Academic Neurosurgery Gender and Authorship Trends in the United States.

Background and objectives: Women represent ∼20% of the national neurosurgical resident cohort but only ∼10% of academic neurosurgeons in the United States. Recognizing that the publication of scientific literature contributes to academic advancement, we measured authorship trends of academic neurosurgeons to query publication differences as an explanation for the discrepancy of female representation in academic positions.

Methods: Physician data were obtained from program and individual physician webpages. Annual total, first author, and senior author publications were recorded for each neurosurgeon from 1980 to 2020. Mean publication number as a function of the year relative to residency graduation was calculated for all, first author, and senior author publications for all timepoints with >50 individuals. The mean first years of publication were compared using unpaired 2-tailed t-tests. The slope of publication for the senior author and all publications was calculated using individual best-fit lines from years 0 to 10 relative to residency graduation.

Results: Overall, 1601 faculty members were evaluated (female = 167 [10.4%], male = 1434 [89.6%]). First-author publication for female members peaked at 0.60 publications/year, and for male members at 0.80 publications/year, both at -1 year from graduation (P = .038). Female first publication occurred earlier (-2.4 vs 1.45 years; P < .00001). The mean increase in all publications/year from years 0 to 10 was 0.25 for women and 0.28 for men (P = .68). The increase in senior publications/year was 0.11 for women and 0.13 for men (P = .39). The ratio of total publications to the Scopus h-index was 3.08 for women and 3.62 for men (P = .07).

Conclusion: These data suggest that women publish earlier but have fewer first-author publications at -1 year, the timepoint of peak publication for both genders. There was no significant gender difference in rates of the first author and all publications over the years 0 to 10. The ratio of publications to the h-index did not differ significantly but showed a trend suggesting that women produce higher-impact articles and may need fewer publications to achieve the same change in the h-index.