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Background: Despite a substantial increase in the number of women matriculating into medical school, a gender gap still exists with respect to academic leadership positions. This gap is apparent in the field of dermatology, particularly in the composition of dermatology journal editorial boards. To address this gap, we must first acknowledge its existence, examine potential reasons for its existence, and propose strategies to narrow the gap. Objective: Our objective is to determine the representation of women as editors in dermatology journals. Methods: A comprehensive search was performed for dermatology journals indexed in Medline, Journal Citation Reports, Scopus, and Embase in August, September, and October 2018. The editorial board of each journal was analyzed for the number and percentage of male and female editors in four different positions. We verified the accuracy of editorial boards listed on publisher websites by emailing administrative personnel. We also recorded the number of years from terminal degree for editorial board members of the 10 journals with the highest impact factors using SCImago Journal Rankings. Results: Women occupied 18% of editor-in-chief positions, 36% of deputy editor roles, 22% of overall editorial board positions, and 22% of other board roles. The average number of years since terminal degree was not statistically different between women and men, with women averaging 30.2 years and men averaging 28.0 years since completion of terminal degree (p = .27). Conclusions: Our findings suggest that women are underrepresented as editors at all levels in dermatology journals. This supports prior findings reporting a minority of women in academic leadership roles. Thus, although women have made major advancements in the medical field over the past century, there remains room for progress with regard to equal representation in academic leadership roles, including editorial positions, professorships, and department chair roles. Keywords: Academic medicine, Editorial boards, Women in medicine

Highlights • The implementation of double- or triple-blind review practices will ensure that authors with worthwhile and prominent research will have fair and equitable review regardless of their prominence in the field. • Improving the quality of our reviews and raising the standings of our publishing authors. This makes way for healthy competition and a drive to produce high quality research. • It is our responsibility to limit or eliminate bias by promoting impartiality and increasing the level of transparency between the editorial teams and authors, allowing peer review to be more inclusive, instructional, and equitable.

Purpose There are concerns in the academic publishing community that it is becoming more difficult to secure reviews for scientific manuscripts. This study examines trends in editorial and peer review processes in an ophthalmological journal over the last decade. Methods A retrospective analysis was performed of editorial data from the journal Acta Ophthalmologica containing all manuscript submissions between 2010 and 2020. Results The number of yearly submissions grew between 2010 and 2019 from 1014 to 1623, and in 2020, the number of submissions increased to 2449. In total, the number of submissions increased by 142% between 2010 and 2020. Similarly, the proportion of desk-rejected manuscripts increased from 48% to 67% during the period 2010-2020. The number of invitations needed to obtain one review showed an increase from 1.9 to 2.6 between 2010 and 2019, but remained stable between 2019 and 2020. However, the number of reviewers per reviewed manuscript, reviewed manuscripts per reviewer and time from invitation to completed review assignment remained almost constant between 2010 and 2020. Researchers based in North American were disproportionally often invited to review (18%) compared to their share of published articles (7%), and they also declined review invitation more frequently compared to scholars in other parts of the world. Conclusions The study revealed an increase in submitted manuscripts to an ophthalmological journal over the last decade, with a further increase during the COVID-19 pandemic. The number of reviewer invitations needed to obtain one review grew during the study period but remained constant between 2019 and 2020, despite a vast increase in submitted manuscripts. Hence, the burden for unique reviewers did not increase. Instead, the proportion of desk-rejected manuscripts grew, and the reviewer pool expanded, which allowed the annual average number of reviews by individual reviewers to remain stable.

Despite the widely accepted benefits, at present, gender equity is a challenge for women, also in science.1 In this context, according to the UN Educational, Scientific, and Cultural Organization's Women in Science data, women represented approximately 30% of researchers in 2018, whereas nearly 75% of trainees, health workers, and faculty involved in global health were characterized by women in the same year.2 In neurology, the analysis of the American Academy of Neurology (AAN) Report led to estimate that in 2016, women were approximately 32% of all US neurologists, whereas in 2008, they were nearly 25%.3 In addition, it also appears that women researchers are much less represented than men among editorial boards of various scientific journals.4,5 In 2011, Amrein et al.4 reported that women represented approximately 18% of all editorial board members of 60 top-ranked journals, whereas they decreased to less than 15% when considering the top 5 neurology journals.