Over the past 25 years, the surgeon-scientist workforce has made significant strides in closing the gender equality gap. But glaring disparities still exist, a new Yale study finds. Women only account for 19% of surgeon-scientists, and they are 25% less likely to be “super principal investigators” (SPIs)—investigators who hold multiple grants from the National Institutes of Health (NIH) and therefore hold considerable influence and career security.
The team, led by first author Mytien Nguyen, a seventh year MD-PhD student in immunology and senior authors Alan Dardik, MD, PhD, professor of surgery (vascular) and of cellular and molecular physiology, and Dowin Boatright, MD, former Yale School of Medicine Teaching and Learning Center (TLC) faculty associate for diversity, equity, and inclusion (DEI) educator development, used publicly available data from the NIH to examine its distribution of biomedical research funding among men and women surgeon-scientists over the last two and a half decades. They published their findings in JAMA Network Open on March 20.
“There is significant gender disparity among surgeon-scientists,” says Nguyen. “Our study shows that we’ve made some progress, but it seems that the glass ceiling still exists and has just moved up a notch.”
The team used the NIH RePORTER (Research Portfolio Online Reporting Tools: Expenditures and Results) database to gather data between 1995 and 2020. They specifically looked at all departments of surgery, including such surgical subspecialties as otorhinolaryngology [ENT], urology, and vascular surgery. Then, they obtained information on the principal investigators who received the grants— academic degree obtained, board certification, gender identity, and year of first faculty appointment.
There is significant gender disparity among surgeon-scientists. Our study shows that we’ve made some progress, but it seems that the glass ceiling still exists and has just moved up a notch.
Mytien Nguyen
They looked at changes in surgeon-scientists’ gender composition. They also looked at the distribution of large-dollar grants and proportions of SPIs with at least $750,000 in annual funding.
The study revealed that as of 2020, only about 19 percent of surgeon-scientists were women. “Even though there’s been a huge increase in representation of female surgeons in the workforce itself, this doesn’t translate to an equivalent increase in the gender composition among NIH-funded surgeon-scientists,” says Nguyen.
At the same time, they found that women surgeon-scientists are receiving their first NIH grant two years earlier than their male counterparts. And over the 25 years, they have closed the gap in terms of receiving large-dollar grants. However, the study found that disparities still exist. Women are still significantly less likely to be an SPI. And even though the gender gap among SPIs was closing between 2006 and 2010, it began widening again between 2016 and 2020. These findings build off of their previous study on SPI status among all NIH-funded investigators, which demonstrated that gender disparities persist in SPI status regardless of career stage.
“We have excellent data showing that diverse teams produce higher quality and more innovative science,” says Boatright, who is now an associate professor of emergency medicine at New York University Langone Health. “When we see these disparities, it’s important to note that not only is this an injustice in terms of the opportunities that are available based on someone’s sex or gender, but also this disparity decreases the quality of care and science that we can ultimately deliver to our patients.”
In future studies, the team is interested in studying gender equity within various surgical specialties. Nguyen also wants to conduct qualitative interviews with female surgeon-scientists on the barriers they face so that scientists can recognize unique challenges faced by women in the workforce and introduce interventions. “I hope our work helps us become more conscious of representation at the top,” she says. “SPIs are the scientists who are influencing research agendas and mentoring the future generations. So we need to not only think about the barriers women face entering the surgical workforce, but also how to promote their career development.”