Gender gap in medical journal first authorship, new research reveals

The study investigated the representation of women among the first authors of original research articles published in the highest-ranked general medical journals over a period of 20 years. It found that, while the representation of women among first authors was significantly higher in 2014 than 20 years earlier, the numbers plateaued in recent years and declined in some journals. Additionally, significant differences in the representation of women were identified between journals.

"The underlying causes need to be investigated to help to identify practices and strategies to increase women's influence on and contributions to the evidence that will determine future healthcare policies and standards of clinical practice," Giovanni Filardo, PhD, MPH, and his co-authors wrote in the paper, titled "Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014)."

Dr. Filardo is director of epidemiology, office of the Chief Quality Officer, for Baylor Scott & White Health and Bradley Family Endowed Chair in Cardiovascular Epidemiology. He led the research team that conducted this study, which began as a project intended to provide hands-on research experience for the summer interns in his department.

"Women made meaningful gains in first authorship -- from 27% in 1994 to 37% in 2014," Dr. Filardo said. "However, since around 2009, female first authorship seems to have stagnated. Moreover, female first authorship declined from 2009 through 2014 compared with 1994 through 1998 in two of the journals with the highest impact factor in the world: The BMJ and the New England Journal of Medicine."

The results provide worrying evidence of a failure to further advance research authorship by women, as Kathryn M. Rexrode, MD, MPH, associate professor of medicine and faculty director of Office for Women's Careers at Harvard Medical School, Boston, states in an editorial accompanying The BMJ article: "Authorship is necessary for career progression and is also a symptom of success; it is the culmination of career development, mentorship, funding, and support. Gender inequity must therefore be tackled at the level of journals, universities, and funding agencies by training leaders to understand unconscious bias and by developing and implementing institutional policies that promote gender equity," Dr. Rexrode wrote.

Dr. David Ballard, MD, PhD, MSPH, FACP, chief quality officer for Baylor Scott & White Health, also views the finding that women continue to be underrepresented among the first authors of high impact original research as concerning.

"These are the research articles that drive health policy and clinical practice guidelines," he commented. "The fact that women are underrepresented among the lead authors of these articles means their evidence does not have the opportunity to be given the full weight it deserves in shaping how we deliver health care. Baylor Scott & White Health is proud to see a team of our researchers drawing attention to this issue -- and being given a forum for discussion by BMJ, which is one of the high impact journals they studied."