Where Are All The Women? The Current Gender Diversity Landscape in Academic Urology
Nina Mikkilineni, MD1, Jon-Michael E. Caldwell, MD2, Cindy L. Buchanan, PhD3, Ruth A. Bush, PhD MPH FAMIA4, Vijaya M. Vemulakonda, MD JD1.
1University of Colorado, Department of Surgery, Division of Urology; Pediatric Urology Research Enterprise (PURE), Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO, USA, 2Panorama Orthopedics and Spine Center, Golden, CO, USA, 3Department of Psychiatry, University of Colorado School of Medicine; Pediatric Urology Research Enterprise (PURE), Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO, USA, 4University of San Diego Beyster Institute for Nursing Research, San Diego, CA, USA.
BACKGROUND: The aim of our study was to investigate the gender landscape within academic urology and to determine if program gender diversity affected academic productivity or female trainee recruitment. METHODS: A web search of faculty and trainees at ACGME-accredited urology programs was conducted. Data extracted included name, gender, and academic rank, if available, for all listed faculty and trainees. Program director and chair gender was also recorded. Faculty publication volume, h-index, and federal grant funding were determined by querying the SCOPUS and NIH RePORT databases, respectively. Univariate analysis was conducted with a Mann-Whitney U test. Multivariate analysis was conducted with a linear regression. Programs with a proportion of female faculty at or above the dataset median (20%) were defined as "diverse." RESULTS: We identified 134 programs with publicly available online directories yielding 2,398 full time faculty (478 female, 19.9%) and 1,614 residents (471 female, 29%). 1,679 faculty listings (70%) included academic rank. H-index could be determined for 1,947 (81.2%) and federal grant funding data was found for 249 (10.4%). The median proportion of female faculty across all programs was 20% and female residents was 30%. Compared to male faculty, more female faculty were Assistant Professor or lower (62% vs. 39.9%, p<0.001). On univariate analysis, female faculty had significantly fewer total publications (20 vs. 45, p<0.001), lower average h-index (7 vs. 15, p<0.001), and lower funding levels (1.1M vs. 2.1M, p=0.004). When controlling for academic rank, gender remained a significant predictor of publication volume (p=0.006) and h-index (p<0.001) but not federal funding (p=0.12). Departments with a diverse faculty had significantly more publications (41 vs. 33, p=0.03) and higher h-index (13 vs 12, p=0.04), but no significant difference in federal funding (2.2M vs 1.5M, p=0.10). Multivariate analysis demonstrated that program diversity was an independent predictor of h-index (p=0.004) and funding (p=0.02) but not number of publications (p=0.35) when controlling for academic rank and gender. Subgroup analysis considering only male faculty revealed the same findings; however, when considering only female faculty, program diversity was not a significant predictor of funding, h-index, or publication volume. More diverse programs were more likely to have a female program director or a female chair (p=0.001, p=0.01, respectively) and to attract a higher percentage of female residents (p=0.005). The presence of a female program director (p=0.11) or chair (p=0.82) did not correlate with an increase in the number of female residents. On multivariate analysis, only the percentage of female faculty (p=0.006) and total program size (p<0.001) were significant predictors of the number of female residents while the presence of a female program director or chair were not while the presence of a female program director or chair were not. CONCLUSIONS: Women represent a minority of academic faculty within Urology and are predominantly at lower academic ranks. Gender-diverse programs had higher academic output and more female trainees than non-diverse programs. Further studies are needed to identify causes for these disparities and how to effectively address them.
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