The researchers compiled a roster of eighty-four unique individuals who have served as president of the American Academy of Dermatology across the 1938 to 2025 period. Of those, seventy-eight were men and just six were women. The first woman to hold the presidency was elected only in 1992, more than half a century after the academy’s founding era. That means that for the first fifty-four years of the organization’s recorded leadership history, the office was held exclusively by men. Even in the decades since that first breakthrough, the pace of change has been slow: six women across thirty-three years of eligibility represents a fraction of the turnover the academy’s presidency has seen overall.

To understand whether the imbalance might reflect differences in qualifications rather than opportunity, the team turned to standard bibliometric measures of academic achievement. They calculated the average years of professional experience, the h-index, the total publication count, and the total citation count for male and female presidents separately. The h-index, a widely used metric in scientometrics, captures both the productivity of a researcher and the impact of their work: an author with an h-index of 30 has published at least thirty papers that have each been cited at least thirty times. Because it combines quantity and influence in a single number, it is often treated as a proxy for scholarly standing when comparing candidates for senior academic positions.

The comparison revealed a striking pattern. Men who became president averaged 29.1 years of experience, while women averaged 28.5 years, a negligible difference suggesting that both groups reached the presidency at comparable career stages. But on every measure of scholarly output, the women outperformed their male counterparts. The average h-index was 32.0 for men versus 34.5 for women. The average publication count was 132.1 for men versus 188.2 for women, meaning the average woman president had produced roughly forty percent more papers than the average man in the role. The gap widened further for citations: male presidents averaged 3,493.8 citations, while female presidents averaged 6,188.7, nearly seventy-seven percent more. In other words, the small group of women who broke through to the academy’s top office did so with scholarly records that were, on average, stronger than those of the men elected around them.

The authors then sharpened the historical lens by dividing the most recent sixty years of leadership into two thirty-year halves, comparing 1966 to 1995 with 1996 to 2025. This split revealed how much the profile of the academy’s presidency has changed over time, and how unevenly that change has been distributed between the sexes. In the earlier half, women held just 3.33 percent of presidencies. In the latter half, that figure rose to 16.7 percent, a fivefold increase that nonetheless leaves women far short of parity in a specialty where they now constitute the majority of practicing dermatologists.

Scholarship itself intensified across the two eras. The average h-index of presidents climbed from 25.9 in the 1966 to 1995 window to 56.9 in the 1996 to 2025 window, more than doubling. Average publication counts rose from 147.6 to 173.3, and average citation counts jumped from 3,671.3 to 6,280.5. These trends reflect broader shifts in academic medicine, where research productivity has become an increasingly important credential for leadership and where digital databases have made citation tracking routine. Notably, the study’s authors highlight that the growth in academic scholarship over time has been driven by women in particular, meaning the female presidents of the recent era arrived with exceptionally strong research credentials even as their numbers remained small.

The findings sit within a growing body of literature on gender and medical society leadership. Previous work had already documented sex trends in the academy’s leadership, including a 2020 cross-sectional study published in the Journal of the American Academy of Dermatology, and a 2023 analysis in the same archives journal traced the evolution of leadership across American dermatology societies more broadly. Related research has measured h-index and scholarly productivity in academic dermatology in Canada, and a 2025 study in JACC: Advances examined the representation of women in professional medical society leadership across the United States and Europe. The new analysis extends this line of inquiry by covering the academy’s full presidential history through 2025 and by explicitly linking gender representation to quantifiable academic metrics.

The disconnect the study exposes is stark when set against workforce data from the Association of American Medical Colleges. Since 2021, women have constituted most of the US dermatology workforce, making dermatology one of the most female-dominated medical specialties. Yet the presidency of its largest professional organization remains a position held by men in ninety-three percent of instances across the academy’s history. Researchers who study the so-called glass ceiling in academic medicine have long argued that such gaps rarely reflect differences in ability or ambition; the metrics in this study support that view, showing that the women who did ascend brought equal experience and superior publication and citation records. The bottleneck, the data imply, lies somewhere in the pathways of nomination, visibility, and election rather than in qualification.

The authors frame their work as a step toward understanding these gender trends so that equity in academic leadership can be actively promoted. Tracking the composition of leadership over time, they argue, is essential for identifying where interventions might succeed, whether in mentorship pipelines, nomination processes, or the culture of professional societies themselves. The study’s title invokes the idea of a dermocracy, a play on democracy and dermatology, underscoring the point that elected leadership should reflect the constituency it serves. With women now forming the majority of the specialty’s workforce and demonstrating, by the study’s own measures, higher average scholarly output when they do reach the top, the academy’s leadership statistics stand as a measurable indicator of how much institutional change remains to be achieved.

For the broader scientific community, the study offers a methodological template: pairing historical leadership rosters with bibliometric data turns anecdotal impressions of underrepresentation into quantifiable evidence. The numbers here tell a consistent story across every metric examined. Six women among eighty-four presidents. A first woman president only in 1992. A rise from 3.33 percent to 16.7 percent female leadership between the two halves of the past sixty years. And, throughout, women presidents with more publications, more citations, and a higher h-index than their male peers on average. Whether the coming decades bring the academy’s leadership closer to the demographics of its membership will depend on whether the profession acts on exactly the kind of evidence this analysis provides.

Subject of Research: Gender representation and scholarly productivity among American Academy of Dermatology presidents from 1938 to 2025

Article Title: “Dermocracy” and Breaking the Glass Ceiling: a gender analysis of American Academy of Dermatology Presidents from 1938 to 2025

Article References: Albucker, S. J., Glick, S. A., & Feig, J. L. (2026). “Dermocracy” and Breaking the Glass Ceiling: a gender analysis of American Academy of Dermatology Presidents from 1938 to 2025. Archives of Dermatological Research, 318(1), Article 438. https://doi.org/10.1007/s00403-026-04861-8

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04861-8

Keywords: dermatology, gender disparities, leadership, American Academy of Dermatology, h-index, bibliometrics, women in medicine, academic medicine, glass ceiling, workforce, scholarly productivity, professional societies

The article, authored by Sophia Williams-Perez of Baylor University and the University of Louisville, Steven W. Thornton and Alexandria L. Soto of Duke University, Mikayla L. Deckard of the University of Louisville, and senior author Christie L. Buonpane, a pediatric surgeon at Norton Children’s Hospital, is deliberately framed as a reflection rather than a traditional research study. That genre choice matters. Rather than presenting survey data or outcome metrics, the authors describe the lived experience of building a committee from scratch: drafting its charge, negotiating its relationship with the Association’s existing leadership structure, recruiting members across training levels, and deciding which projects a brand-new body could realistically accomplish in twelve months. The result is a kind of field manual for any professional society contemplating genuine trainee representation, written by the people who had to improvise it in real time.

The committee did not appear out of thin air. The authors are explicit in crediting a predecessor body, the Association’s Trainee Committee Taskforce, with laying the groundwork. That taskforce, whose contributors included established surgical educators such as Dimitrios Stefanidis, Michael Awad, Mohsen Shabahang, Ranjan Sudan, Roy Phitayakorn, John Paige and Nabil Issa, spent its existence making the institutional case for standing trainee involvement. The distinction between a taskforce and a standing committee is more than semantic. A taskforce is temporary and advisory; it can recommend but cannot act. A standing committee holds a permanent seat in the organizational chart, a budget line, a reporting obligation and, crucially, a future. Converting one into the other required the Association’s leadership and staff to commit resources and political capital, a step the authors acknowledge with explicit gratitude.

The timing of the committee’s creation is no accident. Surgical education in the United States has been under sustained scrutiny, and the pressure has come from the top as well as the bottom. The authors point to the Blue Ribbon Committee II report, published in Annals of Surgery in 2024, which issued sweeping recommendations on surgical education and workforce training nationwide. Reports of that kind tend to diagnose problems in the pipeline, from attrition to skill gaps to burnout, without necessarily consulting the people actually moving through the pipe. A trainee-led committee functions as a structural corrective: it institutionalizes the perspective of learners so that national deliberations no longer have to rely on anecdote or after-the-fact feedback. The Association’s own 2023 to 2026 strategic plan provided the internal framework into which the committee could be embedded, aligning trainee voices with the organization’s stated priorities.

What makes the reflection valuable to readers outside surgery is its honesty about the friction inherent in shared governance. Trainees occupy a paradoxical position in academic medicine. They are simultaneously the primary customers of the education system, the frontline deliverers of much of the teaching that happens on clinical services, and the least powerful people in the room. Their schedules are dictated by call rotations and clinical obligations, which makes sustained committee work logistically difficult. Their tenure is short; a resident rotates off in a handful of years, taking institutional memory with them. The authors’ account of the first year implicitly grapples with these constraints, and the fact that the committee survived its inaugural year with its mandate intact is itself the headline finding. Continuity, in trainee-led structures, is the scarce resource.

The publication also situates itself within a broader scholarly conversation about who gets to produce knowledge in medical education. One of the cited works, a philosophy of science series by Lara Varpio published in Academic Medicine in 2020, explores how paradigms, ontologies and epistemologies shape what medical education research counts as evidence. Invoking that literature signals that the authors see their reflection not merely as a report of activities but as a methodological statement: the experience of trainees is itself data, and first-person accounts of governance are a legitimate way of knowing in this field. Another cited article, on preparing future surgeon-educators through surgical education fellowships, underscores the pipeline logic at work. If the specialty wants a generation of surgeon-educators, it must give trainees authentic opportunities to practice educational leadership before they become attendings.

For a general science audience, the deeper story here is about institutional design. Professional societies in medicine, like scientific societies generally, tend to concentrate decision-making among senior members on the assumption that experience confers judgment. The counterargument, now being tested in surgery, is that the people closest to the learning experience possess operational knowledge that senior faculty simply cannot access: which curricula actually fit around clinical duties, which simulation technologies trainees will actually use, which mentorship models fail quietly. A standing trainee committee creates a formal channel for that knowledge, and the first-year reflection suggests the channel works best when senior leaders treat it as a partnership rather than a token gesture. The authors’ acknowledgements, which thank the Association’s entire leadership and staff, read as evidence that this partnership held during the fragile startup phase.

The mechanics of the committee’s composition also deserve attention. The author group itself spans medical students, residents and faculty across institutions including Baylor, Duke and Louisville, illustrating the multi-institutional recruitment a national committee requires. Contributions listed in the paper show a deliberate division of labor, with four authors sharing conceptualization, writing and editing duties and the senior author providing supervision and editing. That structure mirrors the mentorship model the committee exists to promote: trainees lead the intellectual work, experienced faculty guide and endorse it. The paper’s publication in the Association’s own journal, Global Surgical Education, closes the loop neatly, since the committee’s first-year reflection becomes a citable contribution to the very literature on surgical education it aims to influence.

There are limits to what a single reflective paper can establish. The authors do not present outcome measures, and the article’s modest early readership metrics reflect the niche nature of the field. Supporting data are available only on request from the corresponding author. But the value of the piece lies less in its evidence base than in its replicability. Any society, whether in medicine, biology or engineering, that wants to move trainees from consultative roles to governance roles will encounter the same obstacles: charter language, budget authority, meeting logistics, succession planning and the perennial risk that the committee becomes symbolic. The first-year reflection documents how one group cleared those hurdles, and its publication means the next group starts with a template rather than a blank page.

The inaugural year of the Association for Surgical Education’s trainee-led committee is, on its face, a small administrative milestone. Read more broadly, it is part of a visible shift in how the medical sciences organize expertise, one in which learners are recognized as producers of educational knowledge rather than merely its recipients. The Blue Ribbon Committee II report made the case that surgical training in the United States needs systemic reform; this committee represents one of the concrete mechanisms by which that reform can be built from within, with the people being trained helping to design the training. Whether the committee’s second year consolidates its early gains, secures durable funding and produces measurable improvements in educational programs will determine whether it becomes a lasting fixture or a well-intentioned experiment. For now, the authors have done something quietly radical: they have written the first draft of trainee governance into the permanent record of their specialty, in a peer-reviewed journal, under their own names.

Subject of Research: Trainee-led governance and leadership development in surgical education

Article Title: Breaking ground: reflections from the inaugural year of a trainee-led committee in the association for surgical education

Article References: Williams-Perez, S., Thornton, S. W., Soto, A. L., Deckard, M. L., & Buonpane, C. L. (2026). Breaking ground: reflections from the inaugural year of a trainee-led committee in the association for surgical education. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 145. https://doi.org/10.1007/s44186-026-00551-1

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00551-1

Keywords: surgical education, trainee-led committee, Association for Surgical Education, medical education, shared governance, residents, surgical training, professional societies, mentorship, workforce development, Global Surgical Education, leadership

The survey, which ran from November 20, 2024, to January 7, 2025, was distributed by email to 15,112 physician members of the JSGS aged 65 or younger. Responses were collected anonymously through a web-based questionnaire, and 1,967 surgeons completed the survey, a response rate of 13.0 percent. Respondents were asked about their experiences of and exposure to harassment over the preceding ten years, a deliberately broad recall window chosen because this was the first nationwide survey of its kind conducted by the society and was intended to establish a baseline for future repeated measurements. The cohort skewed heavily male, with 87.0 percent of respondents being men, mirroring the composition of the specialty itself. The median time since medical school graduation was 21 years, meaning that the sample captured surgeons well beyond the training years, from residents and research fellows to department chiefs, professors, and hospital directors.

The study assessed five distinct categories of harassment, defined with reference to guidance from Japan’s Ministry of Health, Labour and Welfare and adapted to the surgical context. These included power harassment, sexual harassment, maternity and paternity harassment, academic harassment, and a newly formulated category called surgery-related harassment, designed to capture inappropriate behavior occurring in intraoperative and perioperative settings that exceeds what is necessary and appropriate for work. All categories were assessed on the basis of each respondent’s subjective perception, and the categories were not treated as mutually exclusive.

Overall, 66 percent of respondents reported experiencing at least one type of harassment during the preceding decade. The figure was dramatically higher among women: 87 percent of female surgeons reported harassment compared with 63 percent of male surgeons. Power harassment and surgery-related harassment were the most common forms, each affecting slightly more than half of all respondents, at 52 percent and 51 percent respectively. Academic harassment was reported by 27 percent, sexual harassment by 11 percent, and maternity or paternity harassment by 6 percent. The seemingly low prevalence of the latter two categories reflects the overwhelmingly male sample; among female surgeons, 55 percent reported sexual harassment and 24 percent reported maternity or paternity harassment, compared with just 8 percent and 4 percent of men respectively. Even for surgery-related harassment, prevalence among women exceeded that among men by 16 percentage points.

Perhaps the most striking finding concerns witnessing rather than experiencing. Eighty-eight percent of respondents reported having seen or heard about at least one type of harassment in their workplace over the past ten years, including 87 percent of men and 94 percent of women. Power harassment was the most frequently witnessed category at 78 percent, followed by surgery-related harassment at 69 percent and sexual harassment at 52 percent. For every single type of harassment, the proportion who had witnessed it exceeded the proportion who had personally experienced it. The researchers interpret this pattern as evidence that harassment is embedded in, and normalized by, the culture of surgical workplaces rather than being confined to individual perpetrator-victim dyads. When abusive conduct is visible across an entire community, they argue, the problem must be treated as organizational rather than purely interpersonal.

The career consequences were equally alarming. Among surgeons who experienced harassment, 56 percent reported that it had driven them to consider leaving the profession, with nearly identical rates among men and women. For power harassment and surgery-related harassment specifically, 57 percent of affected surgeons had contemplated exit. The corresponding figures were 46 percent for maternity or paternity harassment, 37 percent for academic harassment, and 18 percent for sexual harassment. Timing mattered: surgeons who experienced power harassment within ten years of graduation were more likely to consider leaving than those harassed later in their careers, at 61 percent versus 50 percent. Most troubling of all, respondents who reported harassment across multiple career periods were the most likely of all to consider abandoning surgery, regardless of harassment type, suggesting that cumulative exposure compounds the damage.

These results land on a specialty already under demographic strain. Despite an overall increase in the number of medical interns in Japan, applications to surgical training programs have been declining, and the JSGS has documented year-by-year decreases in its own membership even as an aging society sustains demand for operations. A 2023 Health Labour Sciences Research report found that among residents who had originally intended to pursue surgery, one reason for ultimately choosing another path was the perception that harassment was likely to be common, alongside work-life balance concerns and the image of surgery as excessively demanding. An earlier nationwide survey by the Japan Surgical Society found that roughly 40 percent of young surgeons had experienced harassment from supervising surgeons and nearly 30 percent had considered leaving their training program, with harassment accounting for more than half of the reasons for contemplating withdrawal. The new data extend this concern beyond trainees to surgeons at every career stage, indicating that harassment persists throughout professional life rather than ending with residency.

The comparison with the general workforce is stark. In a recent nationwide survey of Japanese workers commissioned by the Ministry of Health, Labour and Welfare, 19.3 percent reported power harassment and 6.3 percent reported sexual harassment. Among gastroenterological surgeons, the corresponding figures were 51 percent and 11 percent. The authors attribute this elevated prevalence to the traditional hierarchical structure of surgical training, long working hours, high clinical demands, and strongly hierarchical organizational cultures, conditions that also make harassment less visible and more likely to persist implicitly. They note that while surgical education sometimes requires strict guidance and tension-filled situations, educational quality and a healthy work environment should not be regarded as mutually exclusive, and that behaviors presented as instruction or supervision may still be perceived as harassment by younger surgeons.

Demand for institutional action proved overwhelming. Fifty-eight percent of respondents strongly agreed and 34 percent agreed that the JSGS should implement countermeasures against harassment, meaning 92 percent supported society-level intervention, while only 5 percent disagreed. The authors argue that professional societies are uniquely positioned to act in hierarchical specialties such as surgery, where institutional responses within hospitals may be constrained by power structures and conflicts of interest. Potential initiatives include structured anti-harassment education for trainers and department leaders, periodic nationwide monitoring, video-based and simulation-based training programs of the kind being explored internationally, and systems to recognize and promote institutions that maintain healthy educational environments. Japan’s Japanese Medical Specialty Board has already established a consultation pathway for trainees who suspect harassment, and international bodies have developed formal professional-society resources addressing harassment-related behaviors, although evidence for real-world effectiveness in surgery remains limited.

The researchers acknowledge limitations, including the possibility of self-selection bias among voluntary respondents, the reliance on subjective perception rather than legal determination, the unavoidable recall bias of a ten-year window, the cross-sectional design that precludes causal inference, and the exclusion of surgeons who had already left practice or the society, including those who may have departed because of harassment. Nevertheless, the large nationwide sample and the inclusion of surgeons across career stages provide an unusually comprehensive view. The survey has already fed into policy: on July 17, 2025, the JSGS issued a formal Declaration for the Eradication of Harassment, and the study’s authors say the findings underscore the importance of translating that declaration into concrete action rather than leaving it as a statement of principle. With the future of the surgical workforce at stake, they argue, harassment must be recognized not merely as an ethical failing but as a workforce policy problem that threatens the sustainability of surgical care in Japan.

Subject of Research: Prevalence and consequences of workplace harassment among gastroenterological surgeons in Japan

Article Title: Workplace Harassment and Consideration of Leaving Surgical Practice: A Nationwide Survey by the Japanese Society of Gastroenterological Surgery

Article References: Kurimoto, K., Fujii, T., Shirai, Y., Fujinaga, A., Fukumoto, M., Ishida, S., Hida, K., Tanaka, C., Mizushima, T., Nomura, S., & Shirabe, K. (2026). Workplace Harassment and Consideration of Leaving Surgical Practice: A Nationwide Survey by the Japanese Society of Gastroenterological Surgery. Annals of Gastroenterological Surgery, Article ags3.70274. https://doi.org/10.1002/ags3.70274

Image Credits: AI Generated

DOI: 10.1002/ags3.70274

Keywords: workplace harassment, gastroenterological surgery, power harassment, sexual harassment, surgeon burnout, workforce sustainability, gender disparity, surgical training, Japan, professional societies, physician attrition, organizational culture