• Kamber L Hart, Laura T Boitano, Adam Tanious, Mark F Conrad, Matthew J Eagleton, Keith D Lillemoe, Roy H Perlis, and Sunita D Srivastava.
• Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
• Ann. Surg. 2022 Jan 1; 275 (1): e115e123e115-e123.

ObjectiveThis study evaluates the distribution of authorship by sex over the last 10 years among the top 25 surgical journals.Summary Of Background DataDespite an increase in women entering surgical residency, there remains a sex disparity in surgical leadership. Scholarly activity is the foundation for academic promotion. However, few studies have evaluated productivity by sex in surgical literature.MethodsOriginal research in the 25 highest-impact general surgery/subspecialty journals were included (1/2008-5/2018). Journals with <70% identified author sex were excluded. Articles were categorized by sex of first, last, and overall authorship. We examined changes in proportions of female first, last, and overall authorship over time, and analyzed the correlation between these measurements and journal impact factor.ResultsThere were 71,867 articles from 19 journals included. Sex was successfully predicted for 87.3% of authors (79.1%-92.5%). There were significant increases in the overall percentage of female authors (β = 0.55, P < 0.001), female first authors (β = 0.97, P < 0.001), and female last authors (β = 0.53, P < 0.001) over the study period. Notably, all cardiothoracic subspecialty journals did not significantly increase the proportion of female last authors over the study period. There were no correlations between journal impact factor and percentage of overall female authors (rs = 0.39, P = 0.09), female first authors (rs = 0.29, P = 0.22), or female last author (rs = 0.35, P = 0.13).ConclusionsThis study identifies continued but slow improvement in female authorship of high-impact surgical journals during the contemporary era. However, the improvement was more apparent in the first compared to senior author positions.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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