Gender-based differences in the representation and experiences of academic leaders in medicine and dentistry: a mixed method study from Pakistan.

BACKGROUND: Research evidence suggests gender-based differences in the extent and experiences of academic leaders across the globe even in developed countries like USA, UK, and Canada. The under-representation is particularly common in higher education organizations, including medical and dental schools. The current study aimed to investigate gender-based distribution and explore leaders' experiences in the medical and dental institutes in a developing country, Pakistan. METHODS: A mixed-method approach was used. Gender-based distribution data of academic leaders in 28 colleges including 18 medical and 10 dental colleges of Khyber Pakhtunkhwa, Pakistan were collected. Qualitative data regarding the experiences of academic leaders (n = 10) was collected through semi-structured interviews followed by transcription and thematic analysis using standard procedures. RESULTS: Gender-based disparities exist across all institutes with the greatest differences among the top-rank leadership level (principals/deans) where 84.5% of the positions were occupied by males. The gender gap was relatively narrow at mid-level leadership positions reaching up to as high as > 40% of female leaders in medical/dental education. The qualitative analysis found gender-based differences in the experiences under four themes: leadership attributes, leadership journey, challenges, and support. CONCLUSIONS: The study showed that women are not only significantly under-represented in leadership positions in medical and dental colleges in Pakistan, they also face gender-based discrimination and struggling to maintain a decent work life balance. These findings are critical and can have important implications for government, organizations, human resource managers, and policymakers in terms of enacting laws, proposing regulations, and establishing support mechanisms to improve gender-based balance and help current and aspiring leaders in their leadership journey.

Women's participation in university management in Spain: The case of Andalusian universities.

This study addresses the presence of women in the management of Andalusian public universities, Spain. The aim of this study is to determine the representation of women in the administration and management of the administrative units of Andalusian public universities at faculty and department level, as well as to identify the distribution of university administration in terms of gender of managers in university centres according to the different macro-areas of the division of scientific knowledge. The method used was a descriptive study with quantitative and ex post facto values. A sample was selected from all public universities in the Autonomous Community of Andalusia, which represent 20% of all public universities in Spain. Information was collected from all academic units and the gender of each responsible administrator was determined. The data were deposited in a virtual repository. The results revealed that, in general, there is a disproportion in the predominance of male managers and administrators compared to the number of women involved in university management tasks in Andalusia. Imbalances in gender representation at different levels of management were observed, reflecting the inequalities reported in the literature. This study confirmed the existence of gender biases in university management, aligning with existing literature, which highlights the importance of addressing gender inequalities from a holistic perspective. The findings underline the importance of continuing to work on promoting gender equality in university management through multi-factorial approaches and concrete actions.

Incorrect and Sex-Inconsistent Mapping of Disorders: Identification of Sex Biases in the ICD-10, ICD-11 and SNOMED CT and How to Work Around Them.

In the international classifications ICD-10-WHO and ICD-11-WHO, many sex-specific diseases have incomplete coding. It is possible to further enhance semantic interoperability using SNOMED CT additionally to ICD. Part of the analysis of semantic interoperability of diagnoses in the ICD are Sexual Dysfunctions, Postpartum Depression, Sexual Assault, Premenstrual Tension Syndrome and Premenstrual Dysphoric Disorder, Female Genital Mutilation and Cutting, Gender Incongruence and Disorders of Breast. Labeling biases have been identified in all diagnoses, either in SNOMED CT or ICD. For mental disorders associated with pregnancy, gender incongruence and sexual violence the use of the GPS of SNOMED CT can help enhance semantic interoperability additionally to ICD.

Exploring community- and systemic-level gender-based violence in visible minority women across five countries from an intersectionality lens: protocol for a mixed-methods systematic review.

INTRODUCTION: The intersection of sexism with racism and xenophobia disproportionately exposes visible minority women to gender-based violence (GBV) at the community and systemic levels. This study aims to understand the knowledge strengths and gaps on GBV against visible minority women with an intersectional lens, revealing systemic barriers to accessing support and how these barriers intensify GBV and its effects. It will also identify effective and ineffective policies and practices in the literature to develop strategies addressing the root causes of GBV and supporting survivors. METHODS AND ANALYSIS: We will conduct a mixed-methods systematic review using a convergent integrated approach to examine current literature on community- and systemic-level GBV against visible minority women. We will follow Joanna Briggs Institute's guidelines to converge data from both qualitative and quantitative studies to obtain an integrated qualitative synthesis on GBV in five countries: Canada, the USA, the UK, Australia and New Zealand. This analysis will be conducted following Thomas and Harden's thematic synthesis guidelines. Community members with lived experience of GBV will actively contribute to improving the relevance and interpretation of results, following a community-engaged research approach. Themes are expected to unveil various aspects of community- and systemic-level GBV due to the intersection of racism, xenophobia and sexism, alongside barriers in addressing GBV and research gaps. ETHICS AND DISSEMINATION: Since this study does not involve primary data collection or the use of identifiable human data, no ethical approval will be needed. Results will be disseminated through integrated knowledge translation, involving collaboration with participants who have lived experience of GBV. The findings will be used to identify specific areas of policy intervention, including adopting culturally sensitive approaches, improving school and workplace policies and promoting rights of visible minority women.

Analysis of Gender Discrepancies in Leadership Roles and Recognition Awards in the Child Neurology Society.

BACKGROUND AND OBJECTIVES: Gender disparities have been demonstrated across several medical specialties, including neurology. Although women have comprised most of the child neurology trainees since 2007, it is not apparent whether this demographic shift is reflected in the Child Neurology Society (CNS) awards and leadership. This study aimed to evaluate the differences in gender representation among leadership positions and award recipients within the CNS. The primary outcome measure was the total number of board of director (BOD) positions or awards given by gender each year. METHODS: A retrospective review of publicly available data was conducted on CNS members, post-training award recipients, and BOD positions, including nomination records, from 1972 to 2023. Data abstracted were restricted to gender to preserve member and nominee anonymity. Gender identification and consensus were determined through a combination of strategies and study members. Data analysis included descriptive statistics, Pearson χ2 test, and the exact binomial test to compare gender proportions and the probability of being underrepresented in awards, leadership, and nominations over time. Data are presented according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS: From 1972 to 2023, women represented 29% (44/152) of the BOD positions and 26% (61/236) of post-training award recipients presented by the CNS. Despite the increase in the proportion of women in child neurology, the overall gap in gender representation in leadership positions remains broadly stable. Only 13% (4/32) of CNS presidents have been women, a significant underrepresentation (95% CI 2.3%-52%, p < 0.004), although the representation of women in nonpresidential positions increased from 2003 to 2023. Women are also underrepresented as overall awardees (95% CI 12%-38%, p < 0.00001) except for the Philip R. Dodge Young Investigator Award, which is an investigator-initiated application. DISCUSSION: Women remain underrepresented at the highest levels of recognition in child neurology despite representing most of the field. Reasons for disparities are known to be multifactorial and likely include gender bias and structural sexism. We present several discussion topics that seek to rationalize this disparity and provide suggestions for improving diversity, equity, and inclusion for leadership roles and awards.

Discrimination based on gender identity against transgender women and travestis in Brazil: a latent class analysis and associated factors.

OBJECTIVE: To identify groups of transgender women and travestis (TGW) with specific patterns of gender-based discrimination (GBD) and analyze the factors associated with GBD. METHODS: A cross-sectional study was conducted with TGW recruited through respondent-driven sampling in five Brazilian cities (2019-2021). Latent class analysis was used to characterize GBD (low, medium, and high) using 14 observable variables. Descriptive analysis was performed, and associations between predictor variables and GBD were estimated by adjusted odds ratios (aOR) using ordinal logistic regression. RESULTS: Out of a total of 1,317 TGW, 906 (68.8%) answered questions about GBD. Most were under 34 years old, single, and had a Brown race/skin color. GBD was classified as "low," "medium," and "high," with estimates of 41.7, 44.5, and 13.8%, respectively. Variables positively associated with higher intensity of GBD included living in Manaus compared to São Paulo, being ≤34 years old compared to >34, being homeless compared to living in one's own house or rented apartment, not having legally changed one's name compared to those who had, and reporting physical or sexual violence compared to those who did not report. Variables negatively associated with higher intensity of GBD included having a Brown or Asian race/skin color compared to White and a monthly income ≥1 minimum wage compared to ³1. CONCLUSION: A high proportion of GBD was observed in Brazilian TGW, with this outcome associated with more vulnerable sociodemographic characteristics and a history of violence.

Examining interviewer bias in medical school admissions: The interplay between applicant and interviewer gender and its effects on interview outcomes.

Selection interviews have long been integral to medical school admissions, yet their limited predictive validity and susceptibility to bias raise concerns. This study delves into potential interviewer bias within the dynamics of interviewee and interviewer gender. We analyze a dataset of 5,200 applicants and over 370 selection committees engaged in semi-structured interviews from 2006 to 2019 at a large German medical school with multiple linear and non-linear regression analyses. Our findings reveal that all-female committees tended to award male candidates, on average, one point more than their female counterparts, significantly enhancing the chances of submission for male applicants despite lower academic grades, which constituted 51% of the selection process points. All-male and mixed-gender committees exhibited similar ratings for both genders. The role of valuing voluntary services emerged prominently: all-male and mixed committees acknowledged women's volunteer work but not men's, while all-female committees demonstrated the opposite pattern. Our results attribute variations in interview outcomes to the absence of standardization, such as insufficient interviewer training, divergent rating strategies, variations in interviewer experience, and imbalances in candidate allocation to selection committees, rather than to a "gender bias", for example by favoritism of males because of their gender.

Gender discrimination in Swedish family courts: A quantitative vignette study.

BACKGROUND: Gender discrimination of women is often emphasized in work contexts, whereas less focus is on how men are discriminated against in social relationships. Gender discrimination in decisions of family relations, is essential to study as the contact between parent and child is commonly viewed as the most important relationship in people's life, as well as being the most important aspect of our life. Following separations, decisions on custody disputes are made by social workers. The purpose of this paper is to study gender discrimination in such decisions. METHOD: Participants were instructed to give a recommendation of shared parenting based on a custody case vinjett, where we manipulate the gender of the risk parent. RESULTS: The participants' recommendation of living was mainly dependent on the risk parent's gender, where the mother was considerably more likely to receive shared custody than the father. CONCLUSIONS: Professional social workers show selective gender discrimination against fathers in terms of living recommendations.

Sex bias in pain management decisions.

In the pursuit of mental and physical health, effective pain management stands as a cornerstone. Here, we examine a potential sex bias in pain management. Leveraging insights from psychological research showing that females' pain is stereotypically judged as less intense than males' pain, we hypothesize that there may be tangible differences in pain management decisions based on patients' sex. Our investigation spans emergency department (ED) datasets from two countries, including discharge notes of patients arriving with pain complaints (N = 21,851). Across these datasets, a consistent sex disparity emerges. Female patients are less likely to be prescribed pain-relief medications compared to males, and this disparity persists even after adjusting for patients' reported pain scores and numerous patient, physician, and ED variables. This disparity extends across medical practitioners, with both male and female physicians prescribing less pain-relief medications to females than to males. Additional analyses reveal that female patients' pain scores are 10% less likely to be recorded by nurses, and female patients spend an additional 30 min in the ED compared to male patients. A controlled experiment employing clinical vignettes reinforces our hypothesis, showing that nurses (N = 109) judge pain of female patients to be less intense than that of males. We argue that the findings reflect an undertreatment of female patients' pain. We discuss the troubling societal and medical implications of females' pain being overlooked and call for policy interventions to ensure equal pain treatment.

Gender awareness among the undergraduate medical students: A cross sectional study from Hyderabad, India.

BACKGROUND: Physician trainees need to have robust gender awareness for better professional relationships and patient outcomes. A cross-sectional study was conducted among undergraduate (UG) medical students (MBBS) of a medical college in Hyderabad, India, in November 2022, to assess their gender sensitivity (GS) and gender-role ideologies. METHODS: A pretested, structured English questionnaire was used for the study, to compute the Nijmegen Gender Awareness Scale in Medicine (N-GAMS) of the participants. RESULTS: The mean age of the students was 20.51 years, with the majority being women (112, 61.2%). The mean GS score was 3.11, while the mean scores for gender-role ideology towards patients (GRIP) and gender-role ideology towards doctors (GRID) were 2.56 and 2.56, respectively. In the adjusted analysis, a significantly better GS score was seen among medical students from urban backgrounds. Significantly more egalitarian GRIP was found among women, participants from urban backgrounds, and among those whose mothers were employed. Significantly more egalitarian GRID was found among women and participants whose mothers were employed. There was a significant negative, but low, correlation between the GS domain and the GRIP (r = - 0.241; p < 0.001) and GRID (r = - 0.192; p = 0.009) scores. There was a high, positive correlation between GRID and GRIP (r = 0.812; p < 0.001). CONCLUSION: Gender awareness is relatively low among Indian medical students and lower still among male students. It was higher among women, particularly among those whose mothers were employed and those who were from urban areas.

The Landscape of Pain Medicine for Women Physicians: A Perspective.

BACKGROUND: The gender bias in academic anesthesiology is well known. Women are not only a minority in the field but also underrepresented in leadership positions. Reported reasons for this underrepresentation include barriers to career advancement, lack of mentorship, and differences in compensation, among others. Interventional pain, a competitive procedural subspecialty of anesthesiology, sees the trickle-down effects of this disparity. According to a report from the ACGME that sorted medical subspecialties by number of female trainees, pain medicine ranked in the bottom quartile across all disciplines from 2008-2016. OBJECTIVES: To better understand the landscape for women physicians in the field of pain medicine, we undertook this investigation to review the knowledge about the topic and what questions remain unanswered. STUDY DESIGN: This study is a review of the current literature and aims to summarize and describe the landscape of pain medicine for women physicians. SETTING: All literature review and manuscript preparation took place at the Yale University School of Medicine. METHODS: We performed a comprehensive search using the PubMed, Scopus, and Cochrane databases for the combined terms "gender disparity," "pain medicine," and "anesthesiology," limiting our search to the year 2000 onward for the most recent literature on the topic. Our initial search retrieved 38 articles. All relevant articles pertaining to this perspective piece were collated. The available literature is discussed below. RESULTS: Women are underrepresented in interventional pain. The grim scarcity of female pain physicians is unlikely to improve soon, since while the number of Accreditation Council for Graduate Medical Education pain fellowship programs continues to grow, women trainees comprise only between 22-25% of all pain medicine fellows. Additionally, although studies have compared the numbers of male interventional pain faculty to their female counterparts in academic hospitals and shown the ratio to range from 71.84-82% to 18-28.52%, respectively, no studies have truly explored the landscape for women physicians in private practice. Patients prefer and have better experiences with physicians who are racially and ethnically like themselves. In fact, the preference for and the lack of female clinicians have been associated with delayed pursuit of care and adverse health outcomes. The consequences of the burnout and attrition caused by the gender disparity, especially in a field like pain medicine, cannot be understate. LIMITATIONS: The review might not have been comprehensive, and relevant studies might not have been included. CONCLUSION: While the gender disparity in academia is well documented for both anesthesiology and pain medicine, the reasons for this disparity have not been fully explored. Moreover, it is also unknown whether the minority of female physicians who select pain medicine as a subspecialty gravitate toward an academic or a private-practice path. To address the existing gender disparity, it is necessary to explore the landscape of interventional pain medicine in both academic and private practices and understand pain physicians' beliefs and sentiments regarding their subspecialty.

Weight stigma is uniquely tied to maladaptive eating across different racial, ethnic, and gender groups.

Weight stigma, racism, and sexism (social devaluation due to body weight, race or ethnicity, and sex or gender), have been linked to increased maladaptive eating behaviors; however, no research has investigated the unique associations between different forms of stigma and eating concurrently. We analyzed within-group (by race/ethnicity and sex) effects of different forms of stigma on maladaptive eating behaviors to test whether there is some unique relationship between weight stigma and maladaptive eating across identities. Additionally, we explored differences by racial/ethnic group and sex, as well as BMI category, in levels of reported weight stigma, racism, sexism, and maladaptive eating. Participants (N = 1051) were recruited so that there were approximately even numbers of participants identifying as Black (33.3%), Hispanic or Latino (32.8%), and White (33.9%). Overall, participants reported similar amounts of weight stigma by race/ethnicity and sex, but different levels of racism and sexism. Weight stigma, but not racism or sexism consistently predicted binge eating and eating to cope across groups, controlling for education, income, BMI, and age. Restricted dieting, however, was only predicted by weight stigma for Hispanic/Latino and Black men. These findings suggest that weight stigma is a unique predictor of maladaptive eating, even when considering the effects of racism and sexism. This study provides evidence of a more focused model of weight stigma and eating outcomes, rather than a more general model of the effect of stigma on eating outcomes due to overall stress. Future research should investigate when and why weight stigma drives restricted dieting, since this relationship seems strongest in men, going against many common inclinations about weight stigma.

Is Program Director Gender Associated With Gender Diversity Among Orthopaedic Surgery Residency Programs?

BACKGROUND: Women remain underrepresented in leadership roles, faculty roles, and among residents in orthopaedic surgery. It has been suggested that having women in leadership positions in orthopaedic surgery may help to increase the gender diversity of residency programs. However, to our knowledge, no study has explored the relationship, if any, between the gender of the residency program director and the percentage of women in the residency program. QUESTIONS/PURPOSES: (1) Is the program director's gender associated with differences in the percentage of women orthopaedic surgery residents? (2) Do women and men differ in the time to appointment of program director? METHODS: A list of 207 orthopaedic surgery residencies was obtained from the Accreditation Council for Graduate Medical Education (ACGME) website for the academic year 2021 to 2022. The study excluded 6% (13) of programs; 4% (8) were those without ACGME accreditation and those with initial accreditation, and 2% (5) did not have updated 2021 to 2022 resident lists. Descriptive information on 194 programs was obtained from publicly accessible resources from July 2021 through July 2022. The institution's website and the American Medical Association's (AMA) Fellowship and Residency Electronic Interactive Database (FREIDA) was used to collect residency program characteristics and resident demographics [ 2 ]. Doximity, Healthgrades, and LinkedIn were used to further collect current orthopaedic surgery residency program director demographics, including gender, age, and education/training history. To determine gender, photographs and pronouns (she/her/hers or he/him/hers) used in their biographies were used first. To confirm this, secondary sources were used including their NPI profile, which lists gender; Doximity; and their LinkedIn profile. Scopus was used to analyze research output by the program directors-using the Hirsch index (h-index) as the primary bibliometric metric. A total of 194 program directors were identified, of whom of 12% (23) were women and 88% (171) were men. Of the 4421 total residents among these programs, 20% (887) were women and 80% (3534) were men. A univariate analysis comparing program directors was conducted, with continuous variables analyzed using an independent-sample t-test and categorical variables analyzed using a Pearson chi-square test. With the numbers available, a post hoc statistical power calculation indicated that we could detect an 32% difference in the percentage of women in a program as significant with 80% power at the p < 0.05 level, whereas we might have been underpowered to discern smaller differences than that. RESULTS: With the numbers available, we found no difference in the percentage of women in residency programs run by women program directors than in programs in which the program director was a man (22% [125 of 558] versus 20% [762 of 3863], mean difference 2% [95% CI -1.24% to 7.58%]; p = 0.08). Comparing women to men program directors, women had fewer years between residency completion and appointment to the position of program director (8 ± 2 years versus 12 ± 7 years, mean difference 4 years [95% CI 2.01 to 7.93 years]; p = 0.02) and had a lower mean h-index (7 ± 4 versus 11 ± 11, mean difference 4 [95% CI 1.70 to 6.56]; p = 0.03) and number of publications (24 ± 23 versus 41 ± 62, mean difference 17 [95% CI 3.98 to 31.05]; p = 0.01), although they did not differ in terms of their advanced degrees, duration of training, or likelihood of having taken a fellowship. CONCLUSION: Orthopaedic residency programs that were run by women did not contain a higher percentage of women residents, suggesting that the gender of the individual in that role may not be as important as has been speculated by others. Future studies should investigate the intersectionality of gender, race, and ethnicity of residents, program directors, and current faculty. CLINICAL RELEVANCE: The fact that women were placed in program director roles earlier in career may also carry special jeopardy for them. Those roles are difficult and can impair a faculty member's ability to conduct individual research, which often is key to further academic promotions. Given that and the fact that the gender of the program director was not associated with differences in gender composition of residency programs, we believe that increasing mentorship and access to pipeline programs will help promote diversity in residency programs.

Institutional Support for the Career Advancement of Women Faculty in Science and Academic Medicine: Successes, Challenges, and Future Directions.

Institutional support is crucial for the successful career advancement of all faculty but in particular those who are women. Evolving from the past, in which gender disparities were prevalent in many institutions, recent decades have witnessed significant progress in supporting the career advancement of women faculty in science and academic medicine. However, continued advancement is necessary as previously unrecognized needs and new opportunities for improvement emerge. To identify the needs, opportunities, and potential challenges encountered by women faculty, the Women's Leadership Committee of the Arteriosclerosis, Thrombosis, and Vascular Biology Council developed an initiative termed GROWTH (Generating Resources and Opportunities for Women in Technology and Health). The committee designed a survey questionnaire and interviewed 19 leaders with roles and responsibilities in faculty development from a total of 12 institutions across various regions of the United States. The results were compiled, analyzed, and discussed. Based on our interviews and analyses, we present the current status of these representative institutions in supporting faculty development, highlighting efforts specific to women faculty. Through the experiences, insights, and vision of these leaders, we identified success stories, challenges, and future priorities. Our article provides a primer and a snapshot of institutional efforts to support the advancement of women faculty. Importantly, this article can serve as a reference and resource for academic entities seeking ideas to gauge their commitment level to women faculty and to implement new initiatives. Additionally, this article can provide guidance and strategies for women faculty as they seek support and resources from their current or prospective institutions when pursuing new career opportunities.

The weaponization of professionalism against physicians of color.

Though we have made ample advances in the field of medicine in recent years, our idea of professionalism continues to be based on the standard of how white men dressed in the nineteenth century. Such a standard of professionalism not only perpetuates gender bias, but also aims to remove the culture, traditions, and behaviors of minority groups with the goal of molding these individuals to resemble the majority, preventing 'Afro' heritage from entering medicine. By contextualizing our own experiences in the medical setting as physicians of color in the context of a variety of supporting literature, we provide an overview of professionalism, its role in medicine, the double standard faced by women, and how it continues to be weaponized against physicians of racial, ethnic, and religious minorities. We advocate for minority physicians to embrace their authenticity and for institutions to develop policies that openly, firmly, and enthusiastically welcome physicians of all ethnicities, religions, and genders. Positionality Statement: In the editorial you are about to read, we, the authors, collectively bring a rich tapestry of backgrounds and experiences to our discussion on healthcare disparities. Our team consists of two Hispanic/Latina oncologists, one Middle Eastern oncologist, one Black/Caribbean-American hematologist, and one White pre-medical student with Middle Eastern heritage. Our diverse backgrounds inform our perspectives and enhance our understanding of the complex and multifaceted nature of healthcare. We are united by a shared commitment to justice, equity, and the belief that every patient deserves high-quality care, regardless of their background. This editorial is informed by our professional expertise, personal experiences, and the diverse communities we serve, aiming to highlight the critical need for inclusivity and representation in healthcare. By acknowledging our positionality, we hope to provide a comprehensive and empathetic analysis that not only identifies the challenges but also offers actionable solutions to improve healthcare outcomes for all. We recognize the power of diversity in fostering innovation and driving positive change, and we are dedicated to using our voices and positions to advocate for a more equitable healthcare system.

Gender Differences in Letters of Recommendations and Personal Statements for Neurotology Fellowship over 10 Years: A Deep Learning Linguistic Analysis.

OBJECTIVE: Personal statements (PSs) and letters of recommendation (LORs) are critical components of the neurotology fellowship application process but can be subject to implicit biases. This study evaluated general and deep learning linguistic differences between the applicant genders over a 10-year span. STUDY DESIGN: Retrospective cohort. SETTING: Two institutions. MAIN OUTCOME MEASURES: PSs and LORs were collected from 2014 to 2023 from two institutions. The Valence Aware Dictionary and Sentiment Reasoner (VADER) natural language processing (NLP) package was used to compare the positive or negative sentiment in LORs and PSs. Next, the deep learning tool, Empath, categorized the text into scores, and Wilcoxon rank sum tests were performed for comparisons between applicant gender. RESULTS: Among 177 applicants over 10 years, 120 were males and 57 were females. There were no differences in word count or VADER sentiment scores between genders for both LORs and PSs. However, among Empath sentiment categories, male applicants had more words of trust ( p = 0.03) and leadership ( p = 0.002) in LORs. Temporally, the trends show a consistently higher VADER sentiment and Empath "trust" and "leader" in male LORs from 2014 to 2019, after which there was no statistical significance in sentiment scores between genders, and females even have higher scores of trust and leadership in 2023. CONCLUSIONS: Linguistic content overall favored male applicants because they were more frequently described as trustworthy and leaders. However, the temporal analysis of linguistic differences between male and female applicants found an encouraging trend suggesting a reduction of gender bias in recent years, mirroring an increased composition of women in neurotology over time.