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Sex differences in academic rank in the allergy / immunology workforce

Published online: July 3, 2019

Despite the increasing presence of women in the medical field, disparities in academic promotion and salary are often identified when female physicians are compared to their male colleagues. Differences in salary have been recognized across many academic medical specialties, even after adjusting for variables associated with academic promotion. Differences in academic rank are also apparent. Male physicians were more often full professors, compared to female physicians, in specialties such as surgery, cardiology, emergency medicine, and infectious disease. Blumenthal and colleagues evaluated the academic allergy and immunology workforce to evaluate academic rank differences between male and female allergists.

In an article recently published in The Journal of Allergy and Clinical Immunology (JACI), Blumenthal and colleagues utilized the physician-centered social networking platform, Doximity, to cross-sectionally analyze the US academic allergist / immunologist in 2014 (n=507). Demographic data included physicians’ sex, age, and years since residency completion. Variables relating to academic achievement included medical school faculty appointment and rank, publications, NIH grants, and clinical trials investigations. Blumenthal et al. performed analyses comparing male and female academic allergists and immunologists, with the primary outcome academic rank and secondary outcomes total and senior author publications.

Female allergists were younger, had fewer total and first/last author average publications, were less likely to have NIH funding, were less frequently a clinical trial investigator, and generated less average annual Medicare revenue. Of 152 full professors, 126 (83%) were male and 26 (17%) were female. After multivariable adjustment for all covariates, rates of full professorship among female and male allergists were not significantly different (absolute adjusted difference for female vs male allergists, 6.0%; 95% confidence interval: -8.3%, 20.2%).  This null finding remained stable across a variety of different sensitivity analyses and models explored. After adjustment solely for age, however, there was a significant difference in full professorship between male and female allergists (adjusted difference, -9.0%; 95% CI: -18.0%, -.03%). The adjusted rate of full professorship was 26.6% among men and 17.3% among women (p = 0.049).  

Similar findings were identified for the secondary outcome of publications. Female allergists had fewer mean total publications than male allergists after adjusting for age only (adjusted mean 17.8 for women and 25.8 for men, p=0.03), but the authors found no significant difference in mean publications between female and male allergists after multivariable adjustment for all covariates (age, years since residency, faculty appointment at US News and World Report “top 20” medical school, NIH funding, and total Medicare payments). The adjusted mean was 13.9 for women and 19.2 for men (p=0.16).  
These findings suggest that although direct, unadjusted comparisons of male and female academic allergists show large differences and just 17% of allergist full professors were female, women in the academic allergy and immunology workforce were being appropriately promoted. However, comparisons between female and male academic allergists revealed significant differences in academic rank, publications, and NIH funding that were not attributed simply to the allergist’s age and may reflect a disparity in opportunity, or different career choices.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.