Purpose: To describe trends in authorship among female radiologists, compared to their overall representation in radiology, and to investigate the tendency of female first authors to publish with female last authors.;Material and Methods: We collected and analyzed data on gender of first and last authors for all original research and guest editorial articles from three main radiology journals - Radiology, American Journal of Roentgenology (AJR), and Academic Radiology. We restricted our analysis to authors with M.D. (medical doctorate) degrees from academic institutions within the United States. Manuscript data were collected for years 1978, 1998, 2008, and 2013. We obtained data on female participation in academic medicine and radiology residencies from the American Association of Medical Colleges. We used a logistic regression model to identify significant trends over time and a chi-square test of independence to determine significant relationships between gender of first and last authors.;Results: We determined gender for 4,214 (99.2%) authors of original research and editorials with M.D. degrees. The proportion of original research articles published by women as first authors increased from 8.3% in 1978 to 32.4% in 2013 (p < .003), and the proportion of original research articles with women as last authors increased from 6.5% in 1978 to 21.9% in 2013 (p < .004). In 1980, 19.2% of radiology residents were women and in 2013 26.9% of radiology residents were women. In 1978, women represented 11.5% of radiology faculty at academic institutions and in 2013 they represented 28.1%.;Demonstrated by logistic regression model, there was a higher representation of women as both first and last authors over time (first author OR = 1.043, p < .001; last author OR = 1.036, p < .001). There was a statistically significant relationship between the gender of first and last authors of original research articles and guest editorials (p < .001).;Conclusion: Over the last 35 years, there has been a statistically significant upward linear trend of female M.D. participation in academic radiology literature authorship. However, the number of female last (senior) authors lags behind the participation of women in clinical and academic radiology. Women are more likely to publish with senior authors of the same gender.;We propose that female radiology residents receive an increased level of support to stimulate their interest and participation in research. Such intervention would allow the field to benefit from the creativity of both genders.
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