Article Text

Original research
Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review
  1. Vaidehi Misra1,
  2. Frozan Safi2,
  3. Kathryn A Brewerton2,
  4. Wei Wu1,
  5. Robin Mason1,3,4,
  6. An-Wen Chan1,2,5,6,
  7. Paula A Rochon1,2,5,6,
  8. Iliana C Lega1,2,5,
  9. Husam Abdel-Qadir1,2,5,6,7
  1. 1Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
  2. 2Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  4. 4Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
  5. 5ICES, Toronto, Ontario, Canada
  6. 6Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
  7. 7Peter Munk Cardiac Centre (PMCC), University Health Network (UHN), Toronto, Ontario, Canada
  1. Correspondence to Dr Husam Abdel-Qadir; h.abdel.qadir{at}


Objectives Evaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics.

Design Cross-sectional review.

Data sources Medline database.

Eligibility criteria Articles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries.

Data extraction Key data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors’ likely gender; this was quantified using adjusted ORs (aORs).

Results We included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe.

Conclusions Women were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women’s authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it.

PROSPERO registration number CRD42020186702.

  • COVID-19
  • medical education & training
  • education & training (see medical education & training)
  • medical journalism
  • journalism (see medical journalism)

Data availability statement

Data are available upon reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.


  • Twitter @RochonPaula, @IlianaLega, @husam247

  • ICL and HA-Q contributed equally.

  • Contributors The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. HA-Q and ICL conceived the study and designed the methods. HA-Q prepared and analysed the data with input from VM, FS, KAB, WW, RM, A-WC, PAR and ICL. VM, FS, KAB, WW, RM, A-WC, PAR, ICL and HA-Q contributed to interpreting the data. HA-Q and VM drafted the manuscript with substantial input from ICL. All authors contributed to and approved the final manuscript.

  • Funding HA-Q is supported by the National New Investigator Award from the Heart and Stroke Foundation of Canada.

  • Competing interests None declared.

  • Patient and public involvement statement It was not possible to involve patients or the public in the design, conduct or reporting of this study. We intend to disseminate the findings of this research to the public.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.