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September 30, 2021
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Q&A: Proportion of female authors still low in ophthalmology journals

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Women still make up a smaller proportion of first and senior authors of editorial articles in top ophthalmology journals despite growth in recent years, according to an investigation.

Cherie A. Fathy, MD, MPH, and colleagues looked at articles published in Ophthalmology, JAMA Ophthalmology and American Journal of Ophthalmology over two time periods — 2005 to 2009 and 2015 to 2019 — to explore the disparity among authors.

Female first and senior authorship grew by 68% from the first time period (18.1%) to the second (30.4%). But compared with male ophthalmologists, female ophthalmologists were more commonly first authors than senior authors, and female authors were more likely to be non-ophthalmologists or to hold nonmedical, non-PhD degrees.

Cherie A. Fathy, MD, MPH
Cherie A. Fathy
Aakriti Garg Shukla, MD
Aakriti Garg Shukla

Healio/OSN spoke with Fathy and co-author Aakriti Garg Shukla, MD, about their findings and the gender disparity among ophthalmology editorial authors.

Healio/OSN: What does the increase in women authors show about the makeup of ophthalmologists in general? Is women authorship rising with the increase in women physicians?

Fathy and Shukla: Demographics are changing within the field of medicine, and ophthalmology in particular. Female surgeons are becoming increasingly common; only 18% of subspecialty surgeons were women in 2000 to 2005, but this number increased to 24% in 2016 to 2017. Within ophthalmology, the proportion of female surgeons increased from 14% in the early 2000s to one-quarter in 2020. Women make up a larger proportion of trainees than practicing ophthalmologists, an observation that is consistent with the rising number of women in ophthalmology. Our study found that the increase in editorial authorship by women aligns with the increase in the proportion of female ophthalmologists. However, we found that while women authored 25% of editorials, they authored 30% to 36% of ophthalmic publications overall in the last decade. This is an important finding, as authors of editorials are generally invited by editorial boards to write these articles.

Healio/OSN: A greater proportion of women authors were not ophthalmologists and had nonmedical or non-PhD degrees. What is the reason for the disparity?

Fathy and Shukla: This observation is likely due to the greater proportion of women in training. Because our criteria defined ophthalmologists as individuals who had completed ophthalmology residency training, medical students and ophthalmology residents were grouped into the non-ophthalmologist category.

Healio/OSN: Are there any initiatives within the ophthalmology community to promote women as senior authors?

Fathy and Shukla: We are not aware of formal initiatives to promote women as senior authors, but anecdotally, we feel that initiatives for the equalization of representation by gender are already underway. Examples of this include an emphasis on increasing diversity among editorial boards and the conscious effort to ensure equitable representation by gender on conference panels.

Healio/OSN: Do you see opportunities for growth?

Fathy and Shukla: Certainly. Given the rising proportion of women as trainees in ophthalmology, we would expect to see rising authorship by women. To support this, we should be proactively ensuring that the pipeline to such leadership opportunities in our field is strong. Supporting and mentoring the next generation of ophthalmologists should be prioritized. Equally important, we should recognize that while we are improving in regard to representation by gender, there is still quite a large gap in underrepresented minorities in medicine entering ophthalmology. There is a huge need for us to ensure that our physician population resembles the community it is serving. Empowering all ophthalmologists, regardless of gender or race, will help drive the success of ophthalmology as a field.