment, rates of full professorship among female and male radiologists were not significantly different (absolute adjusted difference for female vs male radiologists, -1.5%; 95% confidence interval: -3.8%, 0.9%). Conclusion Among radiologists with U.S. medical school faculty appointments in 2014, men and women were similarly likely to be full professor after several factors known to influence promotion were taken into account. However, unadjusted differences in promotion and research productivity were present, which suggests that female radiologists may lack equal research opportunities. ^© RSNA, 2016.