Women now outnumber men among students entering medical schools, an accomplishment that took years of effort. Unfortunately, we have far to go to achieve similar levels of equity throughout academic medicine, especially the higher up the hierarchy you go — only a quarter of medical schools’ full professors are women and fewer than one in five deans are women.

The challenges women face in academic medicine are well-documented and start early in women’s careers. Women receive less institutional support and resources and are less likely to have effective mentors. Women routinely encounter subtle messages that downplay their accomplishments, from being interrupted more frequently or being called by a first name instead of a professional title. They also encounter more overt discrimination and sexual harassment. At the same time, women are paid less than men for the same level of academic achievement. Perhaps it is not surprising that the pipeline is so leaky and that so few women rise to the top of their fields.

But there is another reason behind these disparities — one that is less discussed but equally important. Women’s research is less likely to be cited, even after they’ve published in prestigious medical journals.

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In a study published in JAMA Network Open, we analyzed 5,554 research articles published between 2015 and 2018 in five top academic medical journals and found that articles written by women are cited less often than those written by men. This was true for all research articles, but especially so when women worked together as a team: Articles with women as both the lead author and the most senior author were cited only about half as much as similar articles written by men.

These differences matter. The number of times your research is cited is commonly used to measure your scholarly impact. It signals academic recognition, influence, and acceptance by your scientific community. It is used in professional evaluations and decisions about job promotion.

The disparity in citations is the latest example demonstrating that we don’t equally amplify the voices and work of women. Despite their expertise, women are less frequently asked to author guest editorials in major journals (particularly as first author) or speak at national medical conferences. Women are less frequently nominated for prestigious awards or leadership positions. And universities often fail to recognize women’s accomplishments through honors such as endowed chairs (one of the most distinguished roles in a university setting, which often comes with funding). There are many subtle ways that women’s voices are silenced — quietly and in ways that can go unnoticed.

Our failure to amplify women is not limited to the ivory tower. Prior research from one of us showed the same disparity in amplification of academic women on Twitter, a social media platform commonly used by academics to promote their research.

Amplification of women is important. Without it, the careers of women will continue to trail behind men.

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Addressing disparities in academic medicine will take more than improving the pipeline. More must be done to support and promote the careers of women after they enter the field. Disparities in citations can be directly addressed by authors and journals. We can collect data and hold each other accountable for equally publicizing good science regardless of who writes it.

But there are deeper issues we must also grapple with, including a culture that minimizes and dismisses voices that come from outside of the inner sanctum of academics — a sanctum in which women and individuals from racial and ethnic minority groups have long been underrepresented.

As female academics, it can sometimes feel like we are shouting into a void, with no one hearing what we are saying. It’s past time for academia to start listening.

Rachel M. Werner (@rm_werner) is executive director and Paula Chatterjee (@ChatterjeePaula) is a senior fellow at the Leonard Davis Institute of Health Economics. Both are also professors and physicians in the Perelman School of Medicine.