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Women's Representation in Cardiac Anesthesiology Publications: A Multi-journal Retrospective Analysis
Ashutosh Kaushal1, Soumya Thakur1, Anuj Jain1
1Department of Anaesthesia, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Introduction:
Gender disparities in academic medicine persist despite increasing female enrollment. Cardiac anesthesiology, a predominantly male subspecialty, may reflect systemic inequities. India contributes substantially to cardiac anesthesiology literature, yet the representation of Indian women within this global scholarly output remains uncharacterized.
Materials And Methods:
Retrospective cross-sectional study of four cardiac anesthesiology journals, January 2020 to January 2026. All articles published in the Annals of Cardiac Anaesthesia, Journal of Cardiothoracic and Vascular Anesthesia, Seminars in Cardiothoracic and Vascular Anesthesia, and cardiac anesthesia section of Anesthesia and Analgesia analyzed. Author gender was determined by first-name analysis spanning 45 countries, supplemented by institutional verification.
Statistical Analysis:
Chi-square tests were used to compare gender proportions across authorship positions, journals, and article types. The Cochran-Armitage trend test was used to assess linear temporal trends in female authorship over the study period. P < 0.05 was considered statistically significant.
Results:
Among 5,138 articles representing 22,829 author positions, women comprised 28.4% overall (F: M ratio 1:2.52). Female representation declined progressively from second authors (31.9%) to corresponding authors (22.5%) (P < 0.001). Indian women represented 26.4% of Indian first authors and 18.1% of Indian corresponding authors, both significantly lower than non-Indian counterparts (P = 0.009 and P = 0.001, respectively). Notably, Indian female first authorship showed a significant upward trend from 19.2% (2020) to 35.6% (2024) (Z = -3.65,P < 0.001).
Conclusion:
Significant gender disparities persist across cardiac anesthesiology publications globally, specifically among Indian authors. The pronounced underrepresentation of Indian women in corresponding authorship, despite an encouraging upward trend in first authorship, highlights compounded systemic barriers.