I. Loh1, R. Jindani1, G. Ha1, J.H. Rodriguez-Quintero1, J. Olivera1, J. Rosario1, M. Vimolratana1, N. Chudgar1, B.M. Stiles1 1Montefiore Medical Center/Albert Einstein College Of Medicine, Cardiothoracic Surgery, Bronx, NY, USA
Introduction: Although prominent gender disparities in authorship within specific surgical specialties have been documented, it remains unclear how these disparities differ between subspecialties and how they have evolved over time. We sought to characterize gender differences in first and senior authors across surgical specialties in the last 20 years.
Methods: The top 10 journals in 10 surgical specialties were determined with Google Scholar, and a bibliometric analysis was conducted on all PubMed articles published in this journal pool between 2003 and 2023. Author names and affiliations were extracted using bioPython, and author gender was predicted by first name using GenderAPI. Only articles with a GenderAPI-assigned gender accuracy score of ≥90 were included in the study. Linear regression models were used to assess growth rate in the percent of women authors within subspecialties and two-sided z-tests were used to determine significant differences in this growth rate between specialties.
Results: Out of 794,609 articles, 471,127 had both first and senior authors with GenderAPI-assigned gender accuracies ≥90. When stratified by surgical specialty, we observed an increase over time in the percentage of women for both first and senior authors across all subspecialties, with significant pair-wise differences between a majority of subspecialties (p<0.0002 adjusting for multiple tests, Figure 1). Based on linear regression models, OBGYN first authors have had the highest growth rate in percent women authors at 1.06%/year (95% CI 0.94, 1.19), while Orthopedic senior authors have had the lowest growth rate at 0.11%/year (95% CI 0.02, 0.19). For all specialties except OBGYN, Ophthalmology, and Urology, we found the growth rate in percent women among first authors was significantly greater than that among senior authors (p<0.001). First and senior author gender ratios have remained below one across all specialties except for OBGYN first authors, who have been majority women since 2013.
Conclusions: These findings underscore continued gender inequality in authorship across all surgical specialties; however, the increase in representation of women amongst first and senior authors suggests a trend towards gender equity. Differential growth rates in gender ratio between first and last authors reflects the persistence of the “leaky pipeline,” where representation of women decreases with seniority. Significant differences in women’s authorship between surgical specialties suggests that discrepancies in gender diversity and inclusivity may exist between specialties. These results emphasize the importance of ongoing efforts towards gender equity while highlighting the progress that many specialties have made.