Women in Radiology Project Aims to Increase Scientific Authorship Among Women

Six months into the pandemic, the women of Columbia Radiology met on Zoom for the bi-monthly Women in Radiology group. The pandemic was creating new challenges for women in medicine, many of whom were also caregivers. The group, founded and led by Carrie Ruzal-Shapiro, MD, professor of radiology and chief of the Division of Pediatric Imaging, is a place where issues specific to women in radiology—a specialty in which women represent only 25 percent of the workforce—are regularly discussed and addressed.

Mary Salvatore, MD, associate professor of radiology at CUIMC and a member of the group since 2018, was particularly interested in encouraging her colleagues to find solutions. "I'm a problem solver," she says. "If we're saying women in radiology have fewer opportunities to be successful, then what can we do to bolster our resumes? And for me that goes to research and what can we do to become more impactful scientists."

While women are generally underrepresented in biomedical research, studies show that they significantly decreased the time they spent on research during the pandemic—with a potentially longterm impact on academic medicine. Caregiving responsibilities, which more often fall on women, are often cited as a primary reason for their decline in research participation since 2020. 

For Salvatore, a cardiothoracic radiologist who has focused much of her own research on interstitial lung diseases and patterns of fibrosis on CT imaging, COVID-19 was both the problem and the solution. "I was thinking about what we can do to promote women, which is to have them publish papers," she explains. "It also happened to be in the context of a pandemic."

She and fourth-year resident Kathy Capaccione, MD, PhD, proposed that the members of the group—which brings together senior and junior faculty from all divisions as well as residents—collaborate on a paper that looked at manifestations of COVID-19 on imaging in all body systems. The physicians saw the research as an opportunity to showcase radiology in multiple divisions, which meant they could include everyone who was interested in participating in the project.

Both Salvatore and Capaccione had already published research on COVID-19, a disease that was known at the time to primarily affect the lungs. But physicians were seeing manifestations of COVID-19 in other body systems and radiologists were already weighing in on what they saw on the imaging. As radiologists in the pandemic's epicenter, they had access to a wide range of studies that they could use to illustrate their findings.

The result of the collaboration was a review paper, published in Academic Radiology in February, 2021, with 17 women authors including Capaccione as the lead. The publication became the beginning of a now annual project designed to address both the need to engage more women in biomedical research and the advantages of research collaboration across subspecialties.      

 Capaccione has created a process that breaks down the scientific writing process and facilitates timely and successful completion. She provides detailed outlines for each of the paper's sections and assigns them according to area of interest, with senior faculty mentoring junior faculty and residents. She also provides clear deadlines—the entire process from idea to publication took less than five months.

For many of the residents, it was their first experience publishing a paper. "There was great pride that they could come together, led by the junior cadre, and produce a piece of solid work that was published in a good journal that people will read," says Ruzal-Shapiro.

The paper was one of the earlier discussions on the topic. "I think we were able to demonstrate how widespread COVID-19 is and how many radiographic findings there are," says Capaccione. "People think it's a lung problem, but we showed that many findings, especially related to blood clots, may actually be a sequalae of COVID-19. It's important to have them down on paper and for neuroradiologists and other subspecialties to be aware they should be looking for them."

Now a nuclear radiology fellow at Columbia, Capaccione is currently leading the group's second paper, which will focus on adverse events related to immunotherapy treatment for cancer and how they correlate with the success of treatment. It will again cover all modalities and body systems.

For Salvatore, there is much to be learned from the multi-system approach to research in an institution where scientists are highly specialized. "I think about fibrosis or scarring of the lung, but I don't talk to the person who thinks about scarring of the liver," she says. "So I can't benefit from what they've learned and they can't benefit from what I've learned." Aside from helping women advance their careers, Salvatore sees this project as an ongoing opportunity to break down silos and think about what scientists can learn from each other.

"Every time you can do that, you benefit science," she says.