Sex Differences in Achievement and Faculty Rank in Academic Infectious Diseases

Background: This study assesses differences in faculty rank between female and male infectious diseases (ID) faculty with academic appointments at US medical schools. Methods: We analyzed a complete database of US physicians with medical school faculty appointments in 2014. This database consists of a linkage between the American Association of Medical Colleges faculty roster and a physician database from Doximity, and includes physician age, sex, years since residency completion, publications, National Institutes of Health grants, and registered clinical trials for all academic physicians by specialty. We used multivariable logistic regression models with medical school-specific fixed effects to assess sex differences in full professorship by specialty and the relationship between these factors and achieving the rank of full professor within ID. We compared this adjusted difference in ID to that of peer subspecialties. Results: Among a total of 2016 academic ID physicians, there were 742 (37%) women who together accounted for 48.1% of assistant professors, 39.7% of associate professors, and 19.2% of full professors. Women faculty had fewer total (16.3 vs 28.3, P < .001) and first/last author publications (9.8 vs 20.4, P < .001). In adjusted models, the rate of full professorship (vs assistant or associate) among female compared to male ID physicians was large and significant (absolute adjusted difference, -8.0% [95% confidence interval, -11.9% to -4.1%]). This difference was greater in ID than in cardiology. Conclusions: Significant sex differences in achieving the rank of full professor exist in academic ID, after adjustment for multiple factors known to influence these outcomes. Greater efforts should be made to address equity in academic ID.