Abstract
BACKGROUND: It has previously been reported that authors from developing countries are underrepresented in medical journals. Here, we aimed to build a comprehensive landscape of the geographical representation in medical research publications. METHODS: We collected bibliometric data of original research articles (n = 10,558) published between 2010 and 2019 in five leading medical journals and geolocated these by the institute of the corresponding authors. We introduced two simple metrics, the International Research Impact and the Domestic Self-Citation Index, to assess publishing and citing patterns by cities and countries. RESULTS: We show that only 32 countries published more than 10 publications in 10 years equaling 98.9% of all publications. English-speaking countries USA (48.2%), UK (15.9%), Canada (5.3%), and Australia (3.2%) are most represented, but with a declining trend in recent years. When normalized to citation count, 9/32 countries published ≥ 10% more than expected. In total, 85.7% of the publication excess originate from the USA and UK. We demonstrate similar geographical bias at the municipal level. Finally, we discover that journals more commonly publish studies from the country in which the journal is based and authors are more likely to cite work from their own country. CONCLUSIONS: The study reveals Anglocentric dominance, domestic preference, but increased geographical representation in recent years in medical publishing. Similar audits could mitigate possible national and regional disparities in any academic field.