Purpose: Significant differences in career advancement and opportunities exist within academic medicine, especially in highly subspecialized fields. The objective of this study was to evaluate differences in research activity by gender among Head and Neck Fellowship program directors.
Methods: Head and Neck Fellowship directors were identified through the directory of Accredited Advanced Training in Head and Neck Oncologic and Endocrine Surgery Fellowships. There were 78 relevant programs evaluated for differences in gender among publications (h index, total publications, total citations, publication span, and mean and weighted Relative Citation Ratio (m-RCR and w-RCR). Publication information was extracted using Scopus and iCite.
Results: Seventy-eight program directors were evaluated, of which 15% were women. Female directors were distributed evenly by program focus (p=0.41), with 7 Endocrine programs (29% women), 33 Oncology programs (18% women), and 48 programs without a specific focus (11% women). Similarly, no differences in gender distribution were observed by location (p=0.45), with 20 programs in the Northeast (5% women), 24 in the South (17% women), 20 in the Midwest (25% women), 11 in the West (22% women), and 3 outside the United States (no women). An inverse relationship (p=0.45) was observed between female representation and years in practice, with the highest percentage of women with 0-9 years in practice (24%) and the lowest percentage with over 20 years in practice (11%). Female directors had on average fewer publications (114 vs. 66; p=0.028), and w-RCR (176.3 vs 75.7; p=0.026) compared to male peers. Male directors on average also had more citations (2,722 vs 139; p=0.38) over a greater span of publishing time (20.9 vs 15.2 years; p=0.070). Additionally, male directors had higher average h-index (26.4 vs 18.1; p=0.053), m-RCR (2.1 vs 1.6, p=0.92), and w-RCR (176.3 vs 75.7; p=0.026) compared to their female colleagues.
Conclusion: Head and Neck Fellowship program leadership has significant gender disparities (15% women), which is in line with other analyses of gender within academic medicine leadership. Female directors overall have lower measures of research activity compared to male peers. This may be indicative of an underlying inaccessibility for women to reach positions of authority among the head and neck specialty. However, the impact of the publications, or m-RCR, from male and female directors are similar which indicates the quality of research is comparable. Thus, among female fellowship directors, there may be a lack in support for prolonged research and publication funding in comparison to their male colleagues.