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Trends in authorship in Medicina Clínica: an 11-year analysis of author gender
Tendencias en la autoría en Medicina Clínica: un análisis de 11 años sobre el género de los autores
Xenia Artiga-Solanaa, Ernesto Muñoz-Mahamudb, Andrés Combaliab,c,
Corresponding author
combalia@ub.edu

Corresponding author.
a Facultat de Medicina y Ciencies de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
b Departament de Cirurgia y Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
c Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">When an author&#8217;s research has borne fruit and their article is published in a biomedical journal&#44; not only does it represent a scientific contribution to the community and a step forward in knowledge and in evidence-based medicine&#44; but it also has a bearing on the academic furtherance of the author&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Professional perspectives in hospitals and universities are strongly linked to scientific authorship&#46; Currently&#44; publications in indexed biomedical journals are the most important measurable parameter in the scales of access to a stable position for authors in the centres to which they are attached&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Historically&#44; the majority of authors in biomedical sciences have been men&#44; with women being poorly represented in all fields and specialities&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The last few decades have seen a social shift towards a large number of women being admitted into medical schools&#46; As a result of this feminisation of medicine&#44; it is important to note that more and more women are being named in the authorship of research and publications&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Even so&#44; women are still underrepresented in academic positions&#44; especially in positions of greater responsibility&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study is to analyse the evolution of the percentage of female authors in articles published in <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> over the last 11 years&#46; <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> is a reference journal in Spanish medicine&#46; Its contents cover two fronts&#58; original research papers and papers aimed at continued learning&#46; It is a vehicle for scientific information of acknowledged quality&#44; ranking in the second quartile &#40;Q2&#41;&#44; occupying 58th place out of 167 journals in the &#34;general and internal medicine&#34; category&#44; according to the latest update of the <span class="elsevierStyleItalic">Journal Citation Report</span> &#40;JCR&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">Publications in the <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> journal were accessed through open access provided by the Barcelona University Centre for Resources for Learning and Research &#40;CRAI&#41;&#46; A review of all the articles for the period from 2012 to 2022 was performed&#46; All articles were listed on a spreadsheet &#40;Microsoft Excel&#44; 2013&#41;&#44; and then the type of study&#44; the total number of male authors&#44; female authors and the gender of the first and last author according to their first name was determined for each article&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">For the purposes of this study the first author has been considered as the primary author and the last author as the senior author&#46; The growth in the number of female senior authors is considered as an indirect representation of holding responsible positions in research&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">When there were doubts about the authors&#39; gender&#44; an internet search was carried out&#46; The author was searched for on academic or professional websites such as <span class="elsevierStyleItalic">LinkedIn</span>&#46; If the search was unsuccessful&#44; conventional search tools such as <span class="elsevierStyleItalic">Google</span> were used&#46; When none of the above gave results&#44; or the gender could not be deduced from the name because the article was written by foreign authors&#44; it was considered unknown and the article was excluded from the analysis&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Gender refers to socially constructed roles&#44; behaviours and identities of women&#44; men and gender-diverse people&#46; It influences how people see themselves and others&#44; how they behave and interact&#44; and how power is distributed in society&#46; For this study the terms man&#47;woman and male&#47;female gender are used interchangeably and in relation to gender identification&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">We determined there were 4&#44;229 articles&#44; distributed among 22 volumes &#40;vol&#46; 138&#8211;159&#44; both included&#41; from 2012 to 2022 inclusive&#46; 101 articles &#40;2&#46;4&#37;&#44; less than 3&#37; of the total number of included studies&#41; were removed because we could not reliably verify the gender of the authors&#46; Of the 4&#44;128 articles included in the study&#44; we counted 810 originals&#44; 345 editorials&#44; 329 reviews&#44; 209 special articles&#44; 357 scientific letters&#44; 564 images of the week&#44; 1&#44;248 letters to the editor and 266 others &#40;clinicopathology-MIR conference &#91;16&#93;&#44; consensus conference &#91;43&#93;&#44; book review &#91;three&#93;&#44; diagnosis and treatment &#91;72&#93;&#44; erratum &#91;14&#93;&#44; clinical research and bioethics &#91;20&#93;&#44; clinical note &#91;89&#93;&#44; questions and answers in clinical pharmacology &#91;four&#93; and report &#91;five&#93;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Total authors</span><p id="par0045" class="elsevierStylePara elsevierViewall">A total of 15&#44;983 authors were counted over the 11 years of study&#44; representing 8&#44;877 &#40;55&#46;5&#37;&#41; males and 7&#44;106 &#40;44&#46;5&#37;&#41; females&#46; The percentage of female authors increased from 2012 to 2022 and&#44; consequently&#44; the percentage of male authors decreased&#46; In 2012 there were 39&#37; female authors&#44; which increased to 49&#37; in 2021&#46; In 2022 the percentage decreased to 47&#37; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Primary author</span><p id="par0050" class="elsevierStylePara elsevierViewall">The same trend is observed with primary authors&#44; with an increase in the percentage of female authors from 36&#37; in 2012 to 44&#37; in 2022&#46; Even so&#44; the highest percentage is observed in 2021 with 48&#37;&#46; The percentage of men decreased from 64&#37; in 2012 to 56&#37; in 2022 &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Senior author</span><p id="par0055" class="elsevierStylePara elsevierViewall">When looking at the senior author of each article from 2012 to 2022&#44; we observed a slight increase of women from 29&#37; to 36&#37;&#46; It is important to note that the highest percentage of 38&#37; was seen in the year before 2020 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">The combination of genders of the authors</span><p id="par0060" class="elsevierStylePara elsevierViewall">We studied the number of articles with female-only authors&#44; male-only authors or a combination of both&#46; Although there are only subtle differences over the 11 years of the study&#44; it results in a slight increase of 4&#37; &#40;from 66&#37; in 2012 to 70&#37; in 2022&#41; of articles where both females and males collaborate&#46; More interestingly&#44; the percentage of articles written only by men decreased by 7&#37; over 11 years &#40;26&#37; in 2012 to 19&#37; in 2022&#41;&#44; while articles written only by women showed an increase of 4&#37; &#40;7&#37; in 2012 to 11&#37; in 2022&#41;&#46; Even so&#44; in 2022 &#40;356 published articles&#41; there is still an 8&#37; difference between articles written only by male authors &#40;68 articles&#41; compared to those written only by female authors &#40;39 articles&#41;&#44; with the former being higher &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">By analysing the articles published in the <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> journal over the last 11 years &#40;2012&#8211;2022&#41;&#44; our objective was to analyse the trend of gender in the authorship of articles&#46; In the 4&#44;128 articles analysed between 2012 and 2022&#44; we observe an increasing contribution by the female gender&#46; The participation of women has increased&#44; almost closing the gap between men and women&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">According to data published on the European Union&#39;s statistical portal &#40;<span class="elsevierStyleItalic">Eurostat</span>&#41;&#44; Spain is the most feminised European nation in medicine&#46; In the 2022&#47;2023 academic year&#44; women accounted for 70&#46;6&#37; of students enrolled in a medical degree&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Therefore&#44; it would be logical for the trend of female authorship to continue to increase in the coming years&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The subject of the gender gap has stimulated several studies to be published in biomedical journals&#46; These studies show a progressive increase in the representation of women as primary and senior authors in varying specialities such as epidemiology&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> otorhinolaryngology&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> neurosurgery<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and plastic surgery&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> but in no case do they reach gender equality&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Yamamura et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> analysed the trend in gender equality&#46; This study included the different positions in authorship of scientific publications in five medical specialities &#40;radiology&#44; urology&#44; surgery&#44; gynaecology and paediatrics&#41; and six countries &#40;USA&#44; Canada&#44; UK&#44; France and Japan&#41; over a 10-year period &#40;2007&#8211;2017&#41;&#46; The percentage of women increased over the years&#46; This increase was very significant in the primary author&#44; especially in the specialities of urology and surgery&#46; In contrast&#44; the increase in the senior author was much less significant&#44; especially in specialities with a high percentage of female professionals &#40;paediatrics and gynaecology&#41;&#46; This observed difference may reflect&#44; among other things&#44; dropping-out from the academic career early or mid-term&#44; due for example to structural inequality&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Something similar is observed in the speciality of orthopaedic surgery and traumatology&#46; A very recent study by Ghattas et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> analysed the trend of female authorship in orthopaedic literature between 2002 and 2021&#46; They performed a cross-sectional bibliometric study on a total of 26 journals specialising in orthopaedic surgery and traumatology in the USA&#44; and this included an analysis of 168&#44;451 authors&#46; The percentage of female primary authors &#40;13&#46;6&#37;&#41; was significantly higher than the percentage of female senior authors &#40;9&#46;9&#37;&#41;&#46; The study results showed an increasing trend in the percentage of female primary authors&#44; however&#44; the increase in female senior authors was not significant&#46; It also noted that articles with female primary authors were significantly more likely to have a female senior author&#46; Other articles regarding the speciality of orthopaedic surgery showed similar results&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">These data coincide with the results of our study&#44; in which&#44; based on a prestigious journal such as <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span>&#44; it is observed that&#44; in 2022&#44; 44&#37; of the articles had a woman as the primary author and 36&#37; had a female senior author&#46; This is in line with the articles we have commented on previously&#58; the increase is greater in primary authors than in senior authors&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">A very poor retention rate of female medical students in surgical specialities has also been observed&#44; implying a lower representation of women in both speciality authorship and leadership positions&#46; It appears that when choosing a speciality&#44; women take into account the relationship with a mentor&#44; the intellectual challenge&#44; the rewarding nature of surgery&#44; and the prior knowledge they may have acquired about a speciality in the degree - exposure to the speciality &#8211; rather than the prestige and financial gain men tend to consider&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> On the other hand&#44; women find gender discrimination&#44; the lifestyle of surgeons&#44; and socio-cultural factors observed in surgical specialities to be a deterrant&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> For this reason&#44; the increase of female representation in surgical specialities seems to be slower&#44; although the trends are similar to other medical or medical-surgical specialities&#58; the increase of female representation is more apparent in primary authors than in senior authors&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Whitley et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> reviewed the publications of five high-impact urology journals and compared them with the percentage of women in the speciality of urology&#46; Although the representation of women in the publications is still in the minority &#40;26&#46;3&#37; of primary authors and 14&#46;5&#37; of senior authors&#41;&#44; the percentage of publications with female primary and senior authorship is significantly higher than the percentage of women in the urology speciality&#46; In contrast&#44; Bernardi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> concluded that women surgeons publish research at a rate proportional to the number of females involved in that speciality&#46; The authors suggest that the disparities in leadership roles are likely due to a failure to attract women to academic surgery and failure to promote and mentor women surgeons into leadership positions&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">We have observed that&#44; although in recent years the role of primary author is becoming more equal between genders&#44; there is still a large difference in the case of senior authors&#46; This clearly reflects the fact that leadership positions in working groups are mostly held by men&#44; and that women less often lead research groups&#46; Perhaps the first step in narrowing the gender gap in these positions is to increase the representation of women in all areas of medicine and research&#46; One of the key points to facilitate change would be the presence of transparent&#44; merit-based criteria for eligibility to these senior positions&#46; The existence of such criteria could inspire women to pursue these positions&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> But this gender inequality cannot be attributed solely to the lack of such criteria&#59; several other reasons why women may choose not to pursue or accept project leadership have been described&#46; These include maternity&#44; work-life balance&#44; lack of mentoring and representation&#44; imposter syndrome or systemic gender preference&#46;</p><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Pregnancy&#44; maternity and breastfeeding</span><p id="par0110" class="elsevierStylePara elsevierViewall">For women&#44; one of the problems influencing the decision not to aspire to positions of responsibility in the field of research and health care medicine is the fact of having children&#46; Today&#44; this decision marks a gender-differential path&#44; as the intention to progress academically coincides with a period of life in which family planning is present&#46; In the absence of structural conditions&#44; such as care and support for offspring&#44; many women abandon the competition and opt for a more predictable clinical career in the care sector&#44; rather than in the field of research&#44; be it clinical&#44; basic or translational&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In addition&#44; to achieve the same position as men&#44; women often have to meet higher demands&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Pregnancy means facing a situation that cannot be controlled&#44; for example it may require early leave for different circumstances in addition to maternity leave&#46; This means that for a period of time women cannot be in charge of their professional responsibilities&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> In some European countries&#44; and very recently in Spain too&#44; leave after childbirth can be shared between the parents&#46; But it is usually women who give up working and participating in research studies&#44; because they prioritise having children and being able to care for and educate them&#46; This has been observed during the SARS-CoV-2 pandemic&#44; when female scientists significantly decreased their publication output compared to their male counterparts&#44; among other things due to the closure of nurseries&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Women who decide to have children while maintaining their careers often feel either pressured to work simultaneously and remotely during maternity leave in order to maintain their position&#44; or to reduce the length of their leave&#46; It has also been observed that mothers who choose to breastfeed abandon it earlier than recommended due to incompatibility with work&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> To improve this situation and allow women to aspire to relevant positions with the possibility of becoming pregnant&#44; it is proposed that programmes be created to support these women with mechanisms in place to cope with the situation in the best possible way&#46; Flexible working hours and <span class="elsevierStyleItalic">online</span> working would also be advantageous&#46; All these guidelines could also promote continued breastfeeding once a woman has returned to work&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Reconciling work and family life</span><p id="par0125" class="elsevierStylePara elsevierViewall">Reconciliation measures make it easier to balance work and family life&#46; Historically&#44; women are more likely to reconcile work and family life than men&#44; as women are more willing to sacrifice their professional life for family care&#46; During the SARS-CoV-2 pandemic&#44; it was observed that women were more likely to take on the role of caregivers for their children and sick family members than men&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> It is also known that women do more housework than men&#46; This means that they lag behind and are more disadvantaged in their professional lives than their male colleagues at work&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Lack of mentoring and representation</span><p id="par0130" class="elsevierStylePara elsevierViewall">One of the reasons why women may not consider choosing a speciality or consider themselves for a leading position in research is the lack of representation of women at this level&#46; It has already been noted that the number of female surgeons in medical school faculties is directly related to the percentage of female students who choose surgery as their career path&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Other studies have shown that the presence of female role models and the perceived gender distribution within a speciality has a very strong influence on career choice&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The problem of under-representation of women in research and relevant positions will disappear as the gender gap within specialities decreases&#46; Until this point is reached&#44; in the internship or residency&#44; it might be interesting for a student or resident not to depend on a single mentor or tutor&#44; but to have a gender-varied group so that they can better understand each other in different aspects and find adequate support&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> While this may be a great step forward&#44; the pressure to serve as a role model and mentor for other women may put additional stress on the women themselves&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Impostor syndrome</span><p id="par0140" class="elsevierStylePara elsevierViewall">Imposter syndrome has been described as the feelings of a woman that she is not as qualified as her male peers&#44; or the feelings of doubt about her own achievements or potential for success&#46; It was initially described in women&#44; but has been shown to be present in the vast majority of students&#44; although it is especially prevalent in female students and ethnic minorities&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Related to impostor syndrome is the observation that women tend to be more lacking in confidence than their male peers&#44; making it more difficult for them to present their projects and self-promote&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> As a consequence&#44; they would receive less funding to carry out their scientific work and&#44; consequently&#44; less prestige&#46; To minimise impostor syndrome&#44; it is important that mentors and faculty role models empower women more during their training&#44; so that they have more confidence in themselves and their abilities&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Systemic gender preference</span><p id="par0145" class="elsevierStylePara elsevierViewall">In the present study&#44; although the tendency is for there to be gender variety in the majority of articles published in the <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> journal over the past 11 years&#44; in 2022 we observed a higher number of articles published solely by male authors &#40;19&#37;&#41; compared to solely by female authors &#40;11&#37;&#41;&#46; This can be attributed to the trend towards gender homophily&#44; described as a higher frequency of co-publication of men with men&#44; and women with women&#44; than would be expected by chance&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> This could be caused by women themselves seeking to avoid harassment or sexism from men&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Or even by men because of possible discrimination against women in recruitment to research groups&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Broderick et al&#46; studied the gender dominance of the first author in shared primary authorships&#44; in which the primary authors have contributed equally to the study&#44; but it is the first author who receives the most credit&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> The authors show that men tend to take the position of first author in shared authorships with two or more scientists&#44; combining men and women&#46; Inequality is thus shown for women authors&#44; implying a lower chance of receiving credit&#44; academic positions&#44; project funding and awards&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> One way to reduce these gender inequalities in the first position in shared primary authorships&#44; would be for the journals themselves to require authors to explain how the order is decided in each case&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> Or even for the journals themselves to have standardised guidance on how to make this decision&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> In contrast&#44; Baerlocher et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> proposed eliminating the traditional method of listing authors in which the first and last authors are seen as the most significant&#46; They suggested as early as 2007 to replace it with a system in which there are only three designations&#58; primary author&#40;s&#41;&#44; supervising author&#40;s&#41; and contributing author&#40;s&#41;&#46; In each of these categories there could be more than one author&#46; They also suggested rules for deciding who should be cited as an author and in which category each author falls&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Finally&#44; to our knowledge&#44; no studies have been carried out on the gender of authorship in our country&#46; Only one recent study has been published that analyses the preferential authorship &#40;first or last authorship&#41; of women in articles in the <span class="elsevierStyleItalic">Emergencias</span> journal&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> The results of this study are similar to the present one&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Limitations of this analysis&#44; which has used a binary system to classify researchers by name&#44; include the possibility of excluding people of non-binary or other genders or mistaking the gender of some authors&#46; There is also a greater likelihood of excluding publications&#47;papers by authors with names from Africa or Asia&#44; as these have proven to be the most difficult to determine and account for almost all of the articles discarded from the study&#46; Even so&#44; these should not affect the percentages&#44; as they are expected to be evenly distributed across genders&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">This study is based on counting the number of authors per article and determining whether they are in the position of primary or senior author&#46; It is possible that during the 11 years analysed in the study&#44; some of these researchers are repeated in the sample and therefore it is possible that this study is overestimating the number of authors involved in the research&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusions</span><p id="par0170" class="elsevierStylePara elsevierViewall">In conclusion&#44; between 2012 and 2022&#44; the percentage of female authors in the <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> journal has gradually increased from 39&#37; to 47&#37; in the last year analysed&#46; It is expected that the representation of women in scientific authorship will continue to increase&#44; as in 2022 females represented 70&#46;6&#37; of medical students&#46; Even so&#44; currently only 38&#37; of senior authors are female&#44; and although these figures have also improved over the last 11 years&#44; there is still a large gender gap&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0175" class="elsevierStylePara elsevierViewall">This work has not received any funding&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical considerations</span><p id="par0180" class="elsevierStylePara elsevierViewall">The type of study did not require obtaining informed consent&#46; It does not include analysis of individuals&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interest</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos