Twenty year trends in female first authorship in medical journals

A study in the British Medical Journal examined the sex of first authors in six of the highest impact medical journals (Annals of Internal MedicineArchives of Internal Medicine, The BMJ, JAMA, The Lancet, and the New England Journal of Medicine (NEJM)) and found that the proportion of research article first authors who are women rose from 27% in 1994 to 37% in 2014.  The trend across all six journals showed a significant rise although a plateau in recent years–a plateau not reflective of women’s representation in the medical community.  Female first-authorship also declined in one of the six journals: the New England Journal of MedicineScreen Shot 2016-03-09 at 6.50.05 AM

The authors discuss potential factors underlying their findings. First, of the factors they included in their analysis, they noted the following:

  • journals have varied priorities by study type–for example, some may favor large randomized controlled trials. Because women receive fewer and smaller research grants than do men, they are less likely to be first author on the articles describing trial findings.
  • the proportion of women varies by specialty and geographic region, and journals may favor certain topics or regions.

The authors also note:

Our results therefore indicate that that these factors do not explain the differences observed in our study. Other possibilities, for which we could not account, include differences between journals in how submitted manuscripts are reviewed and how decisions about acceptance or rejection are made…  It is, however, intriguing to note that our data show that the four included journals with female editors-in-chief for all or most of the 2009-14 period had the highest unadjusted rates of female first authorship during these years (45% Annals, 44% JAMA, 42% Archives, and 36% BMJ), whereas the remaining two journals had considerably lower rates (20% NEJM, 35% Lancet). This observation warrants further investigation—it may be that the gender of the journal’s editor-in-chief affects factors such as the likelihood that women will submit their articles to the journal or the prioritization of study types and topics in which female clinical researchers are more likely to engage.


Published by Marion Sills

I am a Professor of Pediatrics and Emergency Medicine at the University of Colorado. I work as a physician in the emergency departments of the Children's Hospital of Colorado and as a health services researcher at the University's Adult and Child Consortium for Health Outcomes (ACCORDS).

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