Abstract
BACKGROUND: As the number of practicing female urologists in Australia continues to increase alongside the academic development of the specialty, it is essential to examine how gender and rurality impact academic performance and expectations. This study aims to assess differences in h-index related to both gender and rurality among Australian urologists. METHODS: We identified all active, practicing Australian urologists through the Urological Society of Australia and New Zealand (USANZ) membership database. Data on each practitioner's gender, subspecialty, academic rank or affiliation, seniority, and h-index from the Web of Science were collected. Differences in h-index by gender and rurality were analyzed using univariable and multivariable regression. RESULTS: A total of 463 Australian urologists were included, of whom 69 (14.9%) were female and 73 (15.8%) practiced in rural areas. Female urologists were less likely to hold an academic position of Associate Professor or Professor compared to their male counterparts (5.8% vs. 11.0%, P = 0.28). The average h-index for female urologists was 39% lower than male urologists (univariable P < 0.001). Adjusting for demographic variables, h-index remained 32% lower (multivariable P = 0.003). The average h-index of rural urologists was 51% lower than their metropolitan colleagues (univariable P < 0.001); and after adjusting for demographics, the average h-index was 30% lower (multivariable P = 0.006). CONCLUSION: Female and rural urologists in Australia produce significantly less research than their male and metropolitan counterparts. To address this disparity, it is crucial to implement enhanced institutional academic support, targeted mentorship, and greater recognition of the challenges posed by caregiving responsibilities and rural practice.