Gender trends and disparities in cardiothoracic surgery authorship: an analysis of two European cardiothoracic surgical journals

A. Galeone¹, J. Cleuziou², F. Perrone¹, I. Maffei¹, M. Denora¹, J. Kluin³, C. Pompili^4
1University of Verona, VERONA, Veneto ²German Heart Center Munich, Technical University of Munich, Munich, Bayern ³Amsterdam University Medical Center, amsterdam, Noord-Holland ⁴St Bartholomew’s Hospital, London, England

Purpose: Previous studies reported significant gender disparities in authorship and editorship of academic literature in many medical specialties. However, the status of gender representation in cardiothoracic publications has not been fully described. The aim of this study was to evaluate authorship trends by gender in two European cardiothoracic surgical journals.

Methods: We performed a retrospective bibliometric analysis of all articles published from 2017 to 2022 in the European Journal of Cardio-Thoracic Surgery (EJCTS) and the Interdisciplinary Cardiovascular and Thoracic surgery (ICTVS), formerly Interactive Journal of Cardiovascular and Thoracic surgery. For each article, the gender of first author, last (senior) author and corresponding author was verified by an Internet search, email contact or by the use of the web-based application Genderize.io. Articles for analysis were also categorized based on their topic: adult cardiac surgery, congenital cardiac surgery, thoracic surgery, vascular surgery, and educational and experimental research. Gender authorship was analyzed for each article topic. The Cochran-Armitage trend test was used to evaluate variations in author gender distributions over time.

Results: A total of 5287 articles were included in the analysis, of which 3107 (59%) articles were published in the EJCTS and 2180 (41%) articles were published in the ICVTS. Overall women represented 1020 (19%) first authors, 459 (9%) senior authors and 752 (14%) corresponding authors (Figure 1). Among 2634 (50%) articles of adult cardiac surgery there were 466 (18%) female first authors, 207 (8%) female senior authors and 344 (13%) female corresponding authors. Among 649 (12%) articles of congenital cardiac surgery, women represented 154 (24%) first authors, 69 (11%) senior authors and 122 (19%) corresponding author. Among 1322 (25%) articles of thoracic surgery we found 268 (20%) female first author, 123 (9%) female senior author and 186 (14%) female corresponding author. In 419 (8%) articles of vascular surgery there were 72 (17%) female first author, 33 (8%) female senior author and 60 (14%) female corresponding author. Among 263 (5%) articles of eduction and experimental research, 60 (23%) had women as first author, 27 (10%) had women as senior author and 15 (14%) had women as corresponding author. Proportions of female first, senior and corresponding authors did not change over time in both EJCTS and ICVTS (table 1).

Conclusion: Women are underrepresented as authors in cardiothoracic journals and no significant increase in women authorship has been demonstrated in recent years. Our results confirm that although women gained gender parity at medical school and an increasing number of women are entering surgical residency, a huge disparity exists in academic leadership positions, where women represent less than 10% of full professors of surgery. It is important to increase awareness of gender disparities in academic surgery and especially in cardiothoracic surgery and to promote gender equity in research publication. This should lead to more equal career opportunities and advancement for women.

Identify the source of the funding for this research project: No funding was received for this research project