Female Authorship in Otolaryngology: A Leaky Pipeline

Introduction: Peer-reviewed publications have become a cornerstone in evaluating the academic potential of otolaryngology residency applicants, serving as a key metric of scholarly achievement. Beyond residency selection, publishing in high-impact journals serves as a powerful catalyst for career advancement in academic medicine, solidifying a physician's role as a leader in the field. Previous analyses of authorship trends in leading general surgery journals revealed that women comprised only 31.2% of first authors and 21.1% of last authors, highlighting a significant gender disparity in scholarly contributions and leadership roles. This cross-sectional, observational study aims to characterize authorship positions in five major otolaryngology journals by gender.

Methods: Original investigations published in 2024 were examined in five otolaryngology journals (JAMA Otolaryngology - Head & Neck Surgery, International Forum of Allergy and Rhinology, The Laryngoscope, Otolaryngology - Head and Neck Surgery, and Clinical Otolaryngology). Authorship and gender data were collected. Descriptive statistics and Chi-square testing were conducted using SPSS.

Results: In 1104 papers included, 2203 authors were examined. First authors were 40.3% female and 59.7% (p < 0.001) male, while last authors were 25.1% female and 74.9% male (p < 0.001). No significant differences across gender existed for corresponding authorship, though more men than women were corresponding authors (66.7% vs 33.3%, p=0.665).

Conclusions: Gender parity in otolaryngology is marginally better than general surgery; female first and last authorships were 9.1% and 4% higher in otolaryngology journals, respectively. However, marked gender differences still exist within ENT publishing, especially for senior female authors. Further studies should seek to address this discrepancy by evaluating potential biases in the submission to acceptance/rejection pipeline and analyzing trends over greater time periods.