Abstract
In 1976 women comprised 20% of US medical students. 1 By the end of the 20th century women accounted for greater than 40% of US medical students. 2 Since 2017, more women than men matriculated in US medical schools and in the 2022–23 academic year, 56% of US medical school, and the majority of UK matriculants, were women.3,4 At both Emory Medical School and Duke Medical School in 2022–23, almost 70% of matriculants were women. 3
The landscape of the physician workforce has evolved as well. The AAMC 2020 Physician Specialty Data Report states more than one-third (37%) of the active physician workforce in the United States are female, and the majority of newly minted physicians are women. 5 Presently, women account for 86% of OB-GYN residents, over 70% of pediatric residents, and there is parity in other fields. 5
While the number of practicing female physicians continues to rise, gender imbalance is evident in academic medicine. Women physicians are less likely to hold the rank of associate professor (34% vs 66%) or full professor (21% vs 79%). 6 Furthermore, women physicians in academic medical centers are both less frequently promoted in academic rank and are less likely to serve as department chairs, and there has been no apparent narrowing in the gap over time. 7
In the realm of publications, an essential component of career advancement and grant funding in academic medicine, gender disparities remain stubbornly persistent. A recent study of first authors in 3 top medical journals (The New England Journal of Medicine, The Lancet, and The Journal of the American Medical Association) from 2002–2019 found that first, second, or last author rates for women (27% overall) were significantly lower than for men. No improvements over time occurred in first authorship rates for women. 8 Keyes et al found similar results in a recent study on gender representation in this journal. 9 Women were first authors in fewer than 25% of Wilderness & Environmental Medicine (WEM) articles, with 26% of all authors, 20% of peer reviewers and reviewers-in-training, and 16% of editorial board members noted to be women. Women received fewer reviewer invitations than men, while accepting at the same rate. 9 Additionally, only 28% of Wilderness Medical Society (WMS) members were women. 9
Barriers to career advancement are seen in other areas. Women continue to lag in leadership positions within the healthcare industry. 10 Analysis of gender equity in leadership of physician-focused medical specialty societies showed that in the decade of 2008–2017 for 43 major specialties, society presidential leadership was held predominantly (83%) by men. 11 A Harvard Business Review article examined some of the barriers holding women back from leadership positions. Implicit gender and maternal bias have been implicated, as have family leave policies. 12
In the past decade, medical societies such as the American Medical Association have focused on outreach and increasing membership among women and younger physicians. The relevance and vibrancy of the WMS and WEM require a similarly robust response to the data uncovered by Keyes et al.
With this background in mind, and on behalf of the editorial board of WEM, we believe it is paramount to make the following statement:
This journal acknowledges that gender equity is a key factor in achieving scientific excellence and innovation. As an editorial board, we are committed to increasing representation among our editors, peer reviewers, and authors. WEM’s commitment to inclusion and diversity in the editorial and publishing environment is an essential part of the journal’s broader ongoing efforts.
In announcing this statement, we are taking the first step in our commitment to increasing the representation of women within WEM. Our next steps include expanding and diversifying our editorial board and reviewer pool; collecting self-reported diversity data from our reviewers and authors; and reporting on these processes annually to our stakeholders (ie, the WEM editorial board, the WMS, and our readership). We are excited to implement our vision over the next several years, and to move the goalposts forward, as we honor our commitment to equity and diversity at WEM.