To gain perspective on the inclusion of women among physician first authors of perspective-type articles, authorship was examined both together and separately in data gleaned from the 2 highest-impact US dermatology journals. A, Data from articles published in Journal of the American Academy of Dermatology and JAMA Dermatology examined together. B, Data from articles published in the Journal of the American Academy of Dermatology Commentary category. C, Data from articles published in the JAMA Dermatology Viewpoint category. Comparators (orange circles), the percentages of women among physicians in active dermatology practice as reported by the Association of American Medical Colleges (AAMC), were not available for every year during the study period.
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Larson AR, Poorman JA, Silver JK. Representation of Women Among Physician Authors of Perspective-Type Articles in High-Impact Dermatology Journals. JAMA Dermatol. 2019;155(3):386–388. doi:10.1001/jamadermatol.2018.5517
In 2015, women comprised 47.1% of active dermatologists in the United States,1 including 47.9% of residency program directors and 55.3%, 42.4%, and 31.2% of assistant, associate, and full professors, respectively, but just 23.5% of department chairs or chiefs.2 In a recent study,3 women accounted for 43.0% of research article authors in dermatology journals, including 50.2% of first authors. However, Silver and colleagues4 recently found that women were underrepresented among physician authors of perspective-type articles published in high-impact pediatric journals despite comprising 61.9% of active pediatricians and 53.0% of full-time physician pediatric faculty. Perspective-type articles are critical and provide platforms for physicians to influence their field and contribute to their career development as authors. In the present study, we hypothesized that despite parity in first authorship of research articles, women in dermatology may be underrepresented among physician authors of perspective-type articles.
The primary outcome measured in this cross-sectional, descriptive study was the number of women among physician first authors of articles published in perspective-type categories in 2 of the highest-impact general dermatology journals (Journal of the American Academy of Dermatology and JAMA Dermatology) over a 5-year period (2013-2017). Article categories were identified as perspective if the journal’s instructions to authors indicated that articles were independent opinions. By focusing on perspective-type categories, we hoped to (1) include articles that could be written by physicians at any stage of their careers and without expertise in any particular subfield of study, and (2) minimize bias stemming from inclusion of editorial or expert commentary–type article categories owing to previous reports of underrepresentation of women among editorial boards and senior academic faculty. Once categories were identified, individual articles were excluded only if gender of the first author could not be determined (n = 1). Coauthors were excluded if gender could not be determined (n = 2). The gender of each author was determined via Internet search of public profiles. Because this study did not involve interaction with human subjects and data were publicly available, the Partners Healthcare institutional review board determined the study did not require review.
Two article categories, 1 from each journal, met the inclusion criteria: Journal of the American Academy of Dermatology’s Commentary category and JAMA Dermatology’s Viewpoint category (Table). The percentage of women among physician first authors (n = 25 of 78 [32%]) was lower than the percentage of women among active dermatologists in 2015 (47.1%).1 Women were more equitably represented among physician first of multiple authors (n = 23 of 63 [37%]) than among physician first and only authors (n = 2 of 15 [13%]). Women physician first of multiple authors were more likely than men to be associated with women coauthors (22 of 44 [50%] vs 29 of 74 [39%]). Similarly, women physician first authors were more likely than men to be associated with women last authors (9 of 23 [39%] vs 12 of 40 [30%]). Overall, there were lower percentages of women among authors than among women in active dermatology practice in 2015 in 90.5% (n = 19 of 21) of the groupings.
When examining trends, we found lower percentages of women among physician first authors than were in active dermatology practice in Journal of the American Academy of Dermatology’s Commentary category in 2015 and in JAMA Dermatology’s Viewpoint category in 2013 and 2015 (Figure).1,5 Between 2013 and 2017, the greatest representation of women among physician first authors of perspective-type articles published in 2 of the highest-impact dermatology journals occurred in 2013. Since then, women have been represented at levels as low as 14.3% (range, 14.3%-42.9%).
Examinations of specific metrics (eg, submission practices and rates, acceptance rates, reviewer assignments) similar to a 6-step process suggested for medical specialty societies6 should be performed by journal leaders to identify potential areas for improvement toward achieving gender parity.
Accepted for Publication: December 9, 2018.
Corresponding Author: Allison R. Larson, MD, Department of Dermatology, Boston Medical Center, 609 Albany St, J-207, Boston, MA 02118 (email@example.com).
Published Online: February 6, 2019. doi:10.1001/jamadermatol.2018.5517
Author Contributions: Dr Silver had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Larson, Silver.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: All authors.
Critical revision of the manuscript for important intellectual content: Larson, Poorman.
Statistical analysis: Silver.
Study supervision: Larson, Silver.
Conflict of Interest Disclosures: None reported.
Additional Contributions: The authors would like to thank Richard Goldstein, PhD, of the department of Physical Medicine and Rehabilitation at Harvard Medical School, which compensated him for his analysis of this work.