Thoracic: Education
Gender trends in cardiothoracic surgery authorship

Read at the 102nd Annual Meeting of The American Association for Thoracic Surgery, Boston, Massachusetts, May 14-17, 2022.
https://doi.org/10.1016/j.jtcvs.2022.12.024Get rights and content

Abstract

Objective

In recent years, the historically low proportion of women cardiothoracic surgeons and trainees has been a subject of intense focus. Publications remain a key metric of academic success and career advancement. We sought to identify trends in the gender of first and last author publications in cardiothoracic surgery.

Methods

We searched for publications between 2011 and 2020 in 2 US cardiothoracic surgery journals, identifying those with Medical Subject Heading publication types of clinical trials, observational studies, meta-analyses, commentary, reviews, and case reports. A commercially available, validated software (Gender-API) was used to associate gender with author names. Association of American Medical Colleges Physician Specialty Data Reports were used to identify concurrent changes in the proportion of active women in cardiothoracic surgery.

Results

We identified 6934 (57.1%) pieces of commentary; 3694 (30.4%) case reports; 1030 (8.5%) reviews, systematic analyses, meta-analyses, or observational studies; and 484 (4%) clinical trials. In total, 15,189 total names were included in analysis. Over the 10-year study period, first authorship by women rose from 8.5% to 16% (0.42% per year, on average), whereas the percentage of active US women cardiothoracic physicians rose from 4.6% to 8% (0.42% per year). Last authorship was generally flat over the decade, going from 8.9% in 2011% to 7.8% in 2020 and on average, increased at just 0.06% per year (P = .79).

Conclusions

Over the past decade, authorship by women has steadily increased, more so at the first author position. Author-volunteered gender identification at the time of manuscript acceptance may be useful to more accurately follow trends in publication.

Section snippets

Methods

We performed a cross-sectional bibliometric analysis, identifying works published in the 2 highest impact factor cardiothoracic surgery-focused journals—the Annals of Thoracic Surgery and the Journal of Thoracic and Cardiovascular Surgery—between January 2011 and December 2020. Associated citation data were downloaded and used to identify journal, year of publication, and first and last author names. Given the use of publicly available data, this study was exempt from institutional review board

Results

We performed an interim sensitivity analysis to evaluate our initial exclusion criteria (less than 90% gender “probability” or fewer than 100 occurrences within the gender inference software database). Author names associated with women were present within the Gender-API inference database, on average, 28,090 times, whereas names associated with men were present 47,509 times (P < .001). Among author names categorized as woman-associated, the average gender probability was 90.81%, whereas for

Discussion

Gender imbalances in the practice of medicine have existed since its inception. Cardiothoracic surgery, holding a long history as a heavily male-skewed subspecialty, is no different. The first women surgeons were certified by the American Board of Thoracic Surgery in 1961, and Dr Nina Starr Braunwald became the first woman to be elected to the AATS in 1967.12,13 Today, more than 50 years later, women still comprise less than 10% of the cardiothoracic surgeon workforce.5 Despite this, there has

Conclusions

In the last 10 years, overall authorship by women in the cardiothoracic surgery literature has increased, and women publish at a rate greater than their presence within the field of cardiothoracic surgery. Publication is more frequent and is growing faster in the first author position than in the last author position (Figure 3). As a field, we should take this finding as a call for ongoing focused support and mentorship of early and mid-career women cardiothoracic surgeons as they transition to

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    All aspects of this project were funded internally. R.B. receives or has received support for his research from Verastem, Genetech/Roche, Myriad Genetics, Novartis, Siemens, Gritstone, Epizyme, MedGenome, Merck, Bicycle Therapeutics, Bayer, Intuitive Surgical, Northpond, the National Cancer Institute, the National Institutes of Health, the Department of Defense, the National Institute of Biomedical Imaging and Bioengineering, and the National Heart, Lung, and Blood Institute.

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    © 2023 by The American Association for Thoracic Surgery