Diversity in Plastic Surgery Authorship: A 14-Year Analysis of 2688 Articles Published in Plastic and Reconstructive Surgery

Abstract

Background: Publication in peer-reviewed journals is a duty and privilege. It is essential to the advancement of evidence-based medicine and often used as a proxy for academic achievement, contributing to decisions around promotion in academia. Within plastic surgery, authors have historically been male surgeons affiliated with academic institutions, lacking representation of women, private practice, medical students, and international collaboration. This study analyzes differences in authors' gender, practice affiliation, degree of education, and international collaboration in articles published in Plastic and Reconstructive Surgery, which was chosen as the representative journal given its high impact factor (3.946) and consistent ranking as the number one journal in plastic surgery worldwide. Methods: A list of Breast, Cosmetic, and Hand/Peripheral Nerve articles published between 2006 and 2019 was compiled from the online archive of Plastic and Reconstructive Surgery. Demographic author characteristics were recorded, and statistical analyses were performed to identify trends over time. Results: A total of 2688 articles were analyzed. The proportion of articles written by female authors in the Breast category, authors in private practice with academic affiliation in the Cosmetic section, and U.S. collaboration with other countries increased over time (p = 0.038, p = 0.029, p < 0.001, respectively). First authors with bachelor's, master's, and doctorate degrees have also been contributing increasingly. Conclusions: This analysis revealed increasing demographic heterogeneity of authors in Plastic and Reconstructive Surgery over time, with increasing contributions from women, surgeons in private practice with academic affiliation, medical students, and international collaborations. The Journal is capturing contributions from an increasingly diverse authorship, consistent with the changing demographics of plastic surgeons.

Is the h-Index Enough? A Comprehensive Bibliometric Analysis of 871 Academic Plastic Surgeons and Their Departments/Divisions

“…[27][28][29] In plastic surgery specifically, gender-in-authorship disparities seem to be decreasing but remain heavily biased toward male-authored publications. 30,31 This observation is unsurprising considering that plastic surgery has been maledominated since its inception, although the percentage of women entering the field has consistently increased. [32][33][34] The h index was thought to be an objective measure of scholarly success, but a single metric is unlikely to provide an objective account of research productivity, especially if it is biased and does not fully represent the quality or value of the publication.…”

“…In general, women authors have fewer publications and citations than their male colleagues, and in some fields, such as neuroscience and physics, manuscripts authored by women are cited by men far less frequently than publications authored by men 27–29 . In plastic surgery specifically, gender-in-authorship disparities seem to be decreasing but remain heavily biased toward male-authored publications 30,31 . This observation is unsurprising considering that plastic surgery has been male-dominated since its inception, although the percentage of women entering the field has consistently increased 32–34 .…”

Diversity in the Plastic Surgery Match: The Effect of Program Chair, Program Director, and Faculties’ Race and Sex on Matched Applicants

“…Similarly, a prior study found no evidence of sex bias in the selection of integrated plastic surgery residents based on the sex of PCs and directors; however, they did not examine the effect of sex composition on the institution's faculty. 7 It has also been demonstrated 14 that a growing number of females are contributing to the plastic surgery literature. These findings, coupled with the results of our study, provide encouraging evidence of the narrowing sex gap and steadily improving sex equity within plastic surgery.…”

The Impact of Senior Author Profile on Publication Level of Evidence in Plastic and Reconstructive Surgery

“…30 The barriers to execution of high LOE research are many, including the ethical concerns associated with use of a surgical control group or placebo, conflict of study design with informed consent, low volume of rare procedures or diseases, and the hurdles of establishing data-sharing infrastructure, to name a few. The low-volume concern can be addressed through multi-institutional studies, which are becoming increasingly popular 24,31 ; however, this often introduces variability in surgical technique and postoperative care that may confound findings. Nevertheless, this interinstitutional variation in medical and surgical management may produce more generalizable conclusions, yet another strength of multicenter research.…”

“…Plastic surgery research has become an increasingly global enterprise over the past decade. [22][23][24] Nevertheless, the desired reliability and granularity of variables from online sources guided our methodology toward exclusion of international authors. This proved helpful in standardizing the sample due to key differences in fellowship requirements, board certification, and lack of NIH funding among non-US-based plastic surgeons.…”