Gender Disparity in Chest Radiology in North America.

PURPOSE: In the current cultural climate, gender disparity is a topical and contentious issue. In academic medicine, there is an underrepresentation of female faculty in leadership positions with lower research output and fewer grant awards. We study the gender differences in faculty rank, leadership positions, and research output among chest radiologists in North America. MATERIALS AND METHODS: A list of clinical faculty at radiology programs in North America was obtained using the FREIDA database and program websites. Demographic information and data pertaining to academic rank, peer-reviewed publications, and research productivity of each chest radiologist was obtained from Doximity and SCOPUS databases. RESULTS: Four hundred ten (281 male:129 female) academic chest radiologists were included. Females were underrepresented at senior faculty level accounting for 18.8% (n = 21) of full, 29.2% (n = 21) of associate and 40.7% (n = 61) of assistant professors. 23.1% (n = 14) of department chiefs were women. Women were more likely to occupy a faculty position in chest radiology in Canada than in US (P < 0.05). The median H-index, and numbers of publications and citations were lower for females than male faculty (P < 0.05). Male faculty had more years of experience - median of 19 years, 16.5 years for females (P < 0.05). CONCLUSIONS: Gender disparity exists in chest radiology with similar male predominance in terms of senior faculty rank, leadership roles, and research productivity to other medical specialties. The observed deficiency of research and scholarly output among female chest radiologists and the paucity of aspirational female radiologists in senior academic/leadership positions are factors which perpetuate this gender disparity and contribute to persistence of the gender pay gap.

Examining Gender Disparity in Academic Abdominal Radiology in North America.

BACKGROUND: Gender disparity exists in nearly every medical specialty, particularly in leadership roles and academia. Radiology is not exempt from this phenomenon, with women making up less than a third of radiology residents in the United States (US). This can have long-lasting effects on the career progression of female radiologists. Our search did not reveal any study on gender composition in academic abdominal radiology. PURPOSE: To evaluate the academic productivity and career advancement of female academic abdominal radiology faculty in the United States and Canada. MATERIALS AND METHODS: Parameters of academic achievement were measured, including the number of citations and publications, years of research, as well as H-index. Information regarding academic and leadership ranking among academic abdominal radiologists in the United States and Canada was also analyzed. RESULTS: In academic abdominal radiology, there were fewer females than males (34.9% vs 65.1%; p-value 0.256). Among the female radiologists, the greatest proportion held the rank of assistant professor (40%). Female representation decreased with increasing rank. Females had a lower H-index than males (P-value = 0.0066) and significantly fewer years of research than males (P-value = 0.0243). CONCLUSION: Male predominance in academic abdominal radiology is similar to many other medical specialties, and encompasses senior faculty rank, leadership roles and research productivity.

Influences for Gender Disparity in Academic Family Medicine in North American Medical Schools.

Background Women physicians continue to comprise the minority of leadership roles in Academic Family Medicine (AFM) faculty across North American medical schools. Our study quantified the current state of gender disparity by analyzing academic position, leadership ranking, and research productivity. Methods We generated a database for 6,746 AFM faculty members. Gender and academic profiles were obtained for 2,892 academic ranks and 1,706 leadership roles by searching faculty listings enlisted in Fellowship and Residency Electronic Interactive Database (FREIDA) and Canadian Resident Matching Service (CaRMS). To measure research productivity, we obtained bibliometric data: h-index, citations, and tenure from 2,383 faculty members using Elsevier's SCOPUS archives. Data analysis and h-index were formulated using Stata version 14.2 (StataCorp LP, College Station, TX). Results Our results indicated that women hold 46.11% (3,110/6,746) of faculty positions. The proportional composition decreased with increasing academic ranking (49.84% assistant, 46.78% associate, and 41.5% full professor). The same decreasing trend was demonstrated with leadership rank (57.14% minor leadership, 47.65% second-in-command, and 36.61 first-in-command). Compared to their gender counterparts, women in AFM demonstrated lower publication productivity as measured by citation number (p=0.04) and years of study (p=0.008). The final prediction equation model after multivariable analyses included gender, publications, citations, country of graduation, and years of active research (p<0.05). Conclusions The composition of academic family medicine faculty members included in this study demonstrated gender disparity. Inclusivity initiatives and policies to tackle the issue of female retention, promotion, and recruitment need to be further explored.

Gender Disparity Among Leaders of Canadian Academic Radiology Departments.

OBJECTIVE. Underrepresentation of women in the top hierarchy of academic medicine exists despite women comprising more than half of the medical school graduates and residency positions. The purpose of this study is to analyze and quantify the relationship of gender, research productivity, and career advancement in Canadian academic radiology departments. MATERIALS AND METHODS. Seventeen academic radiology departments with affiliated residency programs in Canada were searched for publicly available data on faculty to generate a database for gender and academic profiles of the radiologists. Bibliometric data were collected using Scopus archives. The associations of gender, academic ranks, and leadership positions were assessed, and a p value of ≤ 0.05 was defined as significant. Significant variables were analyzed using a multivariate linear regression model. RESULTS. Of 1266 faculty members, gender information and academic rank were available for 932 faculty members: 597 (64.05%) were men and 335 (35.95%) were women (χ2 = 21.82; p < 0.0001). Of a total of 563 assistant professors, 331 (58.79%) were men and 232 (41.21%) were women; of 258 associate professors, 177 (68.60%) were men and 81 (31.40%) were women; and of 111 professors, 89 (80.18%) were men and 22 (19.82%) were women. The gender gap widens at higher academic ranks, displaying a threefold drop in the ratio of women holding the rank of full professor (6.57%) compared with 14.91% male professors; 29.55% of women radiologists have first-in-command leadership positions compared with 70.45% of men. A comparable or higher h-index is noted for women Canadian radiologists after adjusting for number of citations, number of publications, and years of active research. CONCLUSION. Canadian academic radiology departments have fewer women radiologists in senior faculty and leadership positions. Our study results show that Canadian female radiologists at the professor level have more publications than their male counterparts.

Influence of Academic Productivity on Gender Disparity in Academic Interventional Radiology.

OBJECTIVE. This study aimed to determine the effect of academic productivity measured using surrogate metrics, including h-index, publication number, and citation number, on the advancement of academic interventional radiology (IR) staff. MATERIALS AND METHODS. Publicly available data on faculty members in IR departments across academic institutions in Canada and the United States were collected. Gender, academic ranking, leadership position (if any), publication number, citation number, years of active research, and h-index were collected for each faculty member, and these data were used to create a prediction equation. RESULTS. Four hundred twenty IR faculty members met the inclusion criteria for this study. Overall, women were the minority, representing 10% of all IR faculty. Women in academic IR attained academic ranks at a rate comparable to that of men, with 59% of women attaining the rank of assistant professor and 32% attaining associate professor, compared with 59% of men at the assistant professor and 25% at the associate professor level. A trend toward lower female representation was present at the full professor level (women, 8%; men, 15%) but this difference did not reach statistical significance. Leadership position by gender as a percentage of their overall representation in the field was also similar between women and men (first-in-command women, 15%; first-in-command men, 15%; second-in-command women, 2%; second-in-command men, 2%). No significant difference was found between women and men in terms of academic achievement metrics, including publication number, citation number, h-index, and years of active research. CONCLUSION. Women in academic IR achieve similar publication metrics as men and attain promotion to higher academic rank and leadership positions equal to their overall representation in the field. However, women remain the minority among academic IR faculty across North America.

Gender disparity in academic emergency radiology.

OBJECTIVE: This study is intended to better understand how academic productivity and career advancement differs between men and women emergency radiologists in academic practices. MATERIALS AND METHODS: Parameters of academic achievement were measured, including number of citations, number of publications, and h-index, while also collecting information on academic and leadership ranking among emergency radiologists in North America. RESULTS: In emergency radiology, there are significantly fewer women than men (22.2% vs 77.8%). Of these women, the greatest proportion of women held the lower academic rank of assistant professor (95.4%). Female assistant professors had a higher h-index than men at the same rank (4 vs 2), but it was not statistically significantly higher. There was no significant difference between gender and academic (p = 0.089) or leadership (p = 0.586) rankings. CONCLUSION: This study provides further evidence that gender disparity persists in emergency radiology, with women achieving less upward academic career mobility than men, despite better academic productivity in the earlier stages of their careers. The academic productivity of emergency radiologists at the rank of assistant professor is significantly higher for women than men.

Health insurance coverage with or without a nurse-led task shifting strategy for hypertension control: A pragmatic cluster randomized trial in Ghana.

BACKGROUND: Poor access to care and physician shortage are major barriers to hypertension control in sub-Saharan Africa. Implementation of evidence-based systems-level strategies targeted at these barriers are lacking. We conducted a study to evaluate the comparative effectiveness of provision of health insurance coverage (HIC) alone versus a nurse-led task shifting strategy for hypertension control (TASSH) plus HIC on systolic blood pressure (SBP) reduction among patients with uncontrolled hypertension in Ghana. METHODS AND FINDINGS: Using a pragmatic cluster randomized trial, 32 community health centers within Ghana's public healthcare system were randomly assigned to either HIC alone or TASSH + HIC. A total of 757 patients with uncontrolled hypertension were recruited between November 28, 2012, and June 11, 2014, and followed up to October 7, 2016. Both intervention groups received health insurance coverage plus scheduled nurse visits, while TASSH + HIC comprised cardiovascular risk assessment, lifestyle counseling, and initiation/titration of antihypertensive medications for 12 months, delivered by trained nurses within the healthcare system. The primary outcome was change in SBP from baseline to 12 months. Secondary outcomes included lifestyle behaviors and blood pressure control at 12 months and sustainability of SBP reduction at 24 months. Of the 757 patients (389 in the HIC group and 368 in the TASSH + HIC group), 85% had 12-month data available (60% women, mean BP 155.9/89.6 mm Hg). In intention-to-treat analyses adjusted for clustering, the TASSH + HIC group had a greater SBP reduction (-20.4 mm Hg; 95% CI -25.2 to -15.6) than the HIC group (-16.8 mm Hg; 95% CI -19.2 to -15.6), with a statistically significant between-group difference of -3.6 mm Hg (95% CI -6.1 to -0.5; p = 0.021). Blood pressure control improved significantly in both groups (55.2%, 95% CI 50.0% to 60.3%, for the TASSH + HIC group versus 49.9%, 95% CI 44.9% to 54.9%, for the HIC group), with a non-significant between-group difference of 5.2% (95% CI -1.8% to 12.4%; p = 0.29). Lifestyle behaviors did not change appreciably in either group. Twenty-one adverse events were reported (9 and 12 in the TASSH + HIC and HIC groups, respectively). The main study limitation is the lack of cost-effectiveness analysis to determine the additional costs and benefits, if any, of the TASSH + HIC group. CONCLUSIONS: Provision of health insurance coverage plus a nurse-led task shifting strategy was associated with a greater reduction in SBP than provision of health insurance coverage alone, among patients with uncontrolled hypertension in Ghana. Future scale-up of these systems-level strategies for hypertension control in sub-Saharan Africa requires a cost-benefit analysis. TRIAL REGISTRATION: ClinicalTrials.gov NCT01802372.

Academic musculoskeletal radiology: influences for gender disparity.

INTRODUCTION: Research productivity is one of the few quintessential gauges that North American academic radiology departments implement to determine career progression. The rationale of this study is to quantify the relationship of gender, research productivity, and academic advancements in the musculoskeletal (MSK) radiology to account for emerging trends in workforce diversity. METHODS: Radiology residency programs enlisted in the Fellowship and Residency Electronic Interactive Database (FREIDA), Canadian Resident Matching Service (CaRMS) and International Skeletal Society (ISS) were searched for academic faculty to generate the database for gender and academic profiles of MSK radiologists. Bibliometric data was collected using Elsevier's SCOPUS archives, and analyzed using Stata version 14.2. RESULTS: Among 274 MSK radiologists in North America, 190 (69.34%) were men and 84 (30.66%) were women, indicating a statistically significant difference (χ2 = 6.34; p value = 0.042). The available number of female assistant professors (n = 50) was more than half of the male assistant professors (n = 88), this ratio however, plummeted at higher academic ranks, with only one-fourth of women (n = 11) professors compared to men (n = 45). The male MSK radiologist had 1.31 times the odds of having a higher h-index, keeping all other variables constant. CONCLUSIONS: The trend of gender disparity exists in MSK radiology with significant underrepresentation of women in top tiers of academic hierarchy. Even with comparable h-indices, at the lower academic ranks, a lesser number of women are promoted relative to their male colleagues. Further studies are needed to investigate the degree of influence research productivity has, in determining academic advancement of MSK radiologists.