Gender Diversity Among Reconstructive Microsurgery Studies Based on the Relative Citation Ratio: An 18-Year Analysis

Gender disparities in plastic surgery authorship have been previously described in the literature. The relative citation ratio (RCR) index is a new metric that normalizes citation rates for field and time, which can be utilized to compare authors. This study aims to evaluate differences in gender authorship in reconstructive microsurgery (RM) papers, as well as the impact of gender on the RCR index.

A PubMed query isolated RM studies between 2002 and 2020 across the 3 highest impact PS journals. Author names and RCR information were collected from NIH iCite. The likely gender was adjudicated by using NamSor-Software. Unpaired Wilcoxon rank-sum and chi-square tests were used to assess differences between groups.

Of 1146 articles (2172 authors), there was a significant difference between the proportion of females as senior authors compared to first authors ( P < 0.001). Overall, females represented 15.4% of all authors, 19.7% of first authors, and 11.3% of senior authors. Males had a significantly higher weighted RCR ( P < 0.0001) and number of publications ( P < 0.0001), which remained significant when stratified by first and senior author. Female authors collectively had a higher mean RCR ( P = 0.008) and among first authors ( P < 0.0001), with no significant difference among senior authors ( P = 0.47).

A considerably greater number of males are publishing in reconstructive microsurgery compared to females, with significantly more males being senior authors compared to first authors. Males had higher weighted RCR scores and publications compared to females. This study suggests that equity in gender authorship within the field is yet to be achieved.