Abstract：
OBJECTIVE: The gender gap in promotion in academic medicine is well established. However, few studies have reported gender differences in promotion adjusted for scholarly production and national or international reputation, namely, career duration, publications, grant funding, and leadership positions. The authors performed a systematic review and meta-analysis of the differences between men and women in achieving benchmarks for promotion and analyze where such differences lie geographically and within specialties.
METHODS: A systematic search of Academic Search Premier, Business Source Complete, Cochrane Library, ERIC, GenderWatch, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science was conducted from inception to August 17, 2022. All studies that reported the number of male and female full professors on medical school faculty were included. The primary outcome was the adjusted odds ratio (AOR) for promotion to full professor for women compared with men.
RESULTS: Two hundred forty-four studies met the inclusion criteria. The unadjusted OR for promotion to full professor for women was 0.38 (95% confidence interval [CI], 0.36-0.41). Sixteen studies reported an AOR. The pooled AOR of promotion for women to full professor was 0.60 (95% CI, 0.46-0.77). The AOR for promotion to full professor was 0.55 (95% CI, 0.34-0.88) in surgery and 0.80 (95% CI, 0.57-1.11) in internal medicine. Statistical heterogeneity was high ( Q = 66.6, I2 = 79.4%, P < .001). On meta-regression, 77% of the heterogeneity was from studies outside the United States, where more disparity was reported (AOR, 0.29; 95% CI, 0.22-0.38).
CONCLUSIONS: Most studies continued to find decreased promotion of women. Gender disparity was particularly notable in surgery and in studies from outside the United States. The results suggest that differences in promotion were due to differences in productivity and leadership and to gender bias.
METHODS: A systematic search of Academic Search Premier, Business Source Complete, Cochrane Library, ERIC, GenderWatch, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science was conducted from inception to August 17, 2022. All studies that reported the number of male and female full professors on medical school faculty were included. The primary outcome was the adjusted odds ratio (AOR) for promotion to full professor for women compared with men.
RESULTS: Two hundred forty-four studies met the inclusion criteria. The unadjusted OR for promotion to full professor for women was 0.38 (95% confidence interval [CI], 0.36-0.41). Sixteen studies reported an AOR. The pooled AOR of promotion for women to full professor was 0.60 (95% CI, 0.46-0.77). The AOR for promotion to full professor was 0.55 (95% CI, 0.34-0.88) in surgery and 0.80 (95% CI, 0.57-1.11) in internal medicine. Statistical heterogeneity was high ( Q = 66.6, I2 = 79.4%, P < .001). On meta-regression, 77% of the heterogeneity was from studies outside the United States, where more disparity was reported (AOR, 0.29; 95% CI, 0.22-0.38).
CONCLUSIONS: Most studies continued to find decreased promotion of women. Gender disparity was particularly notable in surgery and in studies from outside the United States. The results suggest that differences in promotion were due to differences in productivity and leadership and to gender bias.
摘要：
目的：学术医学晋升中的性别差距已经确立。然而,很少有研究报告根据学术生产和国家或国际声誉调整后的晋升性别差异，即,职业生涯持续时间,出版物,赠款资金，和领导职位。作者对男女在实现晋升基准方面的差异进行了系统的回顾和荟萃分析，并分析了这种差异在地理上和专业内的位置。
方法：对学术搜索Premier的系统搜索，业务源完成,科克伦图书馆,ERIC,GenderWatch,谷歌学者，Embase,MEDLINE,PubMed,Scopus,和WebofScience从成立到2022年8月17日进行。包括所有报告医学院教职员工男女全职教授人数的研究。主要结果是与男性相比，女性晋升为正教授的调整比值比（AOR）。
结果：240项研究符合纳入标准。女性晋升正教授的未调整OR为0.38(95%置信区间[CI]，0.36、0.41）。16项研究报告了AOR。女性晋升为正教授的合并AOR为0.60（95％CI，0.46，0.77）。在手术中晋升为正教授的AOR为0.55（95％CI，0.34，0.88），在内科中晋升为0.80（95％CI，0.57，1.11）。统计异质性高(Q=66.6，I2=79.4%，P<.001)。关于元回归，77%的异质性来自美国以外的研究，报告了更多的差异(AOR，0.29；95%CI，0.22，0.38）。
结论：大多数研究继续发现女性升职率下降。性别差异在手术和美国以外的研究中尤为明显。结果表明，晋升的差异是由于生产力和领导力的差异以及性别偏见。
方法：对学术搜索Premier的系统搜索，业务源完成,科克伦图书馆,ERIC,GenderWatch,谷歌学者，Embase,MEDLINE,PubMed,Scopus,和WebofScience从成立到2022年8月17日进行。包括所有报告医学院教职员工男女全职教授人数的研究。主要结果是与男性相比，女性晋升为正教授的调整比值比（AOR）。
结果：240项研究符合纳入标准。女性晋升正教授的未调整OR为0.38(95%置信区间[CI]，0.36、0.41）。16项研究报告了AOR。女性晋升为正教授的合并AOR为0.60（95％CI，0.46，0.77）。在手术中晋升为正教授的AOR为0.55（95％CI，0.34，0.88），在内科中晋升为0.80（95％CI，0.57，1.11）。统计异质性高(Q=66.6，I2=79.4%，P<.001)。关于元回归，77%的异质性来自美国以外的研究，报告了更多的差异(AOR，0.29；95%CI，0.22，0.38）。
结论：大多数研究继续发现女性升职率下降。性别差异在手术和美国以外的研究中尤为明显。结果表明，晋升的差异是由于生产力和领导力的差异以及性别偏见。
