Research Appraisalobservational

Gender disparities in Italian academic medicine: A cross-sectional study of clinicians in the 2024 stanford top 2% scientists database

PloS oneDe Cassai, Alessandro, Boscolo, Annalisa, Bisi, Maria et al.DOI

Clinical Snapshot

75CEBM
Evidence: Moderateobservational

PICO Framework

P — PopulationItalian clinical scientists included in the 2024 Stanford Top 2% Scientists database (n=3389)
I — InterventionGender classification (female vs male)
C — ComparatorMale clinical scientists
O — OutcomesGender representation across academic fields, institutions, geographic regions, and career characteristics

Bottom Line

This cross-sectional study of 3389 Italian clinical scientists reveals persistent gender disparities in academic medicine, with women comprising only 24% of highly cited researchers. While younger women show increasing representation suggesting gradual improvement, significant underrepresentation persists across most specialties, particularly in surgical fields. The study's strength lies in its comprehensive database approach, but limitations include potential gender misclassification and limited confounding control. For Australian clinicians, these findings highlight similar workforce challenges and support the need for targeted diversity initiatives in academic medicine. The results suggest that structural and cultural factors, rather than field-specific barriers alone, drive gender disparities in research leadership positions.

Evidence: Moderate

Key Findings

  • P Value: Not specified for primary outcome

  • Effect Size: Female representation varied by specialty: lowest in surgical specialties, highest in toxicology

  • Primary Outcome: Women represented 24.3% (824/3389) of highly cited Italian clinical scientists

  • Nnt Or Sensitivity: Only toxicology showed significantly greater female representation in multivariable analysis

  • Confidence Interval: Not reported

Clinical Application

Findings applicable to workforce planning and diversity initiatives in academic medicine Limited direct applicability due to different healthcare systems, though patterns may be similar in Australian academic medicine. Relevant for RACGP workforce planning and medical school diversity initiatives Academic medical institutions and healthcare workforce planners

Abstract

BACKGROUND: Women remain underrepresented in senior and influential research positions despite gradual improvements over recent decades.The aim of this study was to assess gender representation among highly cited Italian clinical scientists and to examine differences across academic fields, institutions, and geographic regions. METHODS: We conducted a cross-sectional analysis of Italian clinical scientists included in the 2024 Stanford Top 2 Percent Scientists database. Gender was determined from given names, and demographic and academic information was obtained from national physician registries and publicly available curriculum vitae. Characteristics were compared by gender, and a logistic regression model was used to examine factors associated with female representation. RESULTS: A total of 3389 clinical scientists were identified, of whom 824 were women. Women represented approximately one quarter of highly cited Italian clinical researchers. They were younger and had more recent years of first publication compared with men. No significant gender differences were observed in academic affiliation or geographic distribution. Representation varied across fields, with surgical specialties demonstrating the lowest proportions of women and toxicology the highest. However, in most disciplines, representation converged toward the overall average when sample sizes increased, indicating that academic fields alone contributed minimally to gender representation. In the multivariable model, only toxicology showed significantly greater female representation, while more recent year of first publication was independently associated with being a woman.. CONCLUSIONS: Women remain underrepresented among highly cited Italian clinical scientists, despite evidence of gradual improvement in representation over time. The limited influence of academic fields suggests that broader structural and cultural factors likely contribute to these gaps. These findings highlight the need for targeted strategies to promote equal representation and support the career advancement of women in academic medicine.

References

  1. 1.De Cassai, A., Boscolo, A., Bisi, M., Chedom, C., De Bernardo, M., Gazzea, S., Paiusco, I., & Navalesi, P. (2024). Gender disparities in Italian academic medicine: A cross-sectional study of clinicians in the 2024 stanford top 2% scientists database. PLoS One. https://doi.org/10.1371/journal.pone.0347836
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