Understanding the Barriers to Hiring and Promoting Women in Surgical Subspecialties

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Abstract
The objective of this study was to characterize potential disparities in academic output, NIH-funding, and academic rank between male and female surgical faculty and identify subspecialties in which these differences may be more pronounced. Eighty metrics for 4,015 faculty members at the top-55 NIH-funded departments of surgery were collected. Demographic characteristics, NIH funding details, and scholarly output were analyzed. A new metric, academic velocity (V), reflecting recent citations is defined. Overall, 21.5% of surgical faculty are women. The percentage of female faculty is highest in science/research (41%) and surgical oncology (34%), and lowest in cardiothoracic surgery (9%). Female faculty are less likely to be full professors (22.7% vs 41.2%) and division chiefs (6.2% vs 13.6%). The fraction of women who are full professors is lowest in cardiothoracic surgery. Overall median numbers of publications/citations are lower for female faculty compared with male surgical faculty (21 of 364 vs 43 of 723, p < 0.001), and these differences are more pronounced for assistant professors. Current/previous NIH funding (21.3% vs 24%, p = NS) rates are similar between women and men, and surgical departments with more female full professors have higher NIH funding ranking (R(2) = 0.14, p < 0.05). In certain subspecialties, female associate and full professors outperform male counterparts. Overall, female authors have higher numbers of more recent citations. Subspecialty involvement and academic performance differences by sex vary greatly by subspecialty type and are most pronounced at the assistant professor level. Identification of potential barriers for entry of women into certain subspecialties, causes for the observed lower number of publications/citations among female assistant professors, and obstacles for attaining leadership roles need to be determined. We propose a new metric for assessment of publications/citations that can offset the effects of seniority differences between male and female faculty members.

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