Study reveals a widening gender gap in the field of family medicine due to COVID-19

As people transitioned to working from home at the onset of the coronavirus pandemic, journal submissions from academics increased across the board. But a new study from Northwestern University found as men's scholarly productivity increased, women physicians were submitting less.

The research reflects wider trends in academic publishing and is the first study to find such patterns in family medicine. The study contributes to a growing body of evidence that the pandemic caused unique career disruptions for women as they became stretched thin during remote work, causing stress, burnout and anxiety.

"The worry is that these problems will compound," said Katherine Wright, the paper's corresponding author and the director of research in the department of family and community medicine at Northwestern University Feinberg School of Medicine. "As men were able to submit more, they may benefit from more citations, promotions, funding and career opportunities as women fall further behind."

The paper, "COVID-19 and Gender Differences in Family Medicine Scholarship," will be published Jan. 24 in the journal Annals of Family Medicine.

Wright said the study was conceived in part because of observations about her own department, where she saw roles changing dramatically and many doctors attempting to play dual roles between childcare or eldercare and work. Santina Wheat, co-first author and program director of the Northwestern-McGaw family medicine residency at Erie Family Health Center in Humboldt Park, emphasized the impact of shifting schedules on her own life.

All of a sudden we were doing telehealth at all hours of the day, and hours of the clinics shifted significantly and quickly. There was also always the sense you may need to cover for someone else, which impacted your ability to think about the academic side -; or mentor others to do the same."

Santina Wheat, Study Co-First Author and Program Director of the McGaw Family Medicine Residency, Northwestern University

To conduct the study, the team performed a bibliometric analysis of journal submissions to see how submission rates changed during the pandemic. With access to the last five years of submission data from the Annals of Family Medicine, the top-ranked primary care journal, the scientists reviewed submission data before and during the pandemic. They examined submission volume by gender in addition to distribution of author's gender by submission type (such as original research versus special reports, which impact tenure differently).

The paper found the Annals of Family Medicine received 41.5% of its submissions from women during the early months of the pandemic -; the period analyzed by scientists -; marking a widening gender gap in the field.

The paper warns the gap is "troubling" and may result in long-term repercussions for women in the medical field because of how tenure decisions are made. Wright's hope is that adding this research to the growing body of data will catalyze change in these fields.

"Publications are still the hallmark of tenure and promotion decisions, so we want to make sure women aren't at risk of falling further behind," Wright said. "Our hope is this data might be used by promotion and tenure committees to reevaluate promotion criteria."

For example, Wright said, women tend to be more involved in creating curriculum and service, so weighting activities like these more equally with publications could help balance the scales. She added that there's both a childcare and eldercare crisis in the country, and that parents and caretakers need strengthened support to thrive in their roles. Wright said without intervention, these impacts will reverberate beyond the pandemic.

Beyond advocacy, the team hopes to look at other metrics of diversity in the data and see if other populations have been impacted disproportionately by the pandemic. They're also currently analyzing the gender composition of peer reviewers, the gatekeepers of the work accepted by scientific journals.

Deborah Smith Clements, chair of the department of family and community medicine, the Nancy Warren Furey Professor of Community Medicine and a professor of medical education, also is a co-author, along with Deborah Edburg, a professor and physician at Rush University.