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We thank Stewart et al for their positive comments on our work and we applaud to their effort in refining and extending our analysis to the senior authorship positions.1 We also read with great interest the paper published by Bagga et al, from the same study group, that explored the gender equality in original clinical works (either funded or not funded by industries).2 In aggregate, an important under-representation of female researchers in the rheumatological field has emerged, regardless of the efforts employed in improving gender equity in the last decade. Indeed, although we found a trend to parity in the last 5 years in the first author position,3 Stewart et al reported a prevalence of men as senior authors and they previously showed that even clinical research is somewhat dominated by men (although to a lesser extent). We should note that, with our reports, we undoubtedly did not want to convey the message that gender parity has been reached. The academic career path is undeniably uneven and slippery for young women researchers.
As an example, we explored the data from the Italian Istituto Nazionale di Statistica, which gather the records regarding the Italian public and private universities. In the last two decades, among students that started their courses in medical school approximately 50%–60% were female. Notwithstanding that, the vast majority of full professors and associate professors of medicine in 2020 are men (1521 vs 277 for full professors and 2159 vs 831 for associate professors). Remarkably, this gender gap in the academic leadership positions seems to be standing even when considering non-professor faculty positions. In 2020, among 4009 non-professor researchers, only 44.6% are women. In summary, our findings and the findings by the group of professor Dalbeth confirmed that the gender gap is still wide open in the academic rheumatology, especially in the leadership positions.4 5 The career advancement is somehow slower for women as compared with men; thus, we strongly endorse the call to action of prioritising gender equity in the academic field.
Handling editor Josef S Smolen
Contributors All the authors contributed equally to the writing of the correspondence.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.
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