1302 Exploring Trends in Authorship by Women in Fifteen Major Neurosurgical Journals

INTRODUCTION: Despite recent advances, we hypothesized that women remain underrepresented as authors in neurosurgical literature–a key indicator of success in academic medicine. METHODS: We queried Web of Science for all contents published in the top 15 neurosurgical journals by h5-index. Articles and metadata were exported. Analyses were performed using Python packages (Gender-Guesser and Wiki-Gendersort for gender identification). RESULTS: 143,713 articles from 112,932 unique authors with full names were identified (62.0% (69,985/112,932) male, 24.0% (27,148/112,932) female, 14.0% (15,799/112,932) unknown). Female co-authorship was limited before 1980, with an increase in the 2000’s (7.0% in 2000 to 60.7% in 2023). However, female first and last authorship have yet to exceed 17.6% (2023) and 11.2% (2022), respectively. This is consistent across the top 3 neurosurgical journals. Compared to male last authors, female last authors are 3.45 times more likely to publish with female first authors (95% CI 3.27-3.64). Female first authors are also 3.73 times more likely than male first authors to publish with female last authors (95% CI 3.53-3.93). Of the 10,000 most productive authors, male authors have a higher h-index than female authors (p<0.001). However, female authors have a higher m-index (p<0.03), which is normalized to impact over time in the field, suggesting an emerging contingent of female authors who are academically productive and authoring impactful works. CONCLUSIONS: While progress has been made in female co-authorship, female first and last authorship remain below 20%. Female last authors are more likely to be associated with female first authors and vice versa. This finding suggests that women are paving the way towards a more equitable future of neurosurgery by mentoring other women, and that efforts to support female senior authors can also benefit female trainees.