Table 3

Methodological quality

Article citationStudy designPopulationComments on quality
Ellinas et al32Cross-sectional quantitative survey614 current academic respondents (of 1456) at one US medical college
Focus on equity: gender
Focus on pipeline: attrition, retention and promotion
Pros: well designed, wide range of factors explored and some significant factors identified
Cons: lacks qualitative data (reported below separately)
Appraisal: good
Huttner et al35Thematic analysis of interviews and focus groups52 interviews and 5 focus groups across 5 European countries
Focus on equity: general
Focus on pipeline: general
Pros: broad range of themes, backed up by primary data
Cons: unclear how the interviews were structured, and what questions/topics were/were not explored
Appraisal: moderate to good
Sánchez et al33Mixed methods survey and focus groupsRecruited from two US academic health conferences, 252 surveys completed by healthcare professionals and trainees and a subset of 41 participated in 8 focus groups
Focus on equity: Lesbian Gay Bisexual Trans(gender) and related communities (LGBT+)
Focus on pipeline: facilitators and challenges on academic careers
Pros: validated questionnaire, large number of focus groups analysed using Consensual Qualitative Research (CQR) methodology, important niche
Cons: none
Appraisal: good
Sanchez et al34Mixed methods survey and focus groups643 survey respondents, 121 focus group participants recruited from attendees at four US national conferences, two that focus on Hispanic/Latino trainees
Focus on equity: race, ethnicity and gender
Focus on pipeline: career interests, influencing factors including influential individuals, and career expectations
Pros: wide national US coverage; open focus group questions analysed using CQR and survey explores relative impacts across a wide range of factors
Cons: extensive quantisation of qualitative results with few verbatim quotes
Appraisal: moderate to good
Martinez et al36Cross-sectional mixed methods survey, snowballing recruitment433 academics who had left 6 US medical schools
Focus on equity: survey on how experiences with harassment/discrimination, family-related issues and recruitment/retention offers impacted their decisions to leave
Focus on pipeline: people who had left tenured positions
Pros: good study design and rich qualitative data
Cons: narrow focus on factors driving attrition
Appraisal: good
Ellinas et al37Cross-sectional qualitative survey491 current academic respondents (of 1456) at one US medical college
Focus on equity: gender
Focus on pipeline: promotion and leadership
Pros: well designed, rich qualitative data
Cons: extensive quantisation of qualitative comments—how were outlying views included?
Appraisal: moderate to good
Ranieri et al38Thematic analysis of semistructured interviews35 interviews doctoral trainee physicians from University College London
Focus on equity: moderate
Focus on pipeline: postdoc
Pros: good study design
Cons: narrow geographical and pipeline focus, moderate focus on equity
Appraisal: good
Rao et al58Cross-sectional quantitative survey1774 (96%) of academic physicians within a single US healthcare organisation
Focus on equity: gender
Focus on pipeline: workload, satisfaction, burnout
Pros: explores impacts of multiple factors across both genders
Cons: moderate quality, heavy emphasis on administrative burden, no data on instrument development, no qualitative data, one relevant factor identified
Appraisal: moderate to poor, limit to single factor
Jagsi et al46Longitudinal quantitative survey1066 (of 1719) US national research awardees from 2006 to 2009, surveyed in 2010–2011 and 2014
Focus on equity: gender
Focus on pipeline: continued engagement in research
Pros: wide range of factors explored and significant factors identified
Cons: lacks qualitative data
Appraisal: moderate
Lopes et al40Cross-sectional quantitative survey322 respondents (of 523) current PhD students at two UK universities
Focus on equity: gender
Focus on pipeline: reasons for staring PhD, experiences during PhD and post-PhD career intentions
Pros: well designed, wide range of factors explored and significant factors identified
Cons: lacks qualitative data
Appraisal: good
Edmunds et al39Narrative review of empirical evidence52 empirical papers exploring reasons for choose/leaving academic medicine
Focus on equity: gender
Focus on pipeline: general
Pros: broad explanatory coverage across 5 themes
Cons: limited qualitative studies in review
Appraisal: good
Ranieri et al31Scoping reviewAll English language papers, all dates: 9 commentaries, 34 empirical papers, 6 reviews, 1 case study identified
Focus on equity: gender included, but not main focus
Focus on pipeline: postdoctoral career progression
Pros: multiple relevant factors in six themes identified
Cons: narrow range of search terms, included opinion pieces; includes publications back to 1991
Appraisal: good
Eley et al41Cross-sectional mixed-methods survey418 (of 2000) Australian medical students at one institution, all years
Focus on equity: gender included, but not main focus
Focus on pipeline: attractiveness, barriers and facilitators
Pros: explored a wide range of factors, rich qualitative data and good analysis
Cons: limited focus on equity
Appraisal: good
Skinnider et al42Cross-sectional quantitative survey70 Canadian MD PhD completers who had completed physician scientist training
Focus on equity: gender
Focus on pipeline: education, career trajectory, publication and funding records, debt and career and lifestyle satisfaction
Pros: explored impacts of multiple factors across both genders
Cons: moderate quality, no qualitative data, many of the outcomes measuring rather than exploring underlying reasons for differential participation
Appraisal: moderate to poor, exclude statistically marginal results for example, prior Masters Degree negatively associated with sustained involvement
Humberstone43Thematic analysis of semistructured interviews8 female deans of US medical schools (of 19)
Focus on equity: gender
Focus on pipeline: barriers facing women becoming deans
Pros: multiple relevant factors identified with strong reference to underlying raw data and strong emergent themes
Cons: small sample and purposive sample of successful women
Appraisal: moderate to good
Wingard et al45Longitudinal action research project involving multiple surveys and interventionsSurvey participants between 478 and 515 (of 1350) faculty at one US health sciences facility
Focus on equity: general
Focus on pipeline: equitable retention, salary, satisfaction and promotion
Pros: multiple factors explored in the discussion section, with reference to strong underlying data
Cons: limited empirical qualitative data
Appraisal: moderate
Kaplan et al44Thematic analysis of semistructured interviews44 senior faculty with responsibility for diversity and inclusion at 24 randomly selected US medical schools
Focus on equity: under-represented racial and ethnic minorities
Focus on pipeline: climate, programme and challenges with regard to recruitment, retention and promotion of minority faculty
Pros: good methodology and strong use of underlying quotes discussed with reference to the literature
Cons: may be biased towards positive as faculty interviewed were responsible for promoting a positive climate
Appraisal: moderate