Sex Disparity in Academic Rank and Industry Payments to Plastic Surgeons

Abstract

Introduction Despite increasing representation in surgery, women continue to lag behind men in important metrics. Little is known on how industry funding may also contribute to this ongoing disparity. This article seeks to quantify industry payments to academic plastic surgeons (APSs) by sex and examine the relationship between funding and academic achievement. Methods We conducted a cross-sectional analysis of industry payments disbursed to APSs in 2017. Faculty were identified using departmental listings of Accreditation Council for Graduate Medical Education plastic surgery residency programs. Payments were identified via the Center for Medicare and Medicaid Services open payment database. Academic achievement was assessed using rank (eg, assistant professor), leadership designation (eg, division head), and Scopus H-index and then controlled for time in practice. Results Of the 805 APSs, the majority were male (82% male vs 18% female, P < 0.0001). Significant sex differences emerged in average yearly industry contributions (men, US $3202, vs women, US $707; P < 0.0001). Across all academic ranks, men received significantly higher payments than women (P < 0.0500). Men constituted 93% of full professors and were almost twice as likely to hold additional leadership positions compared with women (odds ratio, 1.82; P = 0.0143). After adjustment for time in practice, there was no difference in H-indices between male and female APSs, although payment disparity persisted (P < 0.0001). Conclusions Substantial sex-based disparities exist among APSs' academic rank and leadership attainment, which is not attributed to differences in academic qualifications or experience. To better elucidate the sources of this disparity, future studies should assess sexed differences in payment types. Furthermore, we urge for increased transparency in the selection process for industry payments.

Follow the money: Investigating gender disparity in industry payments among senior academics and leaders in plastic surgery

“…Industry preferentially funds senior surgeons as indicated by career length and academic productivity. This data reflects the established ideology of a threshold effect in which individuals must reach an academic benchmark to qualify for industry funding [9][10][11]. Given the increased competition for funding, an understanding of the selection criteria employed by companies is needed.…”

“…Based on the exclusion criteria, 316 academic plastic surgeons were identified. The cohort was predominately male (88%), more academically productive (median H-index: 16 [IQR: 10-23]) and been in practice for 18 years [IQR: [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Nine percent of the cohort (n = 28) were of full professor rank but did not hold an additional departmental leadership role (Table 1).…”

“…For example, research funding has been shown to positively impact scholarly productivity [5][6][7], whereas sponsored speakerships reflect a surgeon's expertise and status as a key opinion leader [8]. However, female academic surgeons face an industry pay gap [9][10][11][12]. Within academic plastic surgery, female surgeons receive fewer industry payments and a lower monetary value per payment compared to their male counterparts [11].…”

“…However, female academic surgeons face an industry pay gap [9][10][11][12]. Within academic plastic surgery, female surgeons receive fewer industry payments and a lower monetary value per payment compared to their male counterparts [11]. Furthermore, lack of funding is often cited by female plastic surgeons as a negative impactor on their ability to publish [5].…”

“…Lower scholarly impact [2,13] and underrepresentation among invited speakers in plastic surgery [14] may augment existing gender disparities in academic promotion and leadership. Industry sponsorship has been shown to be influenced by academic productivity and experience [9][10][11] and the gendered differences in these metrics have been used to explain the observed disparities in industry funding in academic plastic surgery [11].…”