Materials and methods

Research funds in Spanish universities are mainly obtained in two ways. The first one is the participation of researchers and their teams in calls, through which public Administrations (the State, the Regional governments and the European Union) competitively subsidize research projects. The second source of resources for academic research is the signing of contracts and agreements between faculty and researchers with companies and public and private institutions, a way stated in article number 83 of Organic Law 6/2001 on Universities (LOU), through which public universities transfer to society the results of scientific and technical research, carried out on request.

In order to analyze the resources dedicated to research in the area of health sciences from a gender perspective, the study uses as sources anonymized institutional data from the research databases of the University of Valencia, that the academic government team specifically provided for the conduct of this study, upon request.

Three institutional databases have been used, utilizing all of the variables of interest for the purpose of our research:

1) The data provided span practically two decades (2000-2018) and include complete information regarding all of the resources dedicated to research in force in said period of time, either coming from public aid that finances R & D & i projects - in the framework of the State Plan, European projects or research grants from the Valencian government -, as well as those generated by contracts signed for the transfer of research results on request.

The academics, men and women who lead them as main researchers, belong to the totality of departments and disciplines in the area of health sciences. Specifically, they are faculty and researchers assigned to the Schools of Medicine and Dentistry, the Faculty of Pharmacy, the Faculty of Nursing and the Faculty of Physiotherapy. Data have been exploited and analyzed to assess the gender distribution of research funds for the entire study period (2000-2018), not only globally or cumulatively, but also longitudinally, in order to track eventual changes over time and check the trends observed in their evolution. For this last purpose, several intervals have been established, within the global time period, specifically the periods 2000-2005: 2006-2010; 2011-2015; and 2016-2018.

Moreover, we filtered the data considering three variables in addition to the researchers´ sex, in order to find out to what extent they influence and modulate the overall results.

The first is the academic category, since the professional rank is usually decisive in obtaining funds for research, as numerous studies have shown (among all, ^{Waisbren et al., 2008}). Therefore, all of the analyzed questions were additionally considered, taking into consideration the academic category of the researchers, obtaining different results for four groups of faculty: firstly, for the temporary hired professors (a set that includes Assistant professors, as well as Ph.D. Assistant professors, and some other residual figure); secondly, the faculty who have a permanent relationship with the university (Associate Professors from various categories of Spanish universities) were studied; Full Professors, considering that they constitute the highest university category, were also analyzed specifically; as well as Emeritus professors, since they practically are all Full Professors, as the LOU describes this figure as professors who have performed outstanding services to university.

Secondly, we used four age ranges to detect possible differences in access to research funds throughout the life and professional careers of university researchers, given that age is an essential factor in the patterns of dedication to a professional career, either due to the greater need to accumulate merits in the early stages, until reaching tenure, or due to the incidence of various family obligations and especially children raising, specifically for female researchers. The ranges used have been four: from 30 to 40 years; from 41 to 50 years; from 51 to 60 years; and finally, the group of faculty and researchers over 60 years of age.

Finally, gender differences in research throughout the different medical specialties (23 in particular) have also been considered, analyzing the data of each one of them in terms of leadership of research teams and funding dedicated to clinical research, both regarding contracts and research projects, in order to assess whether, considering the issues analyzed, we find situations that make horizontal segregation evident in this academic field.

2) One last issue that this study addresses in order to detect an eventual gender pay gap is the additional remuneration received by male and female researchers from the research contracts in which they participate. For this purpose, the payment invoices delivered by researchers of both sexes have been analyzed, whose amounts have been obtained through the payroll database. In particular, we have analyzed the perceptions of the last five years of data from our study, which cover the period 2014-2018.

We conducted all research throughout the second quarter of 2019.

Results and discussion

Research funds

Firstly, if we analyze from a gender perspective the raising and management of funds dedicated to medical research, for which men and women academics appear as principal investigators, for the entire period 2000-2018, and starting with the Research projects, which result from competitive calls, these are mostly controlled by men, to a much greater extent than by their female colleagues, since they practically double the available research funds (€ 25.681.957, compared to € 13.753.555, respectively) . The number of research projects by sex also shows a balance that favors male academics, who lead 276 projects, compared to 207 in which the principal investigator is a female researcher. Although the numerical difference is not excessive, the fact that the amounts of research funds managed by men practically double those controlled by women, allows us to conclude that they are awarded projects with greater economic endowment than the latter. We also registered a male predominance in the groups of researchers that lead more than 4 projects, from 5 to 9, or more than 10 projects.

Much greater is the imbalance when considering the amounts corresponding to research agreements and contracts, whose subscription implies much more than being a researcher with solvency and competence, since it implies having contacts and knowing how to sell one's own work to the institutions, companies and stakeholders with which such commitments are signed, which are important sources for funding research in a country like Spain, which dedicates modest amounts to research in public budgets. An analysis of the funds obtained in the time elapsed from the beginning of the 21st century to the present, allows us to conclude that male researchers quintuple the amounts available to their female colleagues in medical sciences (€ 20.442.954, compared to € 4.120.611). And again, they are also the ones who appear as responsible, in their role as principal investigators, for a much greater number of research contracts and agreements than their female colleagues (more than double, 2.204 compared to 1.039 led by female researchers), also clearly predominant as incumbents of 3, 4 or more than 5 of these agreements and contracts for the period analyzed. Figure 1 clearly shows such gender gaps.

Source: Institutional Research database of the University of Valencia (2019).

FIGURE 1 AMOUNT AND NUMBER OF CONTRACTS AND RESEARCH PROJECTS IN HEALTH SCIENCES BY SEX 2000-2018 

The analysis of the evolution of the amounts of research contracts and projects by sex throughout the period, carrying out the same study for each one of the selected intervals considered individually (2000-2005: 2006-2010; 2011-2015; 2016-2018), allows us to slightly refine the previous results. Thus, if we consider research contracts, if in the first period male researchers concentrate 90% of the funding (out of a total of € 7.270.779), such amounts lower down to 83.2% (of 8.662 .180 €) in the second interval, representing 75.4% (of € 5.963.662) in the third, to rise slightly to almost 81% (of a global of € 2.666.945) in the 2016-18 period.

In any case the full study of the period shows a decrease in the funds of contracts and agreements for the transfer of the results of medical research for which male researchers are responsible, with the correlated increase in those in charge of a female academic as principal investigator, practically 10 percentage points.

The progress of the research funds obtained through competitive projects, financed by the European Union, the state or regional administration, has differed. The analysis of the aforementioned time intervals shows that men have increased the funds for which they are principal investigators, from 56.5% to 68.5%, while their female colleagues have seen the amounts of their projects gradually reduced, from 43.4 to 31.4 percent. Graph 2 clearly shows the amounts of such contracts, by sex, for each of the chosen intervals, as well as the trend of the evolution operated in them.

Source: Institutional Research database of the University of Valencia (2019).

FIGURE 2 EVOLUTION OF FUNDING IN RESEARCH CONTRACTS AND PROJECTS IN HEALTH SCIENCES BY SEX 2000-2018 

To sum up, much higher amounts of research funds, together with the responsibility for a higher number of research projects and contracts, is the balance of gender inequality within research in health sciences at the University of Valencia in the analyzed period, thus showing a situation that is highly common in the rest of the Spanish universities as well. These gaps imply less visibility of female scientists in medical sciences who then can hardly constitute models for other female students who may want to follow their path, and offer the false construct that scientific progress in medical disciplines is a male achievement; this feeds and consolidates inequality in an area in which there has been a clear predominance of women in Spanish schools for some decades already.

Although male leadership and the predominance of male researchers in the role of principal investigator of funded research projects, contracts and agreements are indisputable facts, this hides a reality in which female academics carry the weight of the teams, given that they predominate in its composition. In this sense, a complementary analysis of the data from the University of Valencia Registry of Research Teams, shows that, in the area of ​​Health Sciences, there are 70 consolidated research groups, and only 30 (42.9%) are led by men academics as main researchers. 498 researchers participate in them, from which 285, that is, 57.2%, are women. These data show that female academics carry out important research tasks integrated into research groups, the majority of them led by men, but with a quantitative predominance of women in their composition. However, they have a glass ceiling when it comes to reaching the position of principal investigators, where their number decreases, and even more when it comes to obtaining funds for their projects, as we have seen, since in the funded research initiatives, male preeminence is absolute.

Age and academic category

When analyzing the age of researchers, considering both research projects and contracts, there is a clear advance towards practically egalitarian situations in the younger and intermediate generations, compared to the absolute predominance of men in the older ones. We particularly observed this situation when analyzing the number and amount of research projects led by women and men from various age groups up to 50 years, as well as, for research contracts, in the group of 41 to 50 years, which has a female predominance as well. It is an age in which women have consolidated their academic career, freeing themselves from the family responsibilities involved in raising children during their first years.

From there, however, the male predominance is absolute, both for projects and for research contracts, considering numbers and quantities, in the cohorts that exceed 50 years old, and particularly in the group of researchers over 60 years of age, where the gap widens dramatically.

Several factors can explain these trends. It has already been noted that funding, in the case of research contracts is usually obtained directly, on request, whereas one gets financing for projects competitively. In the latter, data shows a trend that points to more egalitarian positions between men and women, which can be observed in the younger cohorts, that may respond to elements such as the positive assessment of gender parity in the evaluation of projects, to the impact of some public gender equality policies, such as identical permits and licenses for men and women on issues of childcare, recently implemented in Spain, or the increasing importance that women academics themselves give to their professional careers. The data do, however, present differences by age intervals, which correspond to different phases of the academic career, since after an egalitarian initial stage, in which men and women are strongly committed to finding their place in the university, developing important research work, once tenure is achieved, in many cases women tend to have their first child, a fact that can slow down their professional careers in a second stage. What is indisputable is that, in the older cohorts, male researchers have had and still have an absolute hegemony, in amounts and in the number of research projects and contracts. For such age groups, at the peak of their careers, women did not have as many opportunities as their male colleagues. Perhaps these trends will alter in a few years, in a more egalitarian sense, so it would be interesting to continue studying them over time.

On the other hand, one of the most interesting filters when analyzing university research funds in terms of gender equality is undoubtedly the academic category of researchers.¹ The study of the data allows us to conclude that the academic rank is a relevant factor, that particularly affects research projects, showing a pattern according to which, in the highest categories (Full professors and Emeritus professors), there is a male predominance, both in amounts and in number of projects, while in other figures of lower rank, the situation of men and women researchers is much more egalitarian. The achievement of funds by sex in each of the academic categories has a direct correlation with the proportion of women in each one of them, since although the data in the table cover almost two decades, throughout which the number of female academics in the area of ​​health sciences at the University of Valencia has been on the rise, the fact is that even in 2018, the final year of the analysis, as already noted, female university professors only represent 26.2%, while in the category of emeritus teachers there are no women. And in the other two groups of teaching staff used for the analysis, Assistant Professor and Associate Professor, women academics do not reach more than 4 out of 10. This unequal proportion by sex in the various categories of faculty, and particularly, the fact that women only represent a very discreet proportion of top academic positions, who are the ones who appear as principal investigators in the majority of projects that achieve the highest volume of public funding in the different calls, explains the minor female role in the allocation of R & D & i funds.

This is not the case in research contracts, in which the differences by gender, both in amounts and in number of contracts, do not follow a pattern consistent with the academic category. Male researchers prevail over their female colleagues as principal investigators of such funds for medical research, both in intermediate and higher academic ranks and positions. The reason that research projects do observe a direct relationship with the academic category, unlike contracts, can be found in the fact that in the first, funds are awarded in a competitive way, and the researchers from the higher category tend to have a better curriculum regarding the valuable elements in said calls, while they have a higher ease when configuring teams, to which such funds are awarded. Whereas in the case of research transfer contracts, their achievement does not derive from a process of competitive concurrence, but rather their signature responds to relational elements or others: the academic category of the researcher is not so relevant. Table 1 shows the results of the study in detail, considering the academic category and the age of the researchers.

Clinical areas

If we introduce as a variable the clinical specialties to which the research funds are allocated, the first thing we find is the existence of a group of medical specialties that only have male researchers. This happens in Surgery, Dermatology, Ophthalmology, Obstetrics and Gynecology, Otorinolaryngology, Radiology and Physical Medicine, and Traumatology and Orthopedics. In addition, in the areas of Stomatology and Legal and Forensic Medicine, there are no female academics with research projects; they are only principal investigators of research contracts. Conversely, there is a specialty in which there are only female academics in charge of research funds (Toxicology), while in Pediatrics, male researchers only have research contracts, but no projects.

For the rest of the medical areas, in the vast majority of them there is a clear male predominance in both projects and research contracts, which is even more pronounced when considering the difference in the amount of funds that male and female academics receive to investigate, than by quantifying the number of researchers by sex for each specialty. The medical specialties that stand out, in this regard, are Nursing, Medicine and Physiology, both in projects and in contracts; Human Anatomy and Embryology, as well as Pharmacology and Physiotherapy in research contracts; and Psychiatry, considering research projects: in almost all these areas male researchers concentrate more than 90% of the available funds. Female researchers, on the other hand, have more research fundings in the specialties of Pharmacy and Pharmaceutical Technology, Preventative Medicine and Public Health, and Nutrition and Bromatology, both from contracts and from research projects; and in Microbiology, if we only consider the latter. Table 2 clearly shows all the facts and trends noted.

Revenues from research transfer contracts

In Spanish public universities, ordinary remunerations are necessarily identical for men and women in every academic category. Hence, one of the ways by which there may be salary differences, and with them a gender wage gap, is precisely this: the salaries from research contracts.

The analysis of the amounts received by researchers from R + D + i contracts also shows profoundly uneven results. If there were 41 female scientists who have received supplementary remuneration from R & D & i contracts in the period under study, the number of male academics in the same situation practically triples this figure (there are 117). Much more striking is the wage gap between both sexes, that highlights a significant inequality between men and women (€ 89,026.4 for female scientists, € 1,186,568.4 for male colleagues). Or what is the same, of every € 100, € 93.02 has been collected by men, while the researchers have only received € 6.98. Graph 3 clearly shows the existence and breadth of this wage gap.

Source: Institutional Payroll database of the University of Valencia (2019).

FIGURE 3 INCOME FROM RESEARCH CONTRACTS IN HEALTH SCIENCES, BY SEX 2014-2018 

Situations of gender inequality result in female scientists, in the field of medical disciplines, being responsible for a much smaller number of research transfer contracts, and thus receiving substantially lower salaries than their male colleagues.

Conclusions

Data from the University of Valencia, in the area of medical sciences, in a situation that probably coincides essentially with other Spanish universities, show that male academics are unquestionably leading competitive research projects, as well as research contracts through which the results of scientific work are transferred to society. Male academics are responsible for an overwhelmingly greater number of research projects and contracts and agreements, of a much higher amount than those led by their female colleagues. And this is so, despite the fact that the participation of female academics in health science research groups is higher than that of their male colleagues, which reveals that their work continues to be in the background, and that there is a glass ceiling whose effects are fully in force.

Considering age, there is a slightly more egalitarian situation, especially with regard to research projects, resulting from competitive calls, in the younger and intermediate generations. The academic category is also relevant, since in the case of research projects it reveals the significant male predominance, both in amounts and in number of projects, more pronounced in the highest categories (Full professors and Emeritus professors), which softens in the lower ones, more prone to gender parity. Along with this, there is a horizontal segregation which makes academic research an absolutely male territory in a significant number of specialties.

Finally, as a consequence of the greater prominence of male researchers, they receive revenues from research contracts, additional to the ordinary remunerations, which are comparatively very high in relation to their female academic colleagues, thus generating a significant gender wage gap.

The study has therefore confirmed the persistence of a significant degree of gender inequality in academic medical research, with pernicious effects in many facets. This situation finds its explanation in a series of arguments, which undoubtedly continue to be very valid and still hold an important strength, highlighting the already classic personal and institutional barriers: family responsibilities; an imperfect integration of women in the academic culture, which results in less skills when it comes to management within an organization, university, which has its own operating rules; scarce mentoring, unequal functioning in teams and groups and belonging to academic lobbies, compared to men, who are much more skilled in the academic professional field; in general, less strategic planning of their careers in the case of female researchers, compared to their male colleagues; more or less conscious sexist stereotypes and prejudices, present in research evaluations; or the current representations and the symbolic images of medical sciences, still masculine in certain specialties, representing the idea of scientific excellence itself.

It is striking, however, to see the few advances in gender equality that have been achieved in medical science research within academia, considering some indeniable changes in the Spanish society that could have undermined some of the personal and institutional barriers that prevent more gender equality in the Spanish university. The first one is the high number and the brilliance of female students of Schools of Medicine and other health specialties, which has been recognized for some decades already, whose effects are not reflected in the proportion and importance of female academics in this field. Second, it is not easy to measure accurately the impact of family factors on the career development of female academics, since there are studies with different conclusions. Thus, some empirical studies minimize its weight, considering that there is no evidence that women with children register lower scientific productivity and academic performance than those who do not, whose academic career prospects continue to lag behind those of their male colleagues (European Union, 2012).

Other data and studies, on the contrary, conclude that women spend a much greater portion of their daily time than men on educating their descendants and on caring for the family (at a European level, 37.5 of the women, compared to 24.7% of men, figures that in Spain are, respectively, 39.8 and 27.7%), as well as doing daily cooking and housework (78.7% of women, compared to only 33.7% of men, on a European average, indicators that in Spain account for 84.5 and 41.9% respectively), temporary dedication that can undoubtedly affect the professional sphere (EIGE, 2019a ). In any case, this impact should be substantially cushioned by elements such as a -theorical- greater involvement of men in child rearing and in domestic tasks,² or by the fact that in Spain we have one of the lowest fertility rates in the European Union -1.31- (Eurostat, 2019). Furthermore, academic researchers can usually afford external help for some domestic tasks (^{Escolano, 2006}). In the present study, unfortunately, it has not been possible to measure the impact of housework and childcare on the greater or lesser availability of research funds from the academics involved, as this data is not available. It would be, therefore, desirable, and without a doubt very interesting and useful for various studies on gender and equal opportunities, if the number of children of academics, strictly respecting the data protection regulations, could become part of the databases of the various educational institutions. Finally, numerous and important regulations have been reinforced in Spanish public universities for some time, establishing measures towards gender equality, which nowadays has been achieved on the formal level, but that is bankrupt in reality, as this study reflects. And all of this despite the implementation of positive action measures already present in the competitive calls for research projects, and in the University Equality Plans, which contain monograph positive action measures provided by the University Equality Plans, which contain monographic actions aimed at achieving gender equality and combating discrimination in scientific research.

All of the advances and transformations in this field have not yet managed to change the landscape of Spanish universities in health sciences, revealing the extraordinary resistance of those obstacles that prevent real equality between male and female academics. It is necessary to explore new ways that allow us to go beyond the formal surface and achieve real equality in university medical research, so that Academe becomes a space of equity capable of taking advantage take advantage of the talent and work of Spanish medical scientists for the benefit of society.

Strengths and limitations of the current study and directions for future research

This study has noteworthy strengths and limitations. Its fundamental limitation is that the research was carried out at a single Spanish university, although it includes data from several important departments and schools, all of which belong to the field of Health Sciences. This feature prevents rigorous confirmation that its conclusions are applicable to all Spanish universities. However, the characteristics that outline the situation of female academics in the institution analyzed are very similar to those of the rest of Spanish universities in terms of number, category, academic rank, leadership, and involvement in academic culture. This can be verified, among other ways, by analyzing the data on the composition of faculty of said institutions by sex and category (in both cases, women's access to the highest category, Full professor, in the field of health sciences, is far from presenting an egalitarian situation: if, in the Spanish university system as a whole, Full professors are 25.5%, in the UV they represent 26.2% - 15.3% in the School of Medicine and Dentistry, more than double, 36.4%, in the School of Pharmacy³). Likewise, the diagnostics provided by the Offices for diversity, equity, and inclusion of Spanish universities regarding research and gender, show a degree of inequality practically coincident (Red de Unidades de Igualdad de Género por la Excelencia Universitaria [Network of Gender Equality Units for University Excellence] [RUIGEU], n.d.). Furthermore, although the study is limited to one university, it is a highly relevant academic institution in the field of medical sciences.

In spite of this limitation, it is also important to highlight an important strength of this study, which is that there is no work in the field of health sciences that performs a gender analysis of university contracts for the transfer of research results. Nor has any investigation been carried out comparing the additional remuneration of men vs. women specific to said contracts in order to determine whether there is a gender pay gap. Therefore, this study represents an important initial step in addressing the challenges of gender disparities in medical academic research. It is essential to continue conducting rigorous analysis on this issue in order to increase support for scientific research of female academics in this essential field.