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Objective: Medicine is a discipline where there are still pronounced gender imbalances. Whereas worldwide about 50% of beginners in medical schools are female, only few of them reach leading positions. Our aim was to analyze how this situation is reflected in a peer-reviewed general medical-scientific journal., Methods: We screened all papers submitted to the Wiener klinische Wochenschrift - The Middle European Journal of Medicine between January 2001 and September 2009, analyzing the percentage of female first authors of submitted papers and accepted papers, the contribution of female authors depending on the type of article and medical specialty, and the percentage of invited female peer reviewers as well as the quality of their reviews., Major Results: During the period studied, a total of 2507 manuscripts were submitted to Wiener klinische Wochenschrift. 26% of these papers had female first authors, and this proportion increased continuously from 16% in 2001 to 32% in 2007, whereafter it remained constant. The proportion of papers submitted by female first authors was dependent on the medical subspecialty (e.g. 48% female first authors of pediatric papers, 12% female first authors of cardiology papers). There was no difference in the acceptance rate of papers by male and female first authors; however, a somewhat higher rate of papers with female first authors was subject to rapid rejection (21% vs. 16%). Papers with female first authors more often named a different corresponding author than papers with male first authors, and in most of these cases the corresponding author was a man. More than 40% of all submitted original papers, 24% of the review articles, but only 10% of the editorials had female first authors. During the years studied only 5-11% of reviewers were women, despite that the quality of their reviews was generally better than those by men. Among the 21 members of the editorial board only one is a woman., Conclusion: Between 2001 and 2007 the percentage of manuscripts submitted to Wiener klinische Wochenschrift by female authors constantly increased and is now around 30%, reaching almost 50% in some specialties such as pediatrics. Nevertheless, there remains a massive gender imbalance in Wiener klinische Wochenschrift: review papers or invited editorials are only rarely authored by female researchers, a very low percentage of peer reviewers is female - although the quality of their reviews is generally better - and only one member of the editorial board is female. Even though this is mostly a reflection of the general situation in academic medicine, medical journals can and must take action and contribute to the elimination of these gender inequalities.

The impact factor (Institute for Scientific Information, ISI, Philadelphia, PA, USA) is a widespread used and acknowledged source for judging the quality of a researcher. In addition the "Science Citation Index (SCI)" [Institute for Scientific Information (ISI)] provides the scientific community with a citations database indicating the number of cited references in indexed articles. For several reasons, the SCI seems to be more relevant. To evaluate the quality of the journal "Wiener klinische Wochenschrift", we assessed how often contributors to this journal have been cited during the last decade and which contributions have ranked as top papers. Moreover, with the aim of a more objective type of scientific evaluation, we have employed a new score, the "Citation Per Time Score (CPT-Score--the SCI divided by the number of years of observation, starting one year after publication). We have evaluated the total SCI for the years 1990 to 1994 and for the years 1995 to 1999. The number of total citations between the appearance of an article and the year 2000 was analyzed. The highest ranked publication of the whole decade (1990-2000) was a paper by G. Stanek with 40 citations. Furthermore, we have evaluated the "Top Ten Papers" of the journal. Interestingly, a steady increase of the total citation index of the journal "Wiener klinische Wochenschrift" over the last decade could be demonstrated. This study clearly shows that the citation rate of an article is not determined by the impact factor of the journal but rather the quality of the contribution. Moreover, the citation analysis of papers published in the last ten years in the "Wiener klinische Wochenschrift" shows a satisfactory citation rate for articles published in this journal. It is therefore definitely attractive to submit an article to a journal such as the "Wiener klinische Wochenschrift".

The objective of this study was to perform a citation analysis of the frequency of the various languages used in the bibliographical references of the original articles published in the Wiener klinische Wochenschrift during the past 75 years (1920-1995). The languages of publication were recorded of 14,667 references from 800 original papers, at the rate of 50 articles per year at intervals of five years. The percentage of references in German remained constant until 1946, but has been decreasing progressively since that time: 87% in 1920, 84% in 1946, 51% in 1970, and 20% in 1995. The percentage of references in English, on the other hand, has continued to increase, especially since 1946: 3% in 1920, 9% in 1946, 41% in 1970, and 79% in 1995. Even though the importance of English started to increase as from 1946, it did not supplant German as the main language of medicine in Austria until 1980 (thirty years later than usually accepted up to now).

Between 1989 and 1991 16 Austrian pediatric institutions published 232 scientific papers with a total impact-factor of 200,406 in internationally recognized journals. Seventy-three percent of them came from only three institutions, the University departments of pediatrics in Graz and Vienna and the St. Anna Children's Hospital (77, 63 and 30 publications, respectively). The impact-factor (IF) of these publications ranged from 7.591 to 0.010. The average IF was 0.864 and the median IF 0.430 per paper. Whereas 70 papers (30%) were published in journals with an IF over 1, only one third appeared in pediatric journals.