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In the August 2016 issue of the Journal of the Am Coll Surg, our group reported the differences between male and female academic surgeons by faculty rank, academic output, and NIH funding rates using data of faculty from the 55 departments of surgery with the most National Institutes of Health funding.1 Overall, metrics from 4015 surgical faculty members were examined. The objectives of the study were to identify potential barriers that might be preventing the academic success of all surgical faculty members. Men comprised 76.9 per cent (3087) and females comprised 23.1 per cent (928) of the faculty we could identify. Male surgical faculty also comprised a greater fraction of older surgeons. Overall, male cumulative scholarly output was higher than that of females as measured by total publications (43 ± 97.5 vs 19 58, p < 0.05) and total citations (723 ± 3322 vs 317 ± 1,774, p < 0.05). In terms of gender-based differences in academic rank, female surgical faculty members were far more likely to be represented at lower academic levels. Overall a higher proportion of women faculty are at junior faculty ranks with 49.7 per cent of the female surgical faculty at the assistant professor rank, compared with only 31.8 per cent of male faculty. An equal proportion of male and female surgical faculty were at the associate professor level (27%); with only 22.7 per cent of female surgical faculty being at full professor rank compared with 41.2 per cent of males. This is disproportionate even accounting for the differences in the demographics of medical students and residents five and 10 years prior.2, 3 At higher academic ranks, the publications and citations for women were similar to those of their equivalently ranked male counterparts. Gender-based differences in leadership positions and academic degrees were also found. Female surgical faculty members were, in fact, half as likely to be in divisional leadership positions. The fraction of women by surgical subspecialty examined also differed. Cardiothoracic surgery had the lowest fraction of female full professors (11%). Among thoracic surgeons, 22 per cent of the female faculty were full professors, compared with 48 per cent male surgical faculty. These numbers were lower for female cardiac surgery professors. The findings of lower percentages of women at the rank of full professor were observed for other surgical specialties as well, including both vascular surgery and surgical oncology.1 The data from this analysis are supported by other analyses performed by a variety of other approaches and across different medical specialties or other professions. Nonnemaker, for example, analyzed the promotion trends across all disciplines and departments of academic medicine and evaluated differences in medical student gender and its effect on promotion and academic position by decade.4 The article, published in the N Engl J Med, showed that there were higher numbers of female medical students graduating than men in the 1980s. However, overall promotion of females from assistant professor to associate professor, as observed in our data set, was much less common for women. Similarly, female faculty advancing from associate to full professor deviated from the predicted values considerably. In the same group, the percentage of male full professor faculty was 34 per cent, compared with only 12 per cent for female faculty, regardless of department. This suggests that even accounting for differences in demographics between the graduating medical students and junior residents, the promotion of women in academic surgery has been slow. To evaluate whether female assistant and associate professors were being promoted with similar academic measures, the scholarly output for each academic rank Address correspondence and reprint requests to Leonidas G. Koniaris, M.D., M.B.A., F.A.C.S., 545 Barnhill Drive EH 511 Indianapolis, IN 46202. E-mail: lkoniari@iu.edu.

Current State of Women in Academic Surgical Subspecialties: How a New Metric in Measuring Academic Productivity May Change the Equation