Academic medicine's glass ceiling: Authorship gender disparities identified in top medical journals (supplementary data and files)

Introduction In December 2017, Lancet called for gender inequality investigations. Holding other factors constant, trends over time for significant author (i.e., first, second, last or any of these authors) publications were examined for the three high-impact medical research journals (i.e., New England Journal of Medicine [NEJM], Journal of the American Medical Association [JAMA], and Lancet). Materials and methods Using randomly sampled 2002-2019 MEDLINE original publications (n = 1,080; 20/year/journal), significant author-based and publication-based characteristics were extracted. Gender assignment used internet-based biographies, pronouns, first names, and photographs. Adjusting for author-specific characteristics and multiple publications per author, generalized estimating equations tested for first, second, and last significant author gender disparities. Results Although 37.23% of 2002 – 2019 U.S. medical school full-time faculty were women, women’s first author publication rates in all three journals were lower (26.82% overall, 15.83% NEJM, 29.38% Lancet, and 35.39% JAMA; all p < 0.0001). No changes over time occurred in women authorship rates. Women first authors had lower Web of Science citation counts and co-authors/collaborating author counts, less frequently held M.D. or multiple doctoral-level degrees, less commonly published clinical trials or cardiovascular-related projects, but more commonly were North American-based and studied North American-based patients (all p < 0.05). Women second and last authors had similar findings. Compared to men, women first authors had lower multiple publication rates (p < 0.001). Same gender first/last authors resulted in higher multiple publication rates across top journals (p < 0.001). Discussion Since 2002, this authorship “gender disparities chasm” has been tolerated across all these top medical research journals. Despite Lancet’s 2017 call to arms, furthermore, the Lancet’s author-based gender disparities have not changed - even in recent times. Co-author gender alignment may reduce future gender inequities, but this promising strategy requires further investigation