Gender inequality in leadership and academic rank in academic reproductive endocrinology programs

Gender and the Receipt of the Association of Residents in Radiation Oncology Educator of the Year Award

Purpose

We hypothesized that there may be a gender disparity in the receipt of the Association of Residents in Radiation Oncology (ARRO) Educator of the Year Award and sought to elucidate factors that contribute to differences in award receipt.

Methods and Materials

Using a database provided by the American Society for Radiation Oncology, award recipients were identified from 2010 to 2022. Publicly available websites were accessed to obtain data regarding gender, years since residency graduation, percentage of female faculty, size of residency program, and program director designation. A 1-sample Z-test was used to assess whether the proportion of female ARRO award winners, defined as the proportion of female radiation oncology faculty members in the nominating universities that year, was significantly less than the population average. Secondary analyses used univariable binary logistic regression to identify global associations between gender, year since gradation, or program size.

Results

The lowest proportion of female awardees occurred in 2013 (14.3%) and the greatest proportion in 2022 (30.6%). Compared with the proportion of female faculty members in nominating programs for the respective year, there were significantly fewer female awardees in 2010 (18% female awardees vs 32% female faculty members; P = .02) and 2013 (14% female awardees vs 31% female faculty members; P = .01). There was a statistically significant increase in female awardees during the study period (P < .01). On logistic regression analysis, large program size (≥10 residents) (odds ratio [OR], 6.86; 95% CI, 2.71-23.1; P < .001) and medium program size (5-9 residents) (OR, 4.05; 95% CI, 1.60-13.7; P < .001) were associated with a greater proportion of female awardees compared with small program size (1-4 residents). There was no association between awardee gender and years since graduation.

Conclusions

A gender disparity was present in the receipt of ARRO Educator Awards. Residency chiefs, program directors, and chairs should work to ensure that a diverse slate of faculty is considered annually for the ARRO Educator Award.

Perception of gender disparity in academic reproductive endocrinology and infertility

The aim of this study was to identify gender differences in leadership/academic rank and attitudes regarding gender representation among academic Reproductive Endocrinology and Infertility subspecialists. Members of the Society of Reproductive Endocrinology and Infertility (SREI) were surveyed regarding gender, academic rank, and attitudes concerning gender disparity in academic medicine in March 2021. Univariate comparisons were performed using Chi-squared and Fischer-exact tests with significance at p ≤ 0.05. A total of 237 SREI members completed the survey with a response rate of 28.8%. Of those, 176 practiced in academic medicine. The majority (76.7%) have been in practice for greater than 10 years. The female-to-male ratio changed over time with ratios of 1.1:1 for those in practice over 10 years and 5.8:1 for those less than 10 years. Of providers in practice greater than 10 years, there were significantly more male vs. female full professors (72.3% vs. 48.5%, p < 0.01), less frequent male assistant professors (3% vs.17%, p < 0.01) and a similar percentage of male and female associate professors (24.6% vs. 34.3%, p = 0.2). Among those in practice for less than 10 years, there were no differences in academic rank between males and females. When stratified by years in practice, there was no difference in gender among division directors, fellowship directors, or assistant/associate fellowship directors. 68.2% of respondents believe there is a gender disparity in academic rank, with females more likely to have this opinion (79% vs. 52.1%, p < 0.001). The female-to-male ratio in academic REI has dramatically changed with time. Even with this shift, the majority of providers believe in a gender disparity regarding academic rank that is due to systemic factors limiting the academic advancement of females. When stratified by years in practice, women in practice greater than 10 years were less likely to hold the rank of full professor than men despite equal leadership positions.

Racial and Gender Representation Trends Among National Obstetrics and Gynecology Society Leadership

STUDY OBJECTIVE

The purpose of this study is to review the trends in racial and gender representation among the various national obstetrics and gynecology societies' presidents over the past 15 years.

DESIGN

A retrospective cross-sectional study.

SETTING

Data obtained from publicly available information on official websites of the professional societies studied.

PATIENTS

Presidents of national societies in obstetrics and gynecology.

INTERVENTIONS

The study was performed by obtaining publicly available data for past presidents from the official websites of the professional societies studied. Gender and race were inferred based on name and image. Racial classification was selected using the United States Census classification system. Educational background, residency training, and practice type were also collected. Assessment of 15-year trends was completed using linear regression analysis and differences in representation was assessed using analysis of variance and post hoc analysis.

MEASUREMENTS AND MAIN RESULTS

Over 15 years, there were 134 presidents elected for the 10 obstetrics and gynecology societies. Of those leaders, 85.2% were white, 8.2% Asian, and 5.2% black; 59% were men and 41% were women. During the study period, there was a significantly increasing slope for representation of women (+2.3% per year; 95% confidence interval, 0.4-4.2; p = .016). The representation of nonwhite presidents (+1.5% per year; 95% confidence interval, 0.2-2.8; p = .028) increased significantly during the same time period.

CONCLUSION

Over the last 15 years, less than 50% of obstetrics and gynecology national societies' presidents were women and most were of white race. However, there has been an increasing trend in the ratio of women to men and nonwhite to white representation among presidents of obstetrics and gynecology national societies.

Do gender differences exist in letters of recommendation for reproductive endocrinology and infertility fellowship?

OBJECTIVE(S)

To determine if gender differences exist in letters of recommendation (LORs) for reproductive endocrinology and infertility fellowship.

DESIGN

Cohort study.

SETTING

Academic medical center.

PATIENTS

A cohort of applicants to a reproductive endocrinology and infertility fellowship program at a single Midwestern academic institution in a single year.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Quantitative measures included linguistics inquiry and word count analysis, with 4 summary variables and 25 word categories, to quantify tone and themes present by gender. Performing qualitative analysis in parallel to linguistic analysis allowed for the exploration of themes not conveyed in quantitative methods alone. Qualitative measures included the frequency of code themes in LOR by applicant gender.

RESULTS

There were 272 letters from 72 applicants, 54 (76%) of which were women and 17 (24%) were men. One applicant was excluded because gender information was not specified; 269 letters were included in the quantitative linguistics and qualitative coding analysis. One hundred 10 letters (41%) were written by women and 159 (59%) by men. LOR written for men had a higher mean word count than those written for women (537 vs. 474, P=.04). Linguistics Inquiry and Word Count analysis exhibited more risk words used to describe men applicants (P=.01). When comparing word categories by letter writer gender, women letter writers more frequently used communal, affect, and home word categories whereas men writers more frequently used affiliation-related words. Qualitative analysis revealed that letters for men applicants described leadership, altruism, rapport with patients, and strong endorsements more frequently, whereas women applicants' letters more often mentioned doubt raisers and disclosures of personal life. In addition, letters for women applicants more often described candidates as drama free, not easy to "fluster," and not complainers. Furthermore, letters for women more frequently disclosed parenthood status.

CONCLUSIONS

Gender differences exist among both letter writers and applicants. Qualitative analysis revealed that women applicants were more likely to be described with doubt raisers and personal life disclosures, whereas men were more likely to be described by their altruism and with a strong endorsement. Increasing bias awareness and implementing mitigation strategies would improve gender equity in LOR.

Gender Differences in Academic Rank, Leadership, and Awards Among NIH Grant Recipients in Diagnostic Radiology

Objective: Females have been traditionally underrepresented in academia across multiple medical specialties, including radiology. The present study investigated primary investigators (PIs) who received National Institutes of Health (NIH) radiology funding between 2016 and 2019 to establish if there was a correlation between NIH grants, gender, academic rank, first and second tier leadership positions, geographic location, and professional awards. Materials and Methods: Funding information was obtained from the NIH Research Portfolio Online Reporting Tools Expenditure and Results (RePORTER) website for 2016-2019. Information for each PI was obtained from academic institutional websites, LinkedIn, and Doximity. Mann-Whitney U tests and chi-square analyses were performed to compare and determine associations between gender and the stated variables of interest. Results: Of the 805 radiology PIs included in this study, 78% were male. There was a significant association of gender with the attainment of the highest academic rank (p = 0.026), with females occupied more of the assistant professor ranks (M:F = 1:1.5) and less of the professor ranks (F:M = 1:1.2). Between genders, there was no significant difference in first and second tier leadership positions (p = 0.497, p = 0.116), and postgraduate honors and awards (p = 0.149). The greatest proportion of grants was awarded in the setting of sole male PIs (55%) and the least proportion of grants were awarded when the contact PI and other project leader were female (1%). Conclusion: Despite having similar academic credentials, including number of leadership positions and postgraduate honors and awards, female radiology PIs who have received NIH grants continue to be underrepresented in higher academic ranks.

Predictors of Career Placement Among American Neurotology Society Fellowship Graduates

ABSTRACT AND OBJECTIVE

To identify predictors of practice type and location after neurotology fellowship based on demographics and educational history.

STUDY DESIGN

Cross-sectional analysis.

SETTING

Conference programs from the American Neurotology Society Spring Meeting from 2016 to 2022.

MAIN OUTCOME MEASURE

Percentage of neurotologists who pursued academic careers.

RESULTS

A total of 114 neurotology fellows were identified. Of the 98 individuals included in final analysis, 64 (65%) pursued academic careers. Fellows most likely to enter academic practice trained at a residency program ranked in the top 50% based on Doximity residency rankings by reputation (74 versus 45%, p < 0.01) or graduated from a residency program with a neurotology fellowship (82 versus 56%, p < 0.01). Graduates from fellowship programs in the Northeast were most likely to enter academic careers (83%). Fifty percent of neurotologists practiced in the same region as their residency training, and 48% practiced the same region as their fellowship. The region with the highest number of practicing neurotology graduates was the South (47%).

CONCLUSION

Residency program ranking and residency institutions with neurotology fellowships were the leading predictors of academic career placement in the field of neurotology. Many neurotologists tend to stay in a similar geographical location to where they underwent medical training.

Gender Equity in Academic Female Pelvic Medicine and Reconstructive Surgery Departments: A Cross-Sectional Observational Study

IMPORTANCE

Gender equity in obstetrics and gynecology remains a barrier to career mobility and workplace satisfaction.

OBJECTIVE

This study aimed to evaluate gender equity for academic positions in female pelvic medicine and reconstructive surgery (FPMRS) divisions with an Accreditation Council for Graduate Medical Education-accredited fellowship in the United States.

STUDY DESIGN

This was a cross-sectional observational study of all FPMRS divisions with an Accreditation Council for Graduate Medical Education-accredited fellowship program in the United States in July 2020 using publicly available demographic and academic data collected from online search engines. Gender equity in academic FPMRS was assessed by gender representation, academic appointment, and research productivity of each attending physician within the division. Research productivity was assessed using both the H-index with career length controlled for with the M-quotient.

RESULTS

There were 348 attending physicians from 72 FPMRS divisions (198 female [56.9%], 150 male [43.1%]). A large percentage of female attending physicians were at the assistant professor level (75.8% [94 of 124]) when compared with their male counterparts (24.4% [30 of 124]; P < 0.001). Conversely, there were a larger percentage of male attending physicians (62.2% [56 of 90]) at the professor level when compared with their female counterparts (37.8% [34 of 90]; P < 0.001). There was no difference in research productivity between male and female attending physicians after controlling for career length with the M-quotient (P = 0.65). Only age (odds ratio, 1.14; 95% confidence interval, 1.05-1.24) and the M-quotient (odds ratio, 36.17, 95% confidence interval, 8.57-152.73) were significantly associated with professorship.

CONCLUSIONS

Our study found that there are more female attending physicians in FPMRS and that most are assistant professors. Male and female FPMRS attending physicians had similar research productivity with respect to their career lengths. Gender was not a determinant for achieving a "professor" appointment.

The DIY IVF cycle-harnessing the power of deeptech to bring ART to the masses

The emergence of telehealth including telemedicine, at-home testing, and mobile health applications has enabled patients to self-manage their reproductive care, especially during the COVID-19 pandemic. Reproduction is rapidly changing and embracing deeptech initiatives that can improve outcomes and facilitate personalized fertility solutions in the near future. This so-called DIY IVF informed by deeptech and moderated by femtech not only holds a tremendous amount of promise, but also challenges and possible pitfalls. This review discusses the current status of deeptech and femtech for IVF care in a post-Roe v. Wade environment.

Gender Differences Among Academic Radiation Oncology National Institutes of Health (NIH) Funding Recipients

Purpose

The purpose of our study was to evaluate National Institutes of Health (NIH) funding recipients between 2016 and 2019 to determine if there was an association between gender, research productivity, academic rank, leadership positions, and post-graduate awards.

Materials and Methods

The NIH Research Portfolio Online Reporting Tools Expenditure and Results (RePORTER) website was used to retrieve data for grants in Radiation Oncology from 2016-2019. Demographics and profiles of awardees were retrieved from institutional websites, LinkedIn, and Doximity. Publication metrics were collected through the Scopus database. Mann-Whitney U tests and chi-square analyses were performed to compare and determine associations between gender and other variables. 

Results

Three hundred and forty radiation oncology principal investigators (PIs) were included in this study, of whom 76% were men. Of the 776 total NIH grants awarded, 62% of the grants had a sole male PI and 1% had two or more PIs in which the contact PI and co-PI were women. Between the genders of PIs in this sample, there was no significant difference in highest academic rank, leadership positions (i.e., chair, director, founder, president, and other), and post-graduate honors and awards. Total publications, years of active research, h-index, and m-index were higher amongst men in the professor category but were largely similar between genders in the associate and assistant professor categories.

Conclusions

The results demonstrate that most NIH grants in radiation oncology were awarded to men. Strategies that increase women in radiation oncology (RO), as well as those that increase NIH grants amongst women may also increase the prevalence of women in senior academic ranks and leadership positions.

Training for the future

PURPOSE OF REVIEW

The aim of this study was to review the evolving field of Reproductive Endocrinology and Infertility (REI) and describe the current and future challenges REI fellowship programmes in the United States are facing.

RECENT FINDINGS

The field of REI continues to rapidly evolve largely due to the tremendous advances within the assisted reproductive technologies (ARTs). Alongside this evolution, there is a lessening emphasis on graduates being proficient in all aspects of REI. Ongoing revisions to the REI fellowship structure reflect these changes in technology and contemporary practice patterns.

SUMMARY

REI is a rapidly evolving field and fellowship training is continually adapting to meet the changing landscape of our field.

The Women's Leadership Gap in Diabetes: A Call for Equity and Excellence

Women are broadly underrepresented in scientific leadership positions and their accomplishments are not provided equal recognition compared with those of men, but the imbalance in the field of diabetes is unknown. Hence, we analyzed multiple aspects of historical and present-day female representation in the diabetes field.We quantified gender representation at annual American Diabetes Association (ADA) meetings; editorial board service positions for ADA and the European Association for the Study of Diabetes (EASD) journals; principal investigators for ADA, JDRF, and National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases P30 grant funding; and ADA, JDRF, and EASD award recipients. There are many women in the field of diabetes: registration for the ADA Scientific Sessions has been 43% female since 2016, and for over five decades, women comprised 83% of ADA Presidents of Health Care and Education. Yet, only 9% of ADA Presidents of Medicine and Science have been women. Women were well represented on editorial boards for journals focused on diabetes education (Diabetes Spectrum, 89% female) and primary care (Clinical Diabetes, 49% female) but not for the more academically targeted Diabetes Care (34% female), Diabetes (21% female), and Diabetologia (30% female). Only one-third of ADA Pathway to Stop Diabetes and JDRF grants have been awarded to women, and females only lead 2 of 18 (11%) of the P30-supported Diabetes Research Centers. Finally, only 2-12% of major ADA, JDRF, and EASD awards were given to women, without significant change over time. Despite increasing recognition of gender imbalance in research and medicine, many disparities in the field of diabetes persist. We call for decreasing barriers for advancement of female investigators and creating environments that promote their retention and equitable recognition for their contributions to the field.

The Women's Leadership Gap in Diabetes: A Call for Equity and Excellence

OBJECTIVE

Women are broadly underrepresented in scientific leadership positions and their accomplishments are not provided equal recognition compared with those of men, but the imbalance in the field of diabetes is unknown. Hence, we analyzed multiple aspects of historical and present-day female representation in the diabetes field.

RESEARCH DESIGN AND METHODS

We quantified gender representation at annual American Diabetes Association (ADA) meetings; editorial board service positions for ADA and the European Association for the Study of Diabetes (EASD) journals; principal investigators for ADA, JDRF, and National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases P30 grant funding; and ADA, JDRF, and EASD award recipients.

RESULTS

There are many women in the field of diabetes: registration for the ADA Scientific Sessions has been 43% female since 2016, and for over five decades, women comprised 83% of ADA Presidents of Health Care and Education. Yet, only 9% of ADA Presidents of Medicine and Science have been women. Women were well represented on editorial boards for journals focused on diabetes education (Diabetes Spectrum, 89% female) and primary care (Clinical Diabetes, 49% female) but not for the more academically targeted Diabetes Care (34% female), Diabetes (21% female), and Diabetologia (30% female). Only one-third of ADA Pathway to Stop Diabetes and JDRF grants have been awarded to women, and females only lead 2 of 18 (11%) of the P30-supported Diabetes Research Centers. Finally, only 2-12% of major ADA, JDRF, and EASD awards were given to women, without significant change over time.

CONCLUSIONS

Despite increasing recognition of gender imbalance in research and medicine, many disparities in the field of diabetes persist. We call for decreasing barriers for advancement of female investigators and creating environments that promote their retention and equitable recognition for their contributions to the field.

Reflection of Trainee Class Gender Proportion in the Leadership of Minimally Invasive Gynecologic Surgery Fellowships

STUDY OBJECTIVE

To describe the gender makeup of historic fellow classes, as well as those in the roles of associate program director and program director. To determine the representation ratio of the current fellowship program leadership related to historic fellowship class gender proportion.

DESIGN

Retrospective observational study.

SETTING

Fellowship in minimally invasive gynecologic surgery (FMIGS) sites.

PARTICIPANTS

No patient data were captured or used in this study. The subjects included all FMIGS fellows, program directors, and associate program directors for whom there was publicly available data from 2001 to present.

INTERVENTIONS

Not applicable.

MEASUREMENTS AND MAIN RESULTS

Most FMIGS fellow classes have consisted of mostly female surgeons ranging from 40% to 89% female. The representation ratios for the current program leadership are 0.57, 0.82, and 0.71 for program directors, associate program directors, and all leadership positions, respectively.

CONCLUSION

Representation ratios indicate that the current gender makeup of program leadership is not representative of the gender makeup of graduated fellow classes.