Advertisement

Gender Disparity Trends in Authorship of Hand Surgery Research

Published:February 25, 2022DOI:https://doi.org/10.1016/j.jhsa.2022.01.002

      Purpose

      Despite an overall trend towards gender parity, women continue to remain underrepresented in surgical fields. Until recently, women’s representation in hand surgery literature was largely unexplored. The objective of this study was to examine how authorship gender trends among academic hand surgeons have evolved between 2006 and 2019.

      Methods

      Original research articles published from 2006 to 2019 in 3 leading clinical hand surgery journals were extracted from PubMed. Publications with a full author first name were analyzed, and the gender of each author was assigned with the validated Genderize algorithm. Analyses were performed to evaluate authorship publication trends, unique authors, and research career productivity.

      Results

      From 2006 to 2019, 4,769 articles met the inclusion criteria, and the genders of 17,102 authors were identified. There were 2,848 (16.6%) female authors and 14,254 (83.4%) male authors. The proportion of female authors increased from 13.4% to 19.9% from 2006 to 2019. Similarly, female representation as first and senior authors increased significantly, from 10.9% to 20.1% and 7.6% to 14.2%, respectively. Of the 8,417 unique authors, 1,775 (21.1%) were women and 6,642 (78.9%) were men. Only 3.3% of these unique female authors published 5 or more papers during the study period. Among the 10 most frequently published authors for each gender, 18 of the 20 authors were surgeons.

      Conclusions

      There has been substantial progress toward gender parity in academic hand surgery over the last 14 years, and the proportion of women publishing in leadership positions has increased.

      Clinical relevance

      Increased gender representation in medicine and research is important for both patients and providers, and these findings suggest that ongoing support and mentorship for women in academic careers should be a priority.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Association of American Medical Colleges
        AAMC Facts and figures 2016. Longitudinal applicant, matriculant, enrollment, & graduation tables.
        (Accessed December 10, 2020)
        • Burton K.R.
        • Wong I.K.
        A force to contend with: the gender gap closes in Canadian medical schools.
        CMAJ. 2004; 170: 1385-1386
        • Moberly T.
        Number of women entering medical school rises after decade of decline.
        BMJ. 2018; 360: k254
        • Ziegler S.
        • Zimmermann T.
        • Krause-Solberg L.
        • Scherer M.
        • van Den Bussche H.
        Male and female residents in postgraduate medical education - a gender comparative analysis of differences in career perspectives and their conditions in Germany.
        GMS J Med Educ. 2017; 34: Doc53
        • Heiser S.
        The majority of U.S. medical students are women, new data show.
        (Accessed July 10, 2020)
        • Association of American Medical Colleges
        Where are all the women in surgery?.
        (Accessed June 2, 2021)
        • Linscheid L.J.
        • Holliday E.B.
        • Ahmed A.
        • et al.
        Women in academic surgery over the last four decades.
        PLoS One. 2020; 15e0243308
        • Zhuge Y.
        • Kaufman J.
        • Simeone D.M.
        • Chen H.
        • Velazquez O.C.
        Is there still a glass ceiling for women in academic surgery?.
        Ann Surg. 2011; 253: 637-643
        • O’Connor M.I.
        Medical school experiences shape women students’ interest in orthopaedic surgery.
        Clin Orthop Relat Res. 2016; 474: 1967-1972
        • Okike K.
        • Liu B.
        • Lin Y.B.
        • et al.
        The orthopedic gender gap: trends in authorship and editorial board representation over the past 4 decades.
        Am J Orthop (Belle Mead NJ). 2012; 41: 304-310
        • Lewis V.O.
        • Scherl S.A.
        • O’Connor M.I.
        Women in orthopaedics-way behind the number curve.
        J Bone Joint Surg Am. 2012; 94: e30
        • Silvestre J.
        • Wu L.C.
        • Lin I.C.
        • Serletti J.M.
        Gender authorship trends of plastic surgery research in the United States.
        Plast Reconstr Surg. 2016; 138: 136e-142e
        • Association of American Medical Colleges
        Percentage of women residents by specialty.
        (Accessed July 10, 2020)
        • Chambers C.C.
        • Ihnow S.B.
        • Monroe E.J.
        • Suleiman L.I.
        Women in orthopaedic surgery: population trends in trainees and practicing surgeons.
        J Bone Joint Surg Am. 2018; 100: e116
        • Association of American Medical Colleges
        2018 Physician specialty report data highlights.
        (Accessed July 10, 2020)
        • Association of American Medical Colleges
        2018 Physician specialty data report executive summary.
        (Accessed July 10, 2020)
        • Elsevier
        The researcher journey through a gender lens.
        (Accessed July 10, 2020)
        • Bae G.H.
        • Lee A.W.
        • Park D.J.
        • et al.
        Ethnic and gender diversity in hand surgery trainees.
        J Hand Surg Am. 2015; 40: 790-797
        • Hariri S.
        • York S.C.
        • O’Connor M.I.
        • Parsley B.S.
        • McCarthy J.C.
        Career plans of current orthopaedic residents with a focus on sex-based and generational differences.
        J Bone Joint Surg Am. 2011; 93: e16
        • Hirayama M.
        • Fernando S.
        Organisational barriers to and facilitators for female surgeons’ career progression: a systematic review.
        J R Soc Med. 2018; 111: 324-334
        • Fecher A.M.
        • Valsangkar N.
        • Bell T.M.
        • Lisy M.E.
        • Rozycki G.S.
        • Koniaris L.G.
        Current state of women in academic surgical subspecialties: how a new metric in measuring academic productivity may change the equation.
        Am Surg. 2018; 84: 746-748
        • Association of American Medical Colleges
        Full-time women faculty as a percentage of each rank, 2009–2018. The state of women in academic medicine, 2018–2019.
        (Accessed July 10, 2020)
        • Siegel N.
        • Lopez J.
        • Cho A.
        • Lifchez S.D.
        A bibliometric analysis of research productivity during residency for 125 hand surgery fellows.
        J Surg Educ. 2020; 77: 710-716
        • Peters A.W.
        • Savaglio M.K.
        • Gunderson Z.J.
        • et al.
        Comparative analysis of authorship trends in the Journal of Hand Surgery European and American volumes: a bibliometric analysis.
        Ann Med Surg (Lond). 2020; 55: 200-206
        • Gu A.
        • Almeida N.
        • Cohen J.S.
        • Peck K.M.
        • Merrell G.A.
        Progression of authorship of scientific articles in the Journal of Hand Surgery, 1985–2015.
        J Hand Surg Am. 2017; 42: 291.e1-291.e6
        • Grandizio L.C.
        • Pavis E.J.
        • Hayes D.S.
        • Laychur A.J.
        • Klena J.C.
        Comparison of editor, reviewer, and author demographics in the Journal of Hand Surgery.
        J Hand Surg Glob Online. 2020; 2: 182-185
        • Kim C.Y.
        • Sivasundaram L.
        • Trivedi N.N.
        • et al.
        A 46-year analysis of gender trends in academic authorship in orthopaedic sports medicine.
        J Am Acad Orthop Surg. 2019; 27: 493-501
        • Lerchenmueller M.J.
        • Sorenson O.
        • Jena A.B.
        Gender differences in how scientists present the importance of their research: observational study.
        BMJ. 2019; 367: l6573
        • Xu R.F.
        • Varady N.H.
        • Chen A.F.
        Trends in gender disparities in authorship of arthroplasty research.
        J Bone Joint Surg Am. 2020; 102: e131
        • Vora M.
        • Kuripla C.
        • Ouyang D.
        • Sing D.C.
        Gender trends in authorship of foot and ankle academic literature over 24 years.
        J Foot Ankle Surg. 2019; 58: 898-903
      1. Genderize. Demografix ApS. Accessed August 28, 2020. https://genderize.io/.

        • Sing D.C.
        • Jain D.
        • Ouyang D.
        Gender trends in authorship of spine-related academic literature-a 39-year perspective.
        Spine J. 2017; 17: 1749-1754
        • Fischer J.P.
        • Wininger A.E.
        • Scofield D.C.
        • et al.
        Historical analysis of bibliometric trends in the Journal of Pediatric Orthopaedics with a particular focus on sex.
        J Pediatr Orthop. 2018; 38: e168-e171
        • Dynako J.
        • Owens G.W.
        • Loder R.T.
        • et al.
        Bibliometric and authorship trends over a 30 year publication history in two representative US sports medicine journals.
        Heliyon. 2020; 6e03698
        • Seetharam A.
        • Ali M.T.
        • Wang C.Y.
        • et al.
        Authorship trends in the Journal of Orthopaedic Research: a bibliometric analysis.
        J Orthop Res. 2018; 36: 3071-3080
        • Berger A.
        • Giacalone J.
        • Barlow P.
        • Kapadia M.
        • Keith J.
        Roles of mentorship and research in surgical career choice.
        Plast Reconstr Surg Glob Open. 2016; 4: e783
        • Silvestre J.
        • Wu L.
        • Lin I.
        • Serletti J.
        • Chang B.
        The gender gap in academic plastic surgery: a 45-year analysis.
        Plast Reconstr Surg Glob Open. 2016; 4: 46
        • Kim Y.
        • Pendleton A.A.
        • Boitano L.T.
        • et al.
        The changing demographics of surgical trainees in general and vascular surgery: national trends over the past decade.
        J Surg Educ. 2021; 78: 2117-2126
        • Edmunds L.D.
        • Ovseiko P.V.
        • Shepperd S.
        • et al.
        Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence.
        Lancet. 2016; 388: 2948-2958
        • Bauer J.M.
        • Holt G.E.
        National orthopedic residency attrition: who is at risk?.
        J Surg Educ. 2016; 73: 852-857
        • Sullivan M.C.
        • Yeo H.
        • Roman S.A.
        • et al.
        Surgical residency and attrition: defining the individual and programmatic factors predictive of trainee losses.
        J Am Coll Surg. 2013; 216: 461-471
        • Yeo H.
        • Bucholz E.
        • Ann Sosa J.
        • et al.
        A national study of attrition in general surgery training: which residents leave and where do they go?.
        Ann Surg. 2010; 252 (discussion 534): 529-534
        • Yeo H.L.
        • Abelson J.S.
        • Symer M.M.
        • et al.
        Association of time to attrition in surgical residency with individual resident and programmatic factors.
        JAMA Surg. 2018; 153: 511-517
        • Duch J.
        • Zeng X.H.
        • Sales-Pardo M.
        • et al.
        The possible role of resource requirements and academic career-choice risk on gender differences in publication rate and impact.
        PLoS One. 2012; 7e51332
        • Hoof M.A.
        • Sommi C.
        • Meyer L.E.
        • Bird M.L.
        • Brown S.M.
        • Mulcahey M.K.
        Gender-related differences in research productivity, position, and advancement among academic orthopaedic faculty within the United States.
        J Am Acad Orthop Surg. 2020; 28: 893-899
        • Bastian S.
        • Ippolito J.A.
        • Lopez S.A.
        • Eloy J.A.
        • Beebe K.S.
        The use of the h-index in academic orthopaedic surgery.
        J Bone Joint Surg Am. 2017; 99: e14
        • Ence A.K.
        • Cope S.R.
        • Holliday E.B.
        • Somerson J.S.
        Publication productivity and experience: factors associated with academic rank among orthopaedic surgery faculty in the United States.
        J Bone Joint Surg Am. 2016; 98: e41
        • Carr P.L.
        • Gunn C.
        • Raj A.
        • Kaplan S.
        • Freund K.M.
        Recruitment, promotion, and retention of women in academic medicine: how institutions are addressing gender disparities.
        Womens Health Issues. 2017; 27: 374-381
        • McGuire L.K.
        • Bergen M.R.
        • Polan M.L.
        Career advancement for women faculty in a US school of medicine: perceived needs.
        Acad Med. 2004; 79: 319-325
        • Acai A.
        • Steyn C.
        • Reid S.E.
        • Sonnadara R.R.
        A solution to gender inequity in surgery? Better caregiving policies.
        Can J Surg. 2018; 61: 6-7
        • Schiebinger L.
        • Henderson A.D.
        • Gilmartin S.K.
        Dual-career academic couples: what universities need to know.
        (Accessed July 10, 2020)
        • Russell A.F.
        • Loder R.T.
        • Gudeman A.S.
        • et al.
        A bibliometric study of authorship and collaboration trends over the past 30 years in four major musculoskeletal science journals.
        Calcif Tissue Int. 2019; 104: 239-250
        • Wininger A.E.
        • Fischer J.P.
        • Likine E.F.
        • et al.
        Bibliometric analysis of female authorship trends and collaboration dynamics over JBMR’s 30-year history.
        J Bone Miner Res. 2017; 32: 2405-2414
        • Reed D.A.
        • Enders F.
        • Lindor R.
        • McClees M.
        • Lindor K.D.
        Gender differences in academic productivity and leadership appointments of physicians throughout academic careers.
        Acad Med. 2011; 86: 43-47
        • Baptiste D.
        • Fecher A.M.
        • Dolejs S.C.
        • et al.
        Gender differences in academic surgery, work-life balance, and satisfaction.
        J Surg Res. 2017; 218: 99-107
        • Hill J.F.
        • Johnson A.H.
        • Cannada L.
        A profile of female academic orthopaedic surgeons.
        Curr Orthop Pract. 2013; 24: 636-640
        • Gerull K.M.
        • Holten A.
        • Rhea L.
        • Cipriano C.
        Is the distribution of awards gender-balanced in orthopaedic surgery societies?.
        Clin Orthop Relat Res. 2021; 479: 33-43
        • Gwam C.U.
        • Rosas S.
        • Xiao T.
        • Dawkins A.
        • Sullivan R.J.
        • Emory C.L.
        Are there gender differences among leaders of regional orthopaedic societies of the United States? Clin Orthop Relat Res.
        (Published online August 30, 2019)
        https://doi.org/10.1097/CORR.0000000000000956
        • Rynecki N.D.
        • Krell E.S.
        • Potter J.S.
        • Ranpura A.
        • Beebe K.S.
        How well represented are women orthopaedic surgeons and residents on major orthopaedic editorial boards and publications?.
        Clin Orthop Relat Res. 2020; 478: 1563-1568
        • Earp B.E.
        • Mora A.N.
        • Rozental T.D.
        Extending a hand: increasing diversity at the American Society for Surgery of the Hand.
        J Hand Surg Am. 2018; 43: 649-656
        • McCullough M.
        • Willacy R.A.
        • Luong M.
        • Abzug J.M.
        • Poon S.
        A 5-year review of the designated leadership positions of the American Society for Surgery of the Hand (ASSH).
        J Hand Surg Am. 2021; 46: 151.e1-151.e5
        • Mason B.S.
        • Ross W.
        • Ortega G.
        • Chambers M.C.
        • Parks M.L.
        Can a strategic pipeline initiative increase the number of women and underrepresented minorities in orthopaedic surgery?.
        Clin Orthop Relat Res. 2016; 474: 1979-1985
        • Lattanza L.L.
        • Meszaros-Dearolf L.
        • O’Connor M.I.
        • et al.
        The Perry Initiative’s medical student outreach program recruits women into orthopaedic residency.
        Clin Orthop Relat Res. 2016; 474: 1962-1966
        • Earp B.E.
        • Rozental T.D.
        Expanding the orthopaedic pipeline: the BONES Initiative.
        J Surg Educ. 2020; 77: 704-709
      2. Ruth Jackson Orthopaedic Society.
        (Accessed September 10, 2020)
        • American Society of Plastic Surgeons
        Women plastic surgeons forum.
        (Accessed July 10, 2020)
        • Chang S.
        • Guindani M.
        • Morahan P.
        • Magrane D.
        • Newbill S.
        • Helitzer D.
        Increasing promotion of women faculty in academic medicine: impact of national career development programs.
        J Womens Health (Larchmt). 2020; 29: 837-846
        • Drexel University College of Medicine
        Executive leadership in academic medicine: about ELAM.
        (Accessed July 11, 2020)
        • Costas R.
        • Bordons M.
        Do age and professional rank influence the order of authorship in scientific publications? Some evidence from a micro-level perspective.
        Scientometrics. 2011; 88: 145-161
        • Mattsson P.
        • Sundberg C.J.
        • Laget P.
        Is correspondence reflected in the author position? A bibliometric study of the relation between corresponding author and byline position.
        Scientometrics. 2011; 87: 99-105
        • Bhattacharya S.
        Authorship issue explained.
        Indian J Plast Surg. 2010; 43: 233-234