COVID-19 and the Slide Backward for Women in Academic Medicine | Health Disparities | JAMA Network Open | JAMA Network
[Skip to Navigation]
Sign In
Invited Commentary
Medical Journals and Publishing
September 17, 2020

COVID-19 and the Slide Backward for Women in Academic Medicine

Author Affiliations
  • 1Executive Leadership in Academic Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania
JAMA Netw Open. 2020;3(9):e2021061. doi:10.1001/jamanetworkopen.2020.21061

The coronavirus disease 2019 (COVID-19) pandemic has exposed many faults in our society and has exacerbated many of the already glaring racial and gender inequities that are found in medicine. It has also disrupted the pace and productivity of academic physicians. For women in particular, because of the disproportionate role they played in domestic and childcare work before COVID-191 and now with the COVID-19–related disruptions that have led to changes in childcare and other supports, the impact may be greater than for men. Using metadata from medRxiv and bioRxiv, the study by Wehner et al2 examined changes in the proportion of women corresponding authors since the onset of the pandemic, analyzing a total of 51 249 articles and determining corresponding author gender for 49 924 (97%) of them. They observed a statistically significant increase in the gender gap in medRxiv (Somers D, 0.14; 95% CI, 0.03 to 0.24) but not in bioRxiv (Somers D, 0.06; 95% CI, −0.01 to 0.12). The lack of gender gap observed in the bioRxiv metadata may have been reflective of the different populations of researchers contributing to each service. During the COVID-19 pandemic, the gender gap in medRxiv changed from a low of 23% in January 2020 to 55% in April 2020. In a similar vein, Andersen et al3 found that the research productivity of women, particularly early career women, has been impacted by COVID-19 more than the research productivity of men. The study estimates that the proportion of COVID-19–related papers with a woman first author was 19% lower than the proportion of papers with a woman first author published in the same journals in 2019.

Why is it important to monitor and analyze journal authorship? Journal authorship is one of several important elements necessary for promotion. Without promotion, women cannot reach the highest levels of leadership. While women now are the majority of students in US medical schools, they are still grossly underrepresented in positions of leadership at these same institutions. Publication also leads to invitations for speaking engagements—another area of influence that is marked by lack of gender diversity. Publication and high-profile speaking engagements lead to recognition as an expert in one’s field, which can lead to invitations to write commentaries that have impact and influence. Thus, the inequities in publication in journals that existed before COVID-19 can become even more damaging to women’s careers during COVID-19 as they fall further behind on the career trajectory.

The COVID-19 pandemic has had a disproportionate impact on women in general4; for women in medicine, the pandemic has added an additional barrier as they juggle increased childcare and domestic duties along with their academic and clinical roles. For all of the strides academic medicine has made in recent years in improving gender equity, women now run the serious risk of sliding backward, as evidenced by the study by Wehner et al.2 For Black women, the picture may be even more threatening. Because journals generally do not track race or ethnicity of authorship, we don’t know the proportion of Black authors. But what we do know is that Black women are underrepresented in academic medicine. The American Association of Medical Colleges reported in 20195 that only 2% of full-time faculty at US medical schools were Black women and 1.6% of all department chairs were Black women.

As studies of the impact of COVIID-19 on gender equity emerge in real time, real-time remedies can be instituted. The Parent in Science Movement published a letter in Science6 outlining steps that can be taken immediately, including postponing deadlines for grant proposals, reports, and renewal requests and creating granting programs designed around the reality of academics with families.

Diversity creates a positive impact in the workforce7 and enhances an organization’s return on investment. If we want to create the best opportunity for advancement in science and the best in patient care and outcomes, we need to ensure that equity is operationalized. This will take commitment from journals to enforce a climate of transparency and accountability. Data can be a powerful way to tell the story of inequity. And it can also provide a clear path to change.

Back to top
Article Information

Published: September 17, 2020. doi:10.1001/jamanetworkopen.2020.21061

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Spector ND et al. JAMA Network Open.

Corresponding Author: Nancy D. Spector, MD, Executive Leadership in Academic Medicine, Drexel University College of Medicine, 2900 W Queen Ln, K Wing, Philadelphia, PA 19129 (

Conflict of Interest Disclosures: Dr Spector reported serving as a cofounder and holding equity in the I-PASS Patient Safety Institute, serving as a founding member of Times Up Healthcare, and serving as executive director of Executive Leadership in Academic Medicine.

Jolly  S, Griffith  KA, DeCastro  R, Stewart  A, Ubel  P, Jagsi  R.  Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers.   Ann Intern Med. 2014;160(5):344-353. doi:10.7326/M13-0974 PubMedGoogle ScholarCrossref
Wehner  MR, Li  Y, Nead  KT.  Comparison of the proportions of female and male corresponding authors in preprint research repositories before and during the COVID-19 pandemic.   JAMA Netw Open. 2020;3(9):e2020335. doi:10.1001/jamanetworkopen.2020.20335Google Scholar
Andersen  JP, Nielsen  MW, Simone  NL, Lewiss  RE, Jagsi  R.  COVID-19 medical papers have fewer women first authors than expected.   Elife. 2020;9:e58807. doi:10.7554/eLife.58807PubMedGoogle Scholar
Madgavkar  A, White  O, Krishnan  M, Mahajan  D, Azcue  X. COVID-19 and gender equality: Countering the regressive effects. Mckinsey Global Institute. July 15, 2020. Accessed August 20, 2020.
American Association of Medical Colleges. U.S. medical school department chairs by chair type and sex. Updated December 31, 2019. Accessed August 20, 2020.
Staniscuaski  F, Reichert  F, Werneck  FP,  et al; Parent in Science Movement.  Impact of COVID-19 on academic mothers.   Science. 2020;368(6492):724. doi:10.1126/science.abc2740PubMedGoogle Scholar
Woolley  A, Malone  T.  What makes a team smarter? More women.   Harv Bus Rev. 2011;89(6):32-33.PubMedGoogle Scholar
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words