In the past few decades there has been an increase in the number of women in the field of medicine. Even though more women enter medicine, there are still gender-linked issues and barriers affecting their advancement.1,2 Advancement is most frequently judged by academic rank and responsibilities. Nomination to serve on an editorial board is an indicator of advancement because nominations are based on academic rank, research, publication, and accomplishment. Those who are nominated to join editorial boards are often promoted because of the national recognition they receive. This study measured the advancement of women in medicine by comparing the percentages of women on major medical journals' editorial boards with the percentages of women physicians in the medical specialties of those journals.
Two general medical journals (JAMA: Journal of the American Medical Association and the New England Journal of Medicine) and ten specialty medical journals, thought to be the major journals in their fields, were chosen for study (the journals are listed in Table 1). In 1999, we counted from the mastheads the numbers of women and men who were serving as editors, deputy editors, assistant editors, associate editors, and members of the editorial boards on the 12 journals. We then compared the percentages of women on the editorial boards with the numbers of women physicians in the respective specialties, as garnered from the American Medical Association through December 31, 1997.3
Table 1 shows the numbers of women and men on the editorial boards of the 12 medical journals. Only three of the 12 journals, JAMA, the New England Journal of Medicine, and the American Journal of Psychiatry, had women editors. The specialty journal, Journal of American Academy of Dermatology, had the highest number of women, 28 (33.3%), on its editorial board. The second highest number of women, 12 (36.4%), served on the editorial board of the Annals of Internal Medicine. In contrast, the general medical journals, JAMA and the New England Journal of Medicine, had women editors, but also had low percentages of women on their editorial boards, 7.7% and 8.6%, respectively. The Ear, Nose, and Throat Journal had the lowest percentage of women editorial board members (5.6%).
Table 2 compares the percentages of women physicians in given specialties with the percentages of women on the editorial boards of the journals of those specialties. The Annals of Internal Medicine had 11% more women (36.4%) on its editorial board than the percentage of women physicians in the specialty of internal medicine (25.4%). In contrast, in pediatrics 46.2% of physicians were women, but only 17.9% of the editorial board of Pediatrics were women. In psychiatry, 27.9% of physicians were women, but only 15% of the editorial board members of the American Journal of Psychiatry were women. Five of the 12 journals (42%) approached parity between the percentages of women on their editorial boards and the percentages of women physicians in their specialties: Annals of Internal Medicine, Obstetrics and Gynecology, Journal of the American Academy of Dermatology, Surgery, and Ophthalmology. There were low numbers of women physicians in surgery (9.2%), ophthalmology (13.4%), and otolaryngology (8.2%), and their respective specialty journals had low numbers of women on their editorial boards.
In the past, the absence of a “critical mass” of women has slowed the progress of women ascending the academic and professional ladders.1 However, the number of women in medicine has been rising: In 1999, 42% of medical students were women, 35% of residents were women,5 and almost 34% of women physicians are over 45 years old.3 Corresponding increases in women's professional advancement in academic medicine appear to lag behind; in 1995, only 22% of women were full professors, compared with 35% of men physicians, and 51% of women physicians were assistant professors or instructors, compared with 39% of men physicians.
Our study found that only 25% of the journals had women editors (two of the three were recently appointed), and an average of only 17% of the board members of the 12 journals were women. The Annals of Internal Medicine was the only journal that had more women on the editorial board than there are women physicians in the field; five journals approached parity, and two journals, the American Journal of Psychiatry and the Journal of Pediatrics, had the largest disproportions of women represented on their editorial boards versus women physicians in their specialties. However, since editorial boards are relatively small and we used only a small number of journals, these percentages for women may be inherently “slippery,” and therefore should be considered more suggestive than quantitative. Our findings indicate the need for more women on some editorial boards in order to maintain parity with the numbers of women physicians in the specialties. Medical journals may need to be monitored in order to accomplish this task. The numbers of women physicians on editorial boards may reflect their national prominence in their fields and, thus, support a woman's promotion in academic rank at her own institution.
Being on the editorial board may also assist in the advancement of women academically by increasing the articles being accepted for publication that are written by women. Most studies show fewer publications for women, particularly women faculty with children. However, women and men faculty without children have similar rates of publications.4 Furthermore, Kaplan and colleagues found that the most productive women faculty had less institutional support for research than did the men.5 This, in turn, may influence the number and quality of publications that women can produce, particularly the types of research that will be published in some of the more prestigious journals. Finally, women on editorial boards may also encourage an increase in the number of papers on women's issues in medicine,6 as more women are involved in women's health research through the establishment of the National Institutes of Health's Office for Research on Women's Health in 1991.
1. Waxman M. Women in medicine and the medical sciences: problems, progress, and prospects. Conn Med. 1998;52:717–20.
2. Dickstein LJ, Stephenson JJ. A national survey of women physicians in administrative roles. J Am Med Women's Assoc. 1987;42(4):108–11.
3. American Medical Association. Physician Characteristics and Distribution in the US. Chicago, IL: American Medical Association, 1999.
4. Potee RA, Gerber AJ, Ickovics JR. Medicine and motherhood: shifting trends among female physicians from 1922 to 1999. Acad Med. 1999;74:911–9.
5. Kaplan SH, Sullivan LM, Dukes KA, Phillips CF, Kelch RP, Schaller JG. Sex differences in academic advancement: results of a national study of pediatricians. N Engl J Med. 1996;335:1282–9.
6. Kennedy BL. Women's issues in medicine: an overview. Primary Psychiatry. 1996;1:33–9.