The gender gap in first authorship of research papersBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1130 (Published 02 March 2016) Cite this as: BMJ 2016;352:i1130
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The study by Filardo  on the degree of representation of women among first authors in original research in high impact journals from 1994 to 2014 confirms what we have known for a long time that women are under-represented as first authors and affirms that this is an ongoing concern despite signs of improvement over the past 2 decades. The authors noted a stagnation and decline in the gains in some journals in recent years. They looked at the Annals of Internal Medicine, Archives of Internal Medicine, The BMJ, JAMA, The Lancet, and the New England Journal of Medicine (NEJM). It is important to note that the gender gap in first authorship appears to extend across multiple specialties and well beyond the top 'high impact journals'. The positive signs are that the improvements in female representation among first authors have also been noted by other authors.
One study noted a significant increase in the number of female first authors in relatively junior level ophthalmology academic positions though that trend was not significant among last authors in senior positions. Despite this, the number of female first and last authors lagged behind their male colleagues. 
In family medicine, a review of five family medicine journals published in the United States between 2006-2008 showed that female authors wrote about a third of all original publications despite making up 44% of the faculty. 
In prominent American and European radiology journals, the number of female first authors has increased proportionally to the increase in the number of female radiologists but they remain a minority, especially in senior authorship. [4 ]
A study of authorship in dermatology observed a similar trend of increased female involvement in authorship which the authors thought might be related to a greater number of females pursuing higher research training and degrees such as PHDs and an increase in funding aimed at promoting female researchers. Interestingly they noted an unexplained significant decrease in the proportion of first authors holding Doctor of Medicine degrees (MDs) and an increase in non-degree first female authors such as medical or undergraduate female students.
The problem of female under-representation among first authors should indeed be a priority for governments, providers of research funding, employers and universities. They should assist females to participate more in high quality research so they can get published. Females should also be encouraged to undertake higher research degrees and research training. A study published in the Medical Journal of Australia which looked at the BMJ and the Lancet [UK] and the Annals of Internal Medicine (USA) showed that submitted manuscripts are more likely to be published if they have high methodological quality.  I think medical journal editors and reviewers should still select manuscripts for publication based on scientific merit and not on the basis of gender, race, nationality or other discriminatory criteria. I would encourage double blind peer review processes to continue that assess scientific work on content which is crucial for genuine improvements in medicine and not according to the gender of the author. The major focus should be laying the groundwork to enable females to undertake high quality research suitable for publication in high impact journals.
1. Filardo G, da Graca B, Sass DM, Pollock BD, Smith EB, Martinez MA-M et al. Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014) BMJ 2016; 352 :i847
2. Shah DN, Huang J, Ying G, Pietrobon R, O’Brien JM. Trends in female representation in published ophthalmology literature, 2000–2009. Digital Journal of Ophthalmology : DJO. 2013;19(4):50-55. doi:10.5693/djo.01.2013.07.002.
3. Schrager S1, Bouwkamp C, Mundt M. Gender and first authorship of papers in family medicine journals 2006--2008. Fam Med. 2011 Mar;43(3):155-9.
4. Liang T, Zhang C, Khara RM, Harris AC. Assessing the Gap in Female Authorship in Radiology: Trends Over the Past Two Decades. J Am Coll Radiol. 2015 Jul;12(7):735-41. doi: 10.1016/j.jacr.2015.03.008. Epub 2015 May 29.
5. Zhang S, Kim H-Y, Hill RES, Veledar E, Chen SC, A ten-year comparison of women authorship in U.S. dermatology literature, 1999 vs. 2009
International Journal of Women's Dermatology. Available online 27 January 2016 doi:10.1016/j.ijwd.2015.10.003)
6. Lee KP, Boyd EA, Holroyd-Leduc JM, Bacchetti ,P, Bero LA. Predictors of publication: characteristics of submitted manuscripts associated with acceptance at major biomedical journals. Med J Aust 2006; 184 (12): 621-626.
Competing interests: No competing interests