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Dermatology Makes Some Progress in Gender Equality

For women in dermatology, steady progress in gender equity has been made when it comes to speaking at annual meetings, but lead authorship on journal perspective articles lags, according to a group of new studies in JAMA Dermatology.

From 2013 to 2017, women represented 37% of first authors in dermatology papers with multiple authors, but only 13% of single-authored opinion articles were written by women. Moreover, women physicians listed as first authors were more likely to have women co-authors when compared to men (50% vs 39%), reported Allison Larson, MD, of Boston Medical Center in Massachusetts, and colleagues in a research letter.

Two more studies in the series focused on women speaking at the American Academy of Dermatology (AAD) meetings.

In the first of these, which looked at four AAD annual meetings from 2010 to 2018, Arash Mostaghimi, MD, MPA, MPH, of Brigham and Women’s Hospital in Boston, and colleagues reported in a research letter that there were 1,410 unique speakers that led 4,671 talks, and 47.8% of those talks were led by women.

And looking at six AAD meetings from 1992 to 2017, Hannah Stratman, of the University of Wisconsin-La Crosse, and Erik Stratman, MD, of Marshfield Clinic Health System in Wisconsin, reported in a research letter that as the percentage of board-certified women in dermatology grew (24.0% in 1992 to 52.5% in 2017), so did the percentage of women speaking at AAD meetings (17.9% to 48.0%, respectively).

When compared with other specialties, dermatology has fared better in reaching gender equality, but issues still remain, according to Eleni Linos, MD, MPH, DrPH, of University of California, San Francisco, and colleagues in an accompanying editorial.

“Taken together, these three reports indicate that there is reason for optimism,” Linos and colleagues wrote.

But NIH financial support through the National Institute of Arthritis and Musculoskeletal and Skin Diseases is granted to two men for every woman overall, and three men for every woman for R01 awards, they wrote.

Linos and colleagues pointed out that women are more likely to contemplate leaving careers in academia, and those who stay in academic dermatology are less likely to have investigative roles, and more likely to have educator or clinician roles.

The research letters offer hope, and raise important questions about the future of equity within academic and clinical dermatology, when it comes to effectively limiting disparities based on race, sexual orientation, gender, ethnicity, and promoting diversity, the editorialists noted.

“Studying the problem, raising awareness, and implementing policies that specifically aim to support diversity in dermatology will be critical to the advancement of our specialty. We are optimistic. And we still have a lot of work to do,” Linos’ group wrote.

Larson’s group reported “lower percentages of women among physician first authors than were in active dermatology practice in the Journal of the American Academy of Dermatology’s Commentary category in 2015 and in JAMA Dermatology‘s Viewpoint category in 2013 and 2015.”

They also showed that female doctors listed as first authors were more likely than men to be related to female last authors (39% vs 30%). In 2015, there were fewer percentages of women among authors than among women actively practicing dermatology in 90.5% of the groupings.

Data gathered from 2013 to 2017 showed that women had the greatest representation among first author physicians for perspective-type papers in highly regarded dermatology journals in 2013. However, women have been represented as little as 14.3% since 2013.

“Examinations of specific metrics (e.g., submission practices and rates, acceptance rates, reviewer assignments), similar to a 6-step process suggested for medical specialty societies, should be performed by journal leaders to identify potential areas for improvement toward achieving gender parity,” Larson’s group wrote.

They excluded articles where the gender of the first author, and/or the gender of the co-authors, could not be deciphered.

Mostaghimi and colleagues looked at the even years from 2010 to 2018, and conducted a retrospective review of AAD annual meetings to select presentation times and presenters at symposiums, focus sessions, forum talks, and plenary sessions. To accommodate multiple speakers, time was divided evenly between the presenters.

“These data suggest that representation of female speakers at the AAD Annual Meetings has steadily increased since 2010, with the proportion of female presenters nearing the proportion of women in dermatology residencies by 2018. Gender did not predict speaking time when adjusting for graduation date and board certification,” Mostaghimi’s group wrote.

They showed that the allotted presentation time and percentage of female speakers increased consistently from 2010 (43.6% and 43.6%, respectively) to 2018 (57.0% and 53.8%, respectively).

There was a median number of five speakers at each session, and a median speaking time of 24 minutes.

“As talks at national meetings and publications are leading indicators for academic promotion, we hope that these findings translate to greater representation of women at the highest levels of academic dermatology,” the researchers wrote.

Among all the speakers, 85.1% were MDs and 11.0% were MD/PhDs. Also among all presenters, 81.1% had graduated from medical school over 10 years ago, and only 17.4% presented within 10 years of their graduation. Just under 95% of presenters were board-certified dermatologists.

Presenters were excluded if they could not be matched based on web search results, if they did not have U.S. medical licensure, and did not have demographic information on the state board website.

The study authors and editorialists disclosed no relevant relationships with industry. Erik Stratman, MD, disclosed that he was a former chairman of the AAD Scientific Assembly Committee.


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