Persistent Underrepresentation of Researchers Outside High-Income Countries in Editorial Boards

Background and Aim: Studies have shown that researchers from outside high-income countries (HICs) are underrepresented as editors and board members in various journals. This cross-sectional study analyzed the editorial composition of 25 leading peer-reviewed health professions education (HPE journals) as several recent initiatives to improve diversity have been undertaken. Materials and Methods: Data were extracted from journal websites during June and July 2025. Each editor’s institutional affiliation was classified by country and mapped to the corresponding income groups and continent. To evaluate diversity, we applied the Composite Editorial Board Diversity Score (CEBDS), which incorporates three domains gender diversity (GID), country income-level diversity, and geographic region diversity (RID), with total scores ranging from 0 (no diversity) to 10 (maximum diversity). The CEBDS was compared across journals. Results: Only around 17% of editors and editorial board (EB) members were from outside HICs. The country with the highest representation was South Africa, followed by India, Malaysia, and Indonesia. The journal AMEE MedEdPublish had the highest percentage from outside HICs. Several other journals had fewer than 10% of their EB from outside HICs. The mean gender-specific, income-specific, and geographic region diversity domains scores were 2.24, 1.84, and 1.8, respectively. The mean CEBDS was 5.88. Conclusion: Despite recent diversity initiatives, researchers from low- and middle-income countries remain substantially underrepresented on EBs of HPE journals. Structural interventions and policy-level reforms are urgently needed to foster equitable representation and ensure that global educational publishing reflects diverse perspectives.