Gender representation in Canadian surgical leadership and medical faculties: a cross-sectional study

BACKGROUND

Over the past two and half decades, Canadian medical school students have become majority female, and the medical workforce is therefore increasingly comprised of female physicians. Whether this change, however, has been reflected in the gender balance within medical school faculty positions and leadership has not been well studied in Canada.

METHODS

This cross-sectional study examined the genders of full-time faculty members from the most recently available AFMC data, the current heads of departments of medicine and surgery from department websites and confirmed with respective universities.

RESULTS

Overall, women held 40.5% of full-time faculty positions in Canadian faculties of medicine. Female representation decreased with increasing academic rank, from 57.8% of instructors to 50.8% of assistant, 39.2% of associate, and 28.1% of full professors, respectively, with the greatest rate of increase over the past decade among full professors (0.75% per year). The heads of departments of family medicine were majority female (67%), and heads internal medicine at parity (50% female), consistent with numbers of practicing physicians. However, the heads of surgical divisions were majority male (86% overall). Accounting for the gender balance of practicing surgeons, male compared to female surgeons were 2.9 times as likely to be division head (95% CI 1.78-4.85, p < 0.0001).

CONCLUSIONS

Women remain underrepresented in Canadian faculties of medicine in leadership positions. Leadership in departments of surgery has particularly low female representation, even relative to the proportion of practicing female surgeons within the respective discipline.

Organizational Leadership Gender Differences in Medical Schools and Affiliated Universities

Objective: To compare gender compositions in the leadership of the top 25 medical schools in North America with the leadership of their affiliated university senior leadership and other faculties. Materials and Methods: This retrospective cross-sectional observational study used publicly available gender data from 2018 to 2019 of universities drawn from the U.S. News Best Global Universities for Clinical Medicine Ranking report. Gender compositions in eight leadership tiers from senior leadership to medical school department directors were analyzed. Data analysis included gender compositions by leadership tier and faculty. Results: Male representation is greater at higher leadership tiers, with the largest imbalance being at the level of medical school department heads. The faculty of medicine has more men in leadership positions than the average of the other faculties (p = 0.02), though similar to schools of engineering, business, dentistry, and pharmacy. Across the eight leadership tiers, a significant trend exists between tier and proportions, indicating that male representation was greater at higher tiers (p < 0.001). No correlation was found between a university's leadership gender composition and its ranking. Conclusion: The under-representation of women is greater in medical school leadership than the leadership of their affiliated universities. The faculty of medicine has greater male over-representation than the average of the other faculties.

Gender distribution of North American professional radiology society award recipients

PURPOSE

Women remain underrepresented in radiology and there is a paucity of literature examining the recognition of their professional contributions to the discipline. The purpose of this study was to examine the gender distribution of award winners across all North American radiology societies.

METHODS

The gender distribution of 1923 award recipients from 21 North American radiology societies between 1960 and 2021 was examined. Awards were divided into four categories: leadership, teaching, contribution to radiology, and promising new/young societal member. Primary outcome was the total proportion of awards received by gender. All data was compared to the gender distribution of working radiologists in North America.

RESULTS

A total of 1923 award recipients were identified between 1960 and 2021. Seventy-nine percent of award recipients were men (n = 1527) and 21 % were women (n = 396). As of 1970, the proportion of women award recipients increased 0.55 % ± 0.07 % each year. The proportion of women receiving radiological awards after 2018 is equal to or surpassing the percentage of women radiologists. Women received 36.4 % of leadership, 33.6 % of promising new member, 30.1 % of teaching, and 14.4 % of lifetime contribution awards.

CONCLUSIONS

In the last five years, the proportion of women receiving awards was equal to or greater than the proportion of women radiologists. Women received more leadership awards and fewer lifetime contributor awards compared to men.

Disparities in Radiologist Fee-For-Service Payments by Gender in Canada

Objective: To examine differences in fee-for-service (FFS) payments to men and women radiologists in Canada and evaluate potential contributors. Methods: Publicly available FFS radiology billing data was analyzed from British Columbia (BC), Ontario (ON), Prince-Edward Island (PEI) and Nova Scotia (NS) between 2017 and 2021. Data was analyzed by gender on a per-province and national level. Variables evaluated included year, province, procedure billings, and days worked (BC and ON only). The gender pay gap was expressed as the difference in mean billing payments between men and women divided by mean payments to men. Results: Data points from 8478 radiologist years were included (2474 [29%] women and 6004 [71%] men). The unadjusted difference in annual FFS billings between men and women was $126,657. Overall, payments to women were 81% of payments to men with a 19% gender pay gap. The difference in billings between men and women did not change significantly between 2017 and 2021 (range in gender pay gap, 17-21%) but did vary by province (highest gap NS). Compared to men, women worked fewer days per year (weighted mean 218 ± 29 vs 236 ± 25 days/year, P < .001, 8% difference). Conclusion: In an analysis of fee-for-service payments to radiologists in 4 Canadian provinces between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap. Payments were lower to women across all years evaluated. Women worked 8% fewer days per year on average than men, which did not fully account for the difference in FFS billing payments between men and women. Summary Statement: In an analysis of fee-for-service payments to Canadian radiologists between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap which is not fully accounted for by time spent working.

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.

A Problem of Gender Representation: Adapting the Bechdel Test to Evaluate the Social Media Presence of Radiology Residency Programs

RATIONALE AND OBJECTIVES

Social media serves as recruitment tools for residency programs, allowing programs to "brand" themselves in an era of virtual interviews. For female applicants, viewing their gender represented on Instagram may influence their pursuit of a program. Our study's goal is to quantify how female-presenting professionals are represented on radiology residency (RR) Instagram pages, as these are increasingly important platforms for resident recruitment.

MATERIALS AND METHODS

The Bechdel test is a well-known measure of the representation of women in fiction that requires at least 2 women speak to each other about a topic other than a man. We modified this test to evaluate the portrayal of female-presenting professionals on public Instagram galleries of RR programs. For a photo to pass our test, female-presenting persons are shown physically together, without male-presenting professionals, and in a professional setting. To compare gender depiction, a Male Bechdel Test was also used. RR Instagram pages were identified using the Fellowship and Residency Electronic Interactive Database Access (n = 87) and examined with an adapted framework approach to count female and male-presenting individuals in 1044 images. Results were assessed using paired t-tests and a chi-square with McNemar's test.

RESULTS

Approximately 50% of the RR Instagrams passed the Male Bechdel Test while only 21.3% passed the Female Bechdel Test, a significant difference in gender representation (χ²(1) = 13.255, P = 0.022). Paired sample t-tests revealed that RR Instagram pages are significantly more likely to feature male-presenting professionals in a professional setting (P < 0.0001), feature them with other male-presenting professionals (P = 0.001), and feature them without female-presenting professionals (P = 0.003).

CONCLUSION

Our results suggest female-presenting radiologists are under-represented on the Instagram profiles of RR programs. While this reflects the dearth of females in this field, programs may improve gender inclusion by more prominently displaying females on social media. This may assist in recruiting minority applicants.

Equity, diversity & inclusion in academic radiology: An elusive dream

BACKGROUND

Disparities in sex and race/ethnicity continue to persist in the academic radiology. This study addresses the sex/racial underrepresentation and evolution in the academic radiology.

PURPOSE

To evaluate academic radiology temporal trends disparities by analyzing sex and race/ethnicity diversity in academic degree and tenure status.

MATERIALS AND METHODS

A retrospective cross-sectional analysis conducted using American Association of Medical College database between 2007 and 2018. Trends in academic degree, tenure status, race/ethnicity, and sex assessed with linear regression analysis and Poisson regression model for annual percent change with statistical significance of p < 0.05.

RESULTS

Out of 107,213 radiologists 72%, n = 76,893 males and 64%, n = 68,738 white faculty with 1277 males and 872 females. White MD-degree radiologists constitute 67.2%, Asian (20.9%), Black (2.5%), Hispanic (3.2%), multiple (3.4%), unknown (1.8%) and "other" (1%) races with a similar PhD/other doctoral and dual-degree. White faculty recruitment trend (n2007 = 955, n2018 = 703) and representation (-0.82% per year; 95% CI, -1.00 to -0.63; p < 0.0001) decreased, while Asian URM decreased respectively (n2007 = 152, n2018 = 205) (0.68% per year; 95% CI, 0.58 to 0.77; p < 0.0001). Females were underrepresented in all categories.

CONCLUSION

URM and females are underrepresented in academic radiology. Academic degree types and tenure track may contribute to White and male academic radiologists overrepresentation.

Gender differences and cooperation in medical authorships - an analysis of the recent ten years in five key medical disciplines

BACKGROUND

Career prospects in academic medicine are strongly linked to scientific authorship and this marker has been widely used as an indicator of gender equity in academia. However, direct comparisons of medical disciplines regarding their proportion of female physicians (FP) in different countries are missing. This study examines the gender parity and gender cooperation using first authorships (FA) and senior authorships (SA) of scientific publications in five medical disciplines and six different OECD countries over a 10-year time-trend.

METHODS

Articles from three high-impact journals in each of the medical discipline radiology, urology, surgery, gynecology, and pediatrics from the years 2007/8 and 2017/18 were retrospectively reviewed. The gender and affiliation location of the FA and SA of original research articles and reviews were assigned and compared with the proportion of in each discipline for the United States of America, Canada, United Kingdom, France, Germany, and Japan. Mantel-Haenszel test and multinomial logistic regression models were used to calculate differences in proportions of women authors and FP and to assess trends and proportions of FA and SA.

RESULTS

30,803 articles were evaluated. Equally, with rising proportions of FP in all disciplines, the number of women authors increased across years. The shares of women FAs were either significantly higher (urology/surgery/gynecology) or balanced (pediatrics/radiology) compared to the proportion of FP. In contrast, the shares of women SA were balanced only in disciplines with a low proportion of FP (urology and surgery) and otherwise reduced. Women same-gender cooperation was as common as men same-gender cooperation and preferred over a women-led mixed gender cooperation in disciplines where this seemed to be practicable due to the high proportions of FP.

CONCLUSION

In contrast to FA, a significant disparity persists in SA, particularly in disciplines with a high proportion of FP. The discrepancy between FA and SA may reflect, among others, dropout from an academic career in early or mid-academic levels, for example, due to structural inequality; together with the findings on gender preference in authorship collaborations, this may inform future strategies for promoting equal career advancement for women physicians.

Gender Disparity in Surgical Device Patents: A 5-year Trend From Canada and the United States

INTRODUCTION

Despite an increasing number of women pursuing careers in science, engineering, and medicine, gender disparities in patents persist. This study sought to analyze trends in inventor's gender for surgical device patents filed and granted in Canada and the United States from 2015 to 2019.

METHODS

This study analyzed patents filed and granted by the Canadian Intellectual Property Office (CIPO) in the category of "Diagnosis; Surgery; Identification" and the United States Patent and Trademark Office (USPTO) in the category of "Surgery" from 2015 to 2019. The gender of the patent applicants was determined using a gender algorithm that predicts gender based on first names. Gender matches with names having a probability of less than 95% were excluded.

RESULTS

We identified 14,312 inventors on patents filed and 12,737 inventors on patents granted by the CIPO for "Diagnosis; Surgery; Identification". In the USPTO category of "Surgery," we identified 75,890 inventors on patents filed and 44,842 inventors on patents granted. Female inventors accounted for 7%-10% of inventors from 2015 to 2019 for both patents filed and granted. The proportion of female inventors on patents granted was significantly lower than for patents filed for four of the 5 y analyzed for both the USPTO and CIPO.

CONCLUSIONS

Female representation in surgical device patenting has stagnated, between 7 and 10%, from 2015 to 2019 in Canada and the United States. This underrepresentation of female inventors in surgical device patenting represents sizable gender disparity.

Gender Distribution & Rank of Authorship in Surgical Literature

BACKGROUND

Authorship of surgical literature is important for the career advancement of surgeons, and gender disparities in authorship may hinder the representation and leadership of women within academic surgery. The aim of this systematic review and meta-analysis was to evaluate the gender distribution of first, senior, and overall authorship in peer-reviewed surgical journal studies across all surgical specialties to determine if disparities exist.

METHODS

PubMed, EMBASE, and Google Scholar databases were searched for studies investigating the gender distribution of authorship of surgical literature published before December 10th, 2021. Meta-analysis was performed and Cohen's Q test for heterogenous effects was used to determine whether random or fixed-effects models were appropriate.

RESULTS

Fifteen studies investigating gender distribution of authorship met inclusion, which included a total of 136,627 pooled studies. The meta-analysis demonstrated the meta-proportion of first authorship for women to be 20.6% (95% CI: 13.9, 28.2), the meta-proportion of senior authorship for women to be 11.9% (95% CI: 6.6, 18.5), and the meta-proportion of overall authorship for women to be 23% (95% CI: 16.2, 30.7). In addition, the proportion of senior authorship for women was found to be significantly lower than the proportion of overall authorship for women (11.9% versus 23.0%, P = .0106).

CONCLUSION

There is a significantly smaller proportion of women who are first, senior, and overall authors in surgical literature compared to their colleagues who are men. Sustainable and effective solutions aimed at improving the representation of women surgeons in surgical research and research leadership are necessary.

Women in Radiology: Perceived or True Barrier?

Numbers are facts, and facts need to be publicly discussed for any change to happen [...]

Career Research Performance Among Radiology Early Career Grant Recipients Compared With National Institutes of Health K Award Recipients

OBJECTIVE

To compare academic and demographic metrics among recipients of three major early career radiology, interventional radiology, and radiation oncology grants to National Institutes of Health (NIH) K awardees at the time the grants were awarded and then over the course of their careers.

METHODS

Radiologists who received the RSNA Research Scholar Grant, General Electric Radiology Research Academic Fellowship (GERRAF), American Roentgen Ray Society (ARRS) Scholar Award, or NIH Career Development (K) Award before January 1, 2015, were included. Research metrics at time of grant award (eg, publications) and subsequent scholarly productivity (eg, academic rank, h-index, NIH funding) were recorded until April 2020. Wilcoxon ranked-sum, chi-square, logistic regression, and standard least-square regression were used for data analysis.

RESULTS

There were 279 recipients: 48 K Award, 115 RSNA Research Scholar Grant, 36 ARRS, and 80 GERRAF. At the time of grant awarding, GERRAF recipients were less likely to have an MD-PhD degree (odds ratio [OR]: 0.36; P = .002) and were more likely to be women (OR: 1.55; P = .042) than K Award recipients. Similarly, recipients of the ARRS (OR: 2.87; P = .010) and GERRAF (OR: 3.19; P = .002) were more likely to have a master's degree. Academic rank, leadership positions, and R01 funding were significant predictors of h-index and total publications over time. Academic rank and the GERRAF were significant predictors of subsequent NIH funding duration but there were no significant predictors of NIH funding amount.

CONCLUSIONS

Early career radiology awards, specifically the GERRAF, provide support for female and non-PhD investigators and result in comparable academic performance metrics to NIH K Award recipients.

Glass ceiling or murky waters: The gendered and racialized pathway to full professorship in Canada

We examined the predictors of being in the rank of full professor using a sample of faculty representing English Canadian universities. We hypothesized that women have a lower likelihood of being a full professor, controlling for a range of characteristics, including length of service, discipline, number of publications and Tri-Council grants. We also explored how race and immigrant status factored into the likelihood of being a full professor. Using a sample of associate and full professors, we found evidence of a strong negative effect of the probability of being a full professor for women, even after controlling for all variables in the model. We also found evidence of a glass ceiling, where a difference in the effect of years of service was found for men and women. Finally, racialized immigrant professors had a greater likelihood of being at the rank of full professor and racialized Canadian-born professors had the least.

Gender Distribution of Faculty Is Strongly Correlated With Resident Gender at Canadian Radiology Residency Programs

OBJECTIVE

Women are underrepresented in radiology overall, in radiology subspecialties, and in radiology leadership and academic positions. It is unclear why this disparity persists despite greater gender diversification in medicine. We sought to determine if a correlation exists between the proportion of female faculty at an institution, and the proportion of female residents in the associated residency program across Canada.

METHODS

Faculty gender for each Canadian Diagnostic Imaging Residency Program was obtained through publicly available sources (departmental websites and provincial physician registries) in the fall of 2020. Resident gender data was obtained through a survey emailed to programs following the April 2021 CaRMS match. Data was analyzed using Pearson's correlation coefficient. Research ethics approval was obtained.

RESULTS

Faculty information was available for 15 of the 16 Canadian radiology residency programs (94%) and resident information was obtained for 16 programs (100% response rate). Overall, women accounted for 31.4% of radiologist faculty and 31.9% of radiology residents, with a wide range between institutions (19.5-47.8% for faculty and 13.3%-47.1% for residents). There was a strong positive correlation between the proportion of female faculty and the proportion of female residents within individual programs (r=0.73; R2=0.54; p=0.002).

CONCLUSION

Approximately one third of faculty and residents at Canadian Diagnostic Radiology residency programs were female but there was a wide range across the country with a strong correlation between faculty and resident gender distribution. Further exploration is warranted to determine causes of this correlation including the possible influence of role modeling, mentoring, female-friendly culture, and bias.

Gender of Department Chair and Paid Parental Leave Benefits in Academic Radiology Residency Programs

RATIONALE AND OBJECTIVES

Residency training often overlaps with prime childbearing years, yet variability in availability and duration of parental leave in residency can complicate the decision to become parents. Gender disparities in attitudes towards parenthood in residency is well recognized, with females generally reporting more concerns surrounding prolonged training, hindrance of future career plans, and negative perception from peers. However, gender of the department chair has not yet been examined as a factor influencing parental leave policies for residents in Radiology.

MATERIALS AND METHODS

The gender of the department chair and parental leave policies for residents in 209 ACGME accredited diagnostic radiology programs across the United States were procured from their websites. These programs were stratified into 6 geographical regions to identify regional differences. Chi-squared analyses were used to compare availability of paid parental benefits with the gender of department chairs.

RESULTS

Seventy-seven percent of diagnostic radiology program department chairs were male. 34 of 49 programs (69%) with female department chairs advertised paid parental benefits, compared to 61 of 160 programs (38%) chaired by males (P < 0.001). When stratified by region, this gender difference remained statistically significant in the mid-Atlantic and New England.

CONCLUSION

Female gender of the department chair was associated with the increased availability of paid parental leave benefits for residents, yet females hold fewer academic leadership positions than males. Future discussions regarding parental leave policies for residents will have to consider the unique challenges in residency such as length of training and burden on coresidents.

Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach

PURPOSE

To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students.

METHODS

A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students' perceptions of this experience.

RESULTS

An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or exceed their expectations. Over 80% of students agreed that the course increased their interest in radiology and about 81% agree that the topics presented were excellent and clinically important. The ratings in the final survey results also indicate that students increased their confidence in basic radiology skills after completing the course.

CONCLUSIONS

The implementation of an integrative clinical approach to teaching radiology in a virtual setting is achievable. It provides efficient use of educational resources while being accessible by a large number of students across different medical schools.

Gender disparity in dermatologic society leadership: A global perspective

BACKGROUND

In the last half-century, there has been increased representation of women in medicine. Despite this increase, there continues to be underrepresentation of women in medical leadership positions. The objective of this study was to investigate the phenomenon of gender disparity in the leadership of professional societies of dermatology worldwide.

METHODS

Online databases were used to extract the names of global dermatologic societies. Individual society websites were accessed to obtain information on executive members. Data not available on society websites were obtained through internet searches. Scopus was used to obtain H-indexes and other bibliometric outcomes.

RESULTS

Our data collection spanned 92 countries, with 1733 society leaders identified and information available for 1710. In North America, Europe, Asia, Australia, and the Middle East, women were in a minority in dermatology professional society leadership. In South America, Central America, and Africa, women were in a slight majority. Across all professional societies, the role of president was more frequently held by men (n = 95) as opposed to women (n = 75). Female leaders were less likely to hold concurrent academic positions as deans/chairpersons/directors (83.33%) than their male counterparts (92.06%). The median H-index of female leaders (9) was lower than that of men (14).

CONCLUSION

Gender disparity exists in leadership positions in professional dermatology societies. Cultural/continental specific factors should be explored further. Enhancement of institutional support, mentorship, and sponsorship for female dermatologists should be encouraged.

Gender differences in authorship among Hepato-pancreatico-biliary surgeons

BACKGROUND

While studies have explored the gender gap in scientific publications, no study has investigated surgical literature in much detail. We examined the gender gap in Hepato-pancreato-biliary publications over the last decade.

METHODS

All physician authored original clinical science articles published in HPB, Annals of Surgery, Surgery, Annals of Surgical Oncology, and JAMA Surgery were reviewed from 2008 to 2017. Chi square analysis was used to compare the proportions of female and male authors and Cochrane-Armitage test was used for comparisons over time.

RESULTS

Of the 1067 publications, 84.0% of all authorships were held by men. Women physicians made up 10.3% of senior and 21.4% of first authorships with increased representation from 2.13% in 2007 to 14.8% in 2017 (p = 0.001). Women physicians comprised 14.1% of senior authors in JAMA Surgery, but only 2.46% in Annals of Surgical Oncology. Male authors were five times more likely to publish multiple articles compared to their female counterparts. Female first authors progressed to senior authors at a rate of 1.13% versus 5.73% for male authors (p = 0.89).

CONCLUSION

These findings elucidate the continued underrepresentation of women in senior research roles and the need to recruit and mentor women in all stages of their academic careers.

Analysis of Gender Disparity in US and Canadian Radiology Residency Programs

BACKGROUND

Equity, diversity, and inclusion in academic radiology are a work in progress and although the gender gap has decreased, there remains a paucity of studies examining female representation among radiology trainees over the past decade.

OBJECTIVE

The aim of our undertaking was to evaluate gender parity in United States (US) and Canadian radiology residency programs and to suggest future directions to improve female representation MATERIALS AND METHODS: Retrospective analysis of publicly available data on radiology residents from the US and Canada was performed from 2007to 2019. Data on diagnostic radiology residents was collected from the Accreditation Council for Graduate Medical Education for the US and the Canadian Post M.D. Education Registry for Canada. Statistical tests including regression and ANOVA were used to study the gender proportions from 2007to 2019.

RESULTS

There has been little progress in bridging the gender gap in the last 12 years. The proportion of female residents pursuing radiology has remained at an average of 26.74% (n = 1,238of 4,629) in US programs and 31.78% (n = 28 of88) in Canadian programs. The average change in the percentage of female residents was 0.0% per year (P = 0.0) for US programs and -2.9% per year (P = 0.3) for Canadian programs.

DISCUSSION

Despite a higher proportion of females in North American medical schools, gender disparity persists among radiology residents. More research is needed to identify barriers limiting female representation and improve gender parity across North American radiology programs.

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 diversity among editorial boards of radiology-related journals

PURPOSE

To investigate gender diversity in editorial boards among a wide range of radiology-related journals, the trend in time, and its association with the journal's impact factor (IF).

METHOD

The Journal Citation Reports website was searched for radiology-related journals journals with IF>2.0. Gender of the editor-in-chief and all editorial board members as listed on each journal's official website were determined. Mann-Whitney U test and Spearman's rho test were used for statistical analyses. Current data were compared to historical data.

RESULTS

Fifty-seven radiology-related journals were included. The names of 4176 persons were extracted. A woman was in charge as the only editor-in-chief in 5 of 57 journals (8.8%). Median percentage of female editorial board members was 21.5% (range 3.2%-52.0%). Female editorial board members were in the majority in only two journals, with proportions of 51.4% and 52.0%. IFs between journals with female and male editors-in-chief were not significantly different (median 3.00, range 2.21-7.82 vs. median 3.31, range 2.02-10.98; P = 0.951). There was no significant association between percentage of female editorial board members and a journal's IF (Spearman's rho = -0.019, P = 0.889). The proportion of women has increased compared to historical data.

CONCLUSION

Women are underrepresented in a wide range of radiology-related journals. Comparison with historical data shows that the proportion of women on editorial boards has increased. Nevertheless, gender composition of the editorial board shows no association with IF. This suggests similar gender bias exists across a broad spectrum of high impact factor journals, with no added bias in journals with higher IF.

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.

Gender-Based Disparity in Academic Ranking and Research Productivity Among Canadian Anesthesiology Faculty

Purpose Despite increasing numbers of women entering anesthesiology training, women remain underrepresented in senior academic positions and leadership roles. This study aims to determine the extent of gender disparity in Canadian departments of anesthesiology. In addition, we explore the correlation between publication productivity and academic rank in this cohort. Methods The Canadian Residency Matching Service (CaRMS) was queried to identify 17 training programs for anesthesiology. Department websites were searched to determine the names of faculty members, as well as gender, leadership roles, and academic ranks. The SCOPUS© database was used to generate the number of publications, number of citations, publication range, and h-index of each faculty member. Results In our study cohort of 1404 academic anesthesiologists, 30.1% were women. Women held a minority of 130 leadership positions (27%, n = 35). With increasing academic rank female representation decreased (p = 0.009), such that 21% of full professors were women. Overall, male anesthesiologists had a higher h-index, number of publications, and number of citations (p = 0.001, p = 0.001, and p = <0.001, respectively) than women. Conclusion Despite growing numbers of women entering the academic workforce, women are underrepresented in senior academic ranks and leadership positions. In addition, men and women have significant differences in measures of publication productivity. This study underscores the importance of directed efforts to promote equity in career outcomes.

Equity, Diversity, and Inclusion in Academic American Surgery Faculty: An Elusive Dream

BACKGROUND

In the context of shifting population demographics in the United States, a diverse workforce in health care can lead to improved patient outcomes and enhance access to culturally competent care for minorities. The objective of this study was to analyze and quantify the relationship of gender, race, and academic rank, tenure status, and degree in American academic surgical faculty.

MATERIALS AND METHODS

A 12-y retrospective cross-sectional analysis of the data from the Association of American Medical Colleges was performed. The distribution of race and gender across academic ranks, tenure, and degree types were recorded from 2007-2018. Simple descriptive statistics and chi-square analysis was used to analyze the time trends and association between gender and race across academic rank, tenure status, and degree types.

RESULTS

When averaged over the 12 y of this study, there were significantly more whites (69.8%) and males (74.5%) among the academic surgery faculty compared with other races and females, respectively (P value <0.05). Asians and females experienced the greatest increase in proportional representation across all academic ranks with an absolute increase of 7% and 5% in full professor, 5% and 6% in associate professor, and 7% and 3% in chairperson (P value <0.05), respectively. No significant association was observed between gender and race with tenure status or degree type.

CONCLUSIONS

Female and Asians are increasing in proportional representation; however, racial and gender disparities remain prevalent at higher academic ranks and positions of leadership, especially among black and Hispanic academic surgeons.

Female Authorship in Radiology: Trends in the Past Decade in CARJ

Purpose:

To identify trends in female authorship in the Canadian Association of Radiologists Journal (CARJ) from 2010 to 2019.

Methods:

We retrieved papers published in the CARJ over a 10-year period, and retrospectively reviewed 602 articles. All articles except editorials and advertisements were included. We categorized the names of the first and last position authors as female or male and excluded articles that had at least one author of which gender was not known. We compared the trends in the first and last position authors of the articles from 2010 to 2019. For statistical analysis, logistic regression was performed with reported odds ratios (ORs), and a P value of <.05 was defined as statistically significant.

Results:

Five hundred thirteen articles met inclusion criteria. Among them, 23 articles with a single author were classified as having only a first author. 39.8% (204/513) of first authors were female and 26.9% (132/490) of last authors were female. There has been an overall temporal increase in the odds of both the first and last author being female in CARJ publications (OR: 1.11, P = .034). Similarly, the odds a CARJ publication’s first author being female increased over time (OR: 1.07, P = .033). Female last author did not predict female first author (OR: 1.48, P = .056). There was no association identified between female last author and year of publication (OR: 1.04, P = .225).

Conclusion:

There has been an overall increase in engagement of female authorship in CARJ.

Gender Disparity in Academic Rank and Productivity Among Public Health Physician Faculty in North America

Background The issue of gender disparity is particularly important in the domain of public health where the tone of its leadership is pivotal in bringing about impactful change to research, policies, and the wellbeing of our various populations. Our aim is to explore the gender disparity of author metrics and academic rankings of public health physician faculty through a cross-sectional study. Methods Data collection for this retrospective cross-sectional study took place during June and July of 2017. Public health and preventive medicine residency training programs in the United States and Canada were to compiled and all faculty members that met the inclusion criteria were recorded (n = 973). Variables of interest include gender, h-index, years of active research, and academic appointments. SCOPUS database (Elsevier, Amsterdam, the Netherlands) was used to generate author metrics, and all statistical tests were performed using Statistical Package for the Social Sciences (SPSS) software version 20 (IBM Corp., Armonk, NY). Results Overall, 31.14% (n = 303) of faculty members we studied were from Canada, and 68.86% (n = 670) were from the United States. In both countries, males made up the majority of all faculty members. Female faculty comprised most of the early career positions, and their proportions tapered off with higher academic rank, whereas male faculty trended in the opposite direction. Males generally were higher in all academic measures across all appointments.  Conclusions  Gender disparity exists within the North American public health and preventive medicine discipline. There are underlying factors preventing women from moving beyond early career positions or engaging in academic research.