Gender disparities in Italian academic medicine: A cross-sectional study of clinicians in the 2024 stanford top 2% scientists database

Background: Women remain underrepresented in senior and influential research positions despite gradual improvements over recent decades.The aim of this study was to assess gender representation among highly cited Italian clinical scientists and to examine differences across academic fields, institutions, and geographic regions. Methods: We conducted a cross-sectional analysis of Italian clinical scientists included in the 2024 Stanford Top 2 Percent Scientists database. Gender was determined from given names, and demographic and academic information was obtained from national physician registries and publicly available curriculum vitae. Characteristics were compared by gender, and a logistic regression model was used to examine factors associated with female representation. Results: A total of 3389 clinical scientists were identified, of whom 824 were women. Women represented approximately one quarter of highly cited Italian clinical researchers. They were younger and had more recent years of first publication compared with men. No significant gender differences were observed in academic affiliation or geographic distribution. Representation varied across fields, with surgical specialties demonstrating the lowest proportions of women and toxicology the highest. However, in most disciplines, representation converged toward the overall average when sample sizes increased, indicating that academic fields alone contributed minimally to gender representation. In the multivariable model, only toxicology showed significantly greater female representation, while more recent year of first publication was independently associated with being a woman.. Conclusions: Women remain underrepresented among highly cited Italian clinical scientists, despite evidence of gradual improvement in representation over time. The limited influence of academic fields suggests that broader structural and cultural factors likely contribute to these gaps. These findings highlight the need for targeted strategies to promote equal representation and support the career advancement of women in academic medicine.