Racial and gender disparities in publishing start early for doctors and scientists

For students aiming to establish research careers, publications are crucial. Now, two new studies reveal racial and gender disparities in student publication rates, adding to the ways that inequities in academia manifest early in careers.

Women medical students publish less than men, despite reporting a similar number of “research experiences” in their residency applications, according to a study published yesterday in JAMA Network Open. Among approximately 30,000 medical school graduates who matriculated from accredited U.S. medical schools between 2014 and 2016, white men had higher publication rates than white women and both men and women from underrepresented racial and ethnic groups. (Sex was self-reported in medical school applications, and the data did not allow the authors to include nonbinary identities.) Women from underrepresented racial and ethnic groups had the lowest publication rate, and Asian students had the highest, driven by men.

“It’s critical for us to really understand the inequities that lead to the generation of [the physician] workforce,” says study author Mytien Nguyen, an M.D.-Ph.D. immunology student at Yale University. Gender and racial inequalities “can be traced back to [early] medical education.”

Among doctoral students in the biological and biomedical sciences, men also produce more papers than women, according to a preprint posted earlier this month looking at publications by 42,000 doctoral students at 235 U.S. institutions between 2012 and 2016. The disparities seen in these studies do not parallel the U.S. student population: Women make up about 52% of medical school enrollment and about 54% of doctorates in the biological and biomedical sciences.

“There is something that is keeping an inequality in place with regard to productivity and advancement,” says Anita Raj, director of the Center on Gender Equity and Health at University of California, San Diego, who was not involved in the studies. “What is happening that is not moving us towards equal productivity?”

Underlying causes are hard to pinpoint, but researchers speculate that these disparities likely lie at least in part within the culture and environment of medical and graduate programs, including lack of support and resources for women and other historically marginalized groups. According to the JAMA study, for example, disparities were more pronounced in schools that were not within the top 40 funded by the National Institutes of Health (NIH), suggesting perhaps these institutions lack funding to prioritize diversity initiatives that might help address these issues, Nguyen says. Another study found that men are more likely than women to report receiving faculty encouragement to publish.

Bias is also ingrained in the publication process, points out Michael Schaller, a biochemist at West Virginia University who authored the new preprint. Some studies show blinding the author’s gender made it more likely for women to be published, although there are conflicting results.

Publication differences may also have to do with confidence in one’s ability to perform tasks successfully or achieve a specific goal, which researchers refer to as self-efficacy, as first-year men Ph.D. students report more confidence in designing experiments and formulating research hypotheses than women. “It does not have to do with ability or talent, [men researchers] just put themselves forward more,” Schaller says. Race and ethnicity are also associated with self-efficacy in trainees, according to another recent preprint.

However, these studies only reveal associations, not cause-and-effect relationships. Smaller, institutional studies could begin to parse students’ research and publication experiences and how these factors may play a role. For example, one previous case study found women working with men advisers published about 8% less than women working with women advisers.

Nguyen notes their study examines gender, race, and ethnicity, but future studies should expand to look at the role of other marginalized identities in science and medicine, including students with disabilities, lower socioeconomic status, and marginalized sexual orientations and gender identities. “This study really highlights the need to take an intersectional lens”—referring to how multiple aspects of identity are overlapping and interconnected—“where we talk about students with all their identities.”

Researchers agree that the solutions will be complex, but something needs to be done, not only to improve the science being generated, but also to work toward equity in medicine and science. In addition to more equitable funding by institutions like NIH, scholars suggest accrediting bodies for medical schools should consider aspects of equity and inclusion in research opportunities.

“No more students should be going through this situation,” Raj says. “We need to figure out now how to make sure that [students] have equitable research opportunities and ability to publish.”

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