The influence of first author sex on acceptance rates of submissions to Anaesthesia Cases.

More than 50% of medical students and 45% of practising doctors are female in the UK. In the specialty of anaesthesia, 32% of consultants are female. However, compared with males, females are under-represented as authors of articles published in high-impact journals. We investigated the proportion of female first authors by examining the case reports submitted to Anaesthesia Cases since its inception in 2013. We defined authors by their sex (male or female), that is, biological characteristics, rather than their gender. There were a total of 802 submissions to Anaesthesia Cases over 4.5 years. Sixteen submissions were excluded and of the remaining 786 submissions, 279 were accepted and 507 rejected, an acceptance rate of 35.5%. Twenty (2.5%) authors' sex could not be identified. The overall proportion of female first authors was 37.1%. The proportion of female first authors of accepted case reports was 42.1% and females were first authors of rejected case reports in 34.4%. We found that, compared with previous studies on female sex and gender bias in publishing, there was a relatively high proportion of female first authors publishing in Anaesthesia Cases and female first authors were more likely to be accepted than male first authors. Authorship is considered to reflect career success and there continues to be sex/gender inequity that must be tackled at all levels, from application to medical school, through research funding, journals and Editorial Boards.