Improving Diversity, Inclusion, and Representation in Radiology and Radiation Oncology Part 2: Challenges and Recommendations

Lightfoote, Johnson B.; Fielding, Julia R.; Deville, Curtiland; Gunderman, Richard B.; Morgan, Gail N.; Pandharipande, Pari V.; Duerinckx, André J.; Wynn, Raymond B.; Macura, Katarzyna J.

doi:10.1016/j.jacr.2014.03.008

Cited by 110 publications

(56 citation statements)

References 22 publications

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“…Our profession has an obligation to ensure that scientific publication is merit-based and blind to gender or other minority and contingent identities. 25,26 We present a unique study of the RO literature, which reveals a discouraging stagnation in the incidence of women in high-profile authorship positions, despite a rise in female authorship during the past decade. We propose several interventions, including the introduction of double-blind peer review and the adoption of a modified m-score to assess publication productivity, with the aim of eliminating barriers to impactful authorship for women in RO.…”

Section: Discussionmentioning

confidence: 98%

Are Female Radiation Oncologists Still Underrepresented in the Published Literature? An Analysis of Authorship Trends During the Past Decade

Zayed

Warner

et al. 2020

Advances in Radiation Oncology

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Purpose: We examined whether female authorship, traditionally underrepresented in the radiation oncology (RO) literature, has improved during the past decade, and whether the introduction of double-blind peer review (where reviewers are blinded to author names and vice-versa) improved female authorship rates. Methods: We analyzed authorship lists during a 10-year period (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) from the 2 highest impact-factor RO journals: The International Journal of Radiation Oncology, Biology, Physics (IJROBP) and Radiotherapy and Oncology (R&O). From each journal, 20 articles per year were randomly selected. Gender trends of the first, second, last, and collaborating authors (defined as all other positions), were analyzed. A one-sample proportion test was used to compare US female senior authorship (2012)(2013)(2014)(2015)(2016) with the 2015 benchmark for female US academic radiation oncologists (30.6%). Results: Across 400 articles, the mean AE standard deviation percentage of female authors was 30.9% AE 22.0% with 34.8% of first, 36.7% of second, and 25.4% of last authors being female. The total percentage of female authors per year increased from 2007 to 2016 (P Z .005), with no significant increase in the percentage of first (P Z .250), second (P Z .063), or last (P Z .213) female authors. Double-blind peer review was associated with an increase in the mean percentage of female authors (2007-2011: 27.4% vs 2012-2016: 34.0%; P Z .012). The proportion of US female senior authors in the latter period (27.6%) and the proportion of female US academic radiation oncologists (30.6%) were not significantly different (P Z .570). Conclusions: Although the percentage of female authors in RO has increased during the past decade, this did not correspond to a higher representation of women in high-profile authorship positions. Introduction of double-blind peer review was associated with a rise in female authorship. The proportion of female US senior authors and academic radiation oncologists is similar, suggesting that senior authorship rates are approaching appropriate levels in the United States.

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Section: Discussionmentioning

confidence: 98%

Are Female Radiation Oncologists Still Underrepresented in the Published Literature? An Analysis of Authorship Trends During the Past Decade

Zayed

Warner

et al. 2020

Advances in Radiation Oncology

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“…All members of the radiology department should be provided with opportunities to cultivate these essential skills and gain this knowledge. The radiology department should strive to employ a diverse team of providers, mimicking the diversity of the patient population, a strategy that has been shown to increase patient satisfaction and compliance and improve outcomes (64,65). In addition, leaders in a radiology department should designate a task force of interested and invested physicians, nurses, technologists, and administrative staff to identify specific barriers in place at each step of the patient's journey in the radiology department, engaging colleagues in efforts to minimize these barriers.…”

Section: Implementing Patient-centered Care and Cultural Competencymentioning

confidence: 99%

Improving Imaging Care for Diverse, Marginalized, and Vulnerable Patient Populations

et al. 2018

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Although much attention has been paid to the reduction of disparities in health care within the United States, these issues continue to exist. Such efforts include increased focus on patient centeredness and cultural responsivity. These concepts are based on the recognition that diverse, marginalized, and vulnerable patients may possess different physical, psychologic, or social characteristics that contribute to their diversity and susceptibility. Such patients may face numerous obstacles and barriers when seeking medical care, including financial constraints, difficulties with communication, a limited understanding of how to navigate the health care system, and not feeling welcomed, respected, or safe. It is essential that the radiologist and members of the radiology care team understand and embrace patients' unique characteristics to provide effective and appropriate care to all patients. This article illustrates the spectrum of knowledge that benefits radiologists and members of the radiology care team when interacting with and providing care for the growing pool of diverse, marginalized, and vulnerable patients. © RSNA, 2018 • Abbreviations: LEP = limited English proficiency, LGBTQ = lesbian, gay, bisexual, transgender, or queer, PTSD = posttraumatic stress disorder

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“…In 2004, only nine of the 113 active members of the Society of Chairmen of Academic Radiology Departments were women (7). In academic radiology, women do not advance at the same pace as men do (9), and many women remain assistant professors for their entire careers.…”

Section: Data Sourcesmentioning

confidence: 99%

“…If, in contrast, gender differences in full-time effort were common and independently important for radiology promotion decisions, then not accounting for faculty track or part-time status would lead us to find lower adjusted rates of full professorship among women versus men, which we did not find. Ultimately, it is still possible, however, that parttime status could, in part, explain our likely to be involved in clinical or education tracks, which can have unclear promotional criteria and slower rates of promotion (9). Differences in child care and household responsibilities (21)(22)(23) or work-life balance preferences between the sexes (24,25) may also decrease publications and the likelihood of promotion among women.…”

Section: Health Policy and Practicementioning

confidence: 99%

Gender Differences in Academic Rank of Radiologists in U.S. Medical Schools

et al. 2017

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Purpose To determine whether there were gender differences in full professorship after accounting for factors known to influence academic advancement. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant study, with waiver of informed consent. In this cross-sectional study, the authors used a comprehensive 2014 physician database (5089 academic radiologists, inclusive of all U.S. academic radiologists in 2014; 11.3% of all U.S. radiologists) containing information on physician age, years since residency, National Institutes of Health funding, scientific publications (first or last author and total), clinical trial investigation, and clinical volume measured according to 2013 Medicare reimbursement. Primary outcome of gender differences in full professorship was estimated by using a multilevel logistic regression model adjusting for these factors. Results Among 5089 academic radiologists, 3638 (71.5%) were men. The average age for male and female radiologists was 52 and 49 years, respectively. Overall, 239 women (16.5%) and 948 (26.1%) men were full professors (P < .001). Women had fewer total and first or last author publications than men (total, 12.2 vs 17.6; first or last, 6.8 vs 10.7; P < .001 for both comparisons). Women were less likely than men to have National Institutes of Health funding (2.0% vs 3.6%; P = .004) and generated less annual Medicare revenue ($63 346 vs $75 854; P = .001). After multivariate adjustment, rates of full professorship among female and male radiologists were not significantly different (absolute adjusted difference for female vs male radiologists, -1.5%; 95% confidence interval: -3.8%, 0.9%). Conclusion Among radiologists with U.S. medical school faculty appointments in 2014, men and women were similarly likely to be full professor after several factors known to influence promotion were taken into account. However, unadjusted differences in promotion and research productivity were present, which suggests that female radiologists may lack equal research opportunities. RSNA, 2016.

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Improving Diversity, Inclusion, and Representation in Radiology and Radiation Oncology Part 2: Challenges and Recommendations

Cited by 110 publications

References 22 publications

Are Female Radiation Oncologists Still Underrepresented in the Published Literature? An Analysis of Authorship Trends During the Past Decade

Are Female Radiation Oncologists Still Underrepresented in the Published Literature? An Analysis of Authorship Trends During the Past Decade

Improving Imaging Care for Diverse, Marginalized, and Vulnerable Patient Populations

Gender Differences in Academic Rank of Radiologists in U.S. Medical Schools

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