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US women doctors lag behind men in publishing papers in top journals

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7561.219 (Published 27 July 2006) Cite this as: BMJ 2006;333:219

New York Janice Tanne

Despite increases in the number of women doctors in the United States over the past 40 years they are still under-represented as first or senior authors on papers published in leading journals, finds research in the New England Journal of Medicine (2006;355:281-7).

The observation that many papers in leading journals were written by men prompted the authors to wonder what message that sent to ambitious young women. “Publication in medical journals is an important measure of academic productivity. It is also highly emphasized in the academic promotion process and an important means by which the academic medical community communicates,” they wrote.

The study looked at original articles published in 1970, 1980, 1990, 2000, and 2004 in the New England Journal of Medicine, JAMA, the Annals of Internal Medicine, the Annals of Surgery, Obstetrics & Gynecology, and the Journal of Pediatrics.

The researchers were able to identify the sex of 99% of 7249 US doctors listed as first or senior authors on these papers. They also looked at the sex of authors of guest editorials in the New England Journal of Medicine and JAMA.

Overall the percentage of female first or senior authors increased from 6% in 1970 to 29% in 2004. The percentage of women who wrote guest editorials also rose overall. In JAMA the percentage rose from 0% in 1970 to 19% in 2004, while in the New England Journal of Medicine it rose from 2% in 1970 to 20% in 2000, although it then fell to 11% in 2004.

The greatest increases occurred in the Journal of Pediatrics and Obstetrics & Gynecology, while the smallest gains were made in the Annals of Surgery, changes that broadly reflect the numbers of women in these specialties.

In 1960 6% of medical students were women; now they make up 49% of the total number. One in four practising doctors is a woman, and in academic medicine almost a third of full time faculty members are women. But women represent only 10% of medical school deans, 11% of departmental chairs, and 14% of full professors.

In an accompanying editorial (2006;355:310-2) four women doctors say that the authorship sex gap will narrow only when more women reach senior faculty positions.

They wrote, “Each author … has experienced the challenges of raising children while working full-time in careers in medicine and science. Spending more time on scholarly activities necessarily means less time with family; women may be less likely than men to accept this trade-off.” Career paths in medicine should be more flexible and success less narrowly defined, they say.

The paper's first author, Reshma Jagsi, an assistant professor of radiation oncology at the University of Michigan Medical Center in Ann Arbor, said that formal mentoring and additional financial support would help the goal of increasing diversity in the medical workforce to be met.

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