A 46-year Analysis of Gender Trends in Academic Authorship in Orthopaedic Sports Medicine

Introduction: Participation of women in medicine has increased markedly in recent decades, but gender disparities still exist, particularly in academic medicine. To provide insight into the gender gap, specifically in academic orthopaedic sports medicine, we investigated the relationship between gender and authorship in orthopaedic sports literature from 1972 to 2018. Methods: Information about every original article in four prominent orthopaedic sports medicine journals between 1972 and 2018 was extracted from PubMed. The proportions of female first, second, middle, and senior authors over time were determined. Gender influences on level of evidence, academic degrees, and academic productivity and longevity were also studied. Student t-test, multiple linear regression, chi-square test, Cochran-Armitage trend test, and Kaplan-Meier analysis were used to determine significance between groups. Results: In our sample, 16.6% of all authors were female. The proportion of female authors increased from 2.6% (1972 to 1979) to 14.7% (2010 to 2018). Female authors averaged fewer publications (1.9 versus 2.8 articles for male authors) and were more likely to be attributed middle authorship (45.9% versus 37.1%) than senior authorship (14.7% versus 22.1%, P < 0.001). Female authors were more likely to be full-time research staff, such as a PhD (18.2% versus 9.0%, P < 0.001), which correlated with a higher level of evidence (B = -0.162, P < 0.001). Gender differences in academic longevity decreased over decades (1972 to 1989, 1990 to 1999, 2000 to 2008), demonstrated by decreasing significance of Kaplan-Meier log-rank tests (<0.01, <0.01, 0.045). Conclusion: Female investigators in orthopaedic sports medicine are authoring publications at a growing rate, increasing almost sevenfold from 1972 to 2018. Although women published two-thirds the volume of male investigators overall, and were more likely to be full-time research staff, gender differences in academic productivity and longevity have decreased over time.