High-profile scandals and downfalls of the rich, famous, and powerful have been in the news on a daily basis in what has become a reckoning for decades of bad behavior. Still, issues like equal pay, equal opportunity for advancement, and equal recognition persist, and they plague just about every industry. Science and medicine are no exception.
Erin Aakhus, MD
For the most part, academic medicine provides examples of the same gender gaps as any other profession, like a tougher path to promotion or fewer opportunities for those just starting out. Studies have found women who graduate medical school are less likely than their male counterparts to rise to the ranks of associate or full professor, despite the fact that more female med school graduates go on to pursue a career in academic medicine. Other research shows women are less likely than men to receive funding and career development awards from the National Institutes of Health, though some studies suggest that may be due to women leaving the research field altogether.
In light of all of this research, Erin Aakhus, MD, associate director of the Hematology Oncology fellowship program in Penn’s Abramson Cancer Center, wanted to pull back the curtain to see what might be behind it.
Aakhus and her team tried to find out if gender remains an influence even when two people work as a team and share equal responsibilities for the science. The resulting research focused on the gender of co-first authors of scientific studies offers a glimmer of hope. Being the first author carries enormous weight in academic medicine, especially for junior faculty, and is a crucial component when it comes to who gets promoted. In recent years, with the rise of team science, more and more medical and scientific articles are written with co-first authors. When that’s the case, and the authors are from different genders, whose name is listed first?
That should be a coin flip if both authors truly contributed equally,” Aakhus said.
At least in one group, it was. Researchers looked at every article published in ten high impact journals from 2005-2014. Of the thousands of studies, they found 862 with two co-first authors of different genders. Among the subset of basic science articles, it was a 50/50 split.
“It’s not what I thought we would find,” said the study’s senior author Steven Joffe, MD, MPH, chief of Medical Ethics at Penn. “I thought we would find gender bias in the whole data set. I was happily surprised”
But the news isn’t all good. While basic science research was divided evenly, clinical research articles were a different story, with female co-authors being listed first just 37 percent of the time.
“This suggests there are differences in the basic science and clinical medicine communities,” Aakhus said. “Further study might be able to tell us more about the cause of these differences. We’d have to look at how teams work together comparatively between the lab and the clinic.”
“It’s possible there are valid reasons for who is listed first,” Joffe added. “Maybe one person did more work, or maybe one person is more junior and needs the listing. In a lab, everyone is working side by side and it could be a literal coin flip, whereas in the clinic, people could be doing different things and thus the work isn’t truly equal.”
Steven Joffe, MD, MPH
The gender of the senior author on the paper – the last author listed and typically someone who outranks the lead authors – may also have an effect.
“Our analysis showed that if the senior author is female, the female co-first author is more likely than her male counterpart to be listed first,” Aakhus said. “It wasn’t a huge difference, but it was statistically significant.”
While the researchers say they plan to continue to study this issue, they did make two recommendations for how this problem could be addressed: First, they suggested that when there are co-first authors, the journal should flip a coin to decide who goes first, taking institutional or interpersonal politics and bias out of the equation. Second, they urged journals to get away from the common practice of listing authors in a line.
“The science community can be more creative about the way we list and acknowledge authorship, perhaps by specifically labeling lead, senior, and contributing authors or writing the list in a way that reflects everyone’s contribution,” Joffe said. “When journal articles were on paper, it meant things had to be formatted a certain way. In the digital era, there’s no particular reason why we can’t have a more nuanced authorship system.”
Overall, the researchers say these findings represent progress.
“The clinical findings will get attention, but overall, this story is a good one,” Joffe said. “We hope this suggests that in some small way, gender disparities in authorship are starting to be addressed.”