Gender-based disparities in academic productivity arise during neurosurgery residency:​ a systematic review

Ong, Vera; Harary, Maya; Mozaffari, Khashayar; Mekonnen, Mahlet; Hwang, Leslie; Patel, Shravan; Mahgerefteh, Natalie; Nayeri, Diba; Chandla, Anubhav; Duong, Courtney; Yang, Isaac; Aghi, Manish K.

Affiliations

¹John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA

²Department of Neurological Surgery, University of California, Los Angeles, California, USA;

³Department of Head and Neck Surgery, University of California, Los Angeles, California, USA;

⁴Department of Radiation Oncology, University of California, Los Angeles, California, USA;

⁵Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, USA;

⁶Los Angeles Biomedical Research Institute, University of California, Los Angeles, California, USA;

⁷Harbor-UCLA Medical Center, University of California, Los Angeles, California, USA;

⁸Department of Neurological Surgery, University of California, San Francisco, California, USA

Abstract and keywords

Background: Although female neurosurgery residents are increasing, women remain underrepresented in academic leadership.

Objectives: To assess academic productivity differences between male and female neurosurgery residents.

Methods: We used the Accreditation Council for Graduate Medical Education records to obtain 2021-2022 recognized neurosurgery residency programs. Gender was dichotomized into male/female by male-presenting/female-presenting status. Extracted variables included degrees/fellowships from institutional websites, number of preresidency and total publications from PubMed, and h-indices from Scopus. Extraction occurred from March to July 2022. Residency publication number and h- indices were normalized by postgraduate year. Linear regression analyses were conducted to assess factors associated with numbers of in-residency publications. P < .05 was considered statistically significant.

Results: Of 117 accredited programs, 99 had extractable data. Information from 1406 residents (21.6% female) was successfully collected. 19 687 and 3261 publications were evaluated for male residents and female residents, respectively. Male and female residents' median preresidency publication numbers did not significantly differ (M:3.00 [IQR 1.00-8.50] vs F:3.00 [IQR 1.00-7.00], P = .09), nor did their h -indices. However, male residents had significantly higher median residency publications than female residents (M:1.40 [IQR 0.57-3.00] vs F:1.00 [IQR 0.50-2.00], P < .001). On multivariable linear regression, male residents (odds ratio [OR] 2.05, 95% CI 1.68-2.50, P < .001) and residents with more preresidency publications (OR 1.17, 95% CI 1.16-1.18, P < .001) had higher likelihood of publishing more during residency, controlling for other covariates.

Conclusion: Without publicly available, self-identified gender designation for each resident, we were limited to review/designate gender based on male-presenting/female-presenting status from gender conventions of names/appearance. Although not an ideal measurement, this helped show that during neurosurgical residency, male residents publish significantly more than female counterparts. Given similar preresidency h- indices and publication records, this is unlikely explained by differences in academic aptitude. In-residency gender barriers to academic productivity must be acknowledged and addressed to improve female representation within academic neurosurgery.

Keywords: Gender; Research productivity; Academic productivity; Neurosurgery residency; Male; Female; Leadership; Publishing

Links

DOI: 10.1227/neu.0000000000002547

PubMed: 37283523

WoS: 001087785100016

History

Received: 2023-02-17

Accepted: 2023-04-06

Online: 2023-06-07