Gender Bias in Otolaryngology Research Funding

Editor’s note: This is part one of a two-part series on gender disparity in otolaryngology. Part two, which will publish in the June issue of ENTtoday, will focus on gender disparity in clinical trials.

Gender bias in research funding has been persistent and deep seated in many aspects of medicine for a long time; only recently has it started to get the attention it deserves. “It’s simply unfair for women to encounter barriers to their success outside of their control,” said Zainab Farzal, MD, resident and researcher in the department of otolaryngology/head and neck surgery, University of North Carolina at Chapel Hill. “Acknowledging it is important because women’s progress is society’s progress. For these reasons, sex disparities need to be studied and tackled on multiple levels.”

Sujana S. Chandrasekhar, MD, past president of the American Academy of Otolaryngology–Head & Neck Surgery and partner at ENT and Allergy Associates, LLP, in New York City, and her colleagues have documented the existence of gender-based funding disparities in otolaryngology. In a 2013 study, these researchers found that male faculty have higher National Institutes of Health (NIH) funding levels than their female colleagues. This disparity is true both for early and mid-to-late career individuals (Otolaryngol Head Neck Surg. 2013 Jul;149:77–83). Sex bias also occurs in industry funding, research and otherwise, for both otolaryngology and neurosurgery (JAMA Otolaryngol Head Neck Surg. 2017;143:796–802; World Neurosurg. 2017;103:517–525).

Dr. Farzal pointed to a study analyzing NIH research project grant renewal summary statements written by grant reviewers that show substantial implicit biases in the grant peer review process. (J Womens Health. 2017;26:560–570). For instance, male principal investigators were referred to as “leaders” or “pioneers,” and their work was referred to as “highly innovative” or “highly significant research” in summary statements. Conversely, less weighty words were used to describe female principal investigators and their work. They were said to have “expertise” and worked in “excellent” environments.

If we don’t support the growth and professional development of female surgeons who, year after year, become a greater percentage of the specialty, we hold back the whole otolaryngology field.—Zainab Farzal, MD

Another study demonstrated that grant proposals by male and female principal investigators received similar critiques when they were judged primarily on the science in the proposal (Lancet. 2019;393:531–540). However, when the grant review was based on an assessment of the principal investigator’s credentials, grants with female principal investigators received significantly lower scores, Dr. Farzal said.