How women in medicine struggle for equality in academic publishing

By Yasmine S. Ali, MD, MSCI, FACC, FACP | Fact-checked by Barbara Bekiesz
Published March 7, 2024

Key Takeaways

  • Female physicians and researchers continue to face disparities in getting published as primary and senior authors in academic medical journals compared with their male peers, stunting career advancement.

  • Contributing factors likely include lack of mentorship for junior female faculty, implicit gender biases in journal editorial and peer review processes, and systemic barriers in academia.

  • Strategies to help address this gap include deliberately fostering young female researchers, enforcing authorship policies that promote equity among journal editors, calling out disparities, and empowering female authors to employ best practices in writing and submitting high-quality manuscripts.

Despite progress toward gender equality in medicine over the past few decades, female physicians and researchers continue to face barriers in publishing scholarly work at the same rate as their male counterparts. 

This gap highlights ongoing challenges women face in advancing their academic careers.

Under-representation in medical journals

An assessment of female authorship in high-impact pediatric journals found that women were underrepresented among first authors, final authors, and co-authors in every category examined, from scholarly to narrative articles.[]

Interestingly, it can be particularly difficult for women in their early- to mid-career stages to gain authorship and publication in prestigious journals. In contrast, during training, women in medicine are often able to find male mentors who are well-published, and can serve as co-authors on journal submissions. 

This was certainly the case for me, and all of my early peer-reviewed publications followed this route. 

"I feel very fortunate for the many male mentors during my early career who made this possible."

Yasmine S. Ali, MD, MSCI, FACC, FACP

However, once a woman becomes an attending physician, perhaps even when managing their own research lab, it can be a steep uphill climb to publish with peer-reviewed journals. 

Evidence has already shown that gender inequity and bias continue to exist in NIH grant funding, with a substantial negative impact on the career trajectories and mental health of females and minorities in medicine. This both extends to and is reflected in academic publication rates as well.[]

Gender disparities in journal citations continue to exist, especially in high-impact journals. In a 2021 study, researchers found that, of 5,554 articles, those written by female primary or senior authors had fewer citations than those written by male primary or senior authors.[] Additionally, articles with females as both primary and senior authors were cited approximately half as often as those authored by men as both primary and senior authors. 

The researchers concluded that such disparities may be a key contributor to the obstacles faced by women in academic medicine, particularly in relation to career advancement and promotion.

Tips for getting published 

There are steps women in medicine can take to increase their chances of publication in academic journals. As someone who has been a medical editor, peer reviewer, and chief editor for nearly 2 decades, I have seen a range of successes and pitfalls. 

Based on my experience, here are some best practices to keep in mind.

Make sure your abstract shines

Journal editors are as busy as anyone else these days, and with so many submissions coming across their desks and flooding their inboxes, the abstract is usually their decision point—the key part that can make them decide to read the rest of your manuscript. So make it a good one! Your abstract should be structured, succinct, and provide compelling data and conclusions.

Proofread for typos, grammar, and spelling

This should go without saying, but you would be amazed at how many poorly written manuscripts are submitted daily. With careful proofreading, your research will likely stand out among the rest.

Follow the journal’s submission instructions

These often vary from journal to journal, and include their preferred styles for formatting, structure, figures, and references. If you’re not following their specific instructions, you’re making it very easy for an editor to throw out your submission.

Be prepared to revise

If your manuscript makes it to the peer-review stage, it is likely that some revisions will be requested by both the reviewers and the managing editor. Don’t hesitate to make these revisions—or to explain why you disagree with the requested revisions—and come to an amicable agreement with the editor on an alternative course of action.

Focus your theme

Your paper, whether it represents scholarly research or editorial opinion, should generally have no more than three important points or highlights. What is the theme or key finding you are trying to get across? Make sure this is clear. 

System-wide efforts

Achieving gender equity in academic medicine will require overcoming implicit biases and dismantling systemic barriers that have disproportionately hindered the advancement of female faculty and researchers. 

This must be a comprehensive effort spanning the entire career pipeline—from deliberate mentoring and sponsorship of young investigators to reform of promotion criteria at academic institutions. Journal editors also have a crucial role through enforcing authorship and peer-review policies that minimize gender bias.

For the foreseeable future, it will remain important to continue calling attention to the ongoing publication gap, pressuring the medical community and leaders in academic publishing to make substantive change, while also empowering female physicians and researchers to employ personal strategies to maximize their prospects for success.

What this means for you

For a woman in academic medicine, persistent gender disparities in publishing mean you may face unfair disadvantages in progressing in your career. Without visibility as a lead or senior author in medical literature, you risk missing out on citations, grants, promotions, leadership roles, and the ability to shape the research agenda. This requires developing savvy strategies as an author while also advocating for change in journal policies and academic culture. Be sure to utilize best practices to give yourself the best chance at publishing.

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