The Importance of Diversity and Inclusion in Peer Review - European Medical Journal

The Importance of Diversity and Inclusion in Peer Review

8 Mins
General Healthcare

Written by Harriet Lacey  |  Editorial Administrator, European Medical Journal

On 10th September 2018, as part of Peer Review Week 2018, members of the EMJ Editorial team attended the ‘The Importance of Diversity and Inclusion in Peer Review’ event at the Wellcome Trust Centre, London, UK, where a panel of experts and an audience of enthusiasts explored the issues within the peer review process.

Concerns regarding bias, diversity, and inclusion are, arguably, part of every aspect of life; so, why should peer review be any different? Only, these issues should not be present at all, and peer review is no exception.

Through discussing a wider view of under-represented minorities and country bias, focus quickly turned to gender, and the lack of women both within the peer review sphere and across employment sectors as a whole. Although the argument stands that improving diversity improves the broader outcomes of peer review and allows more knowledge and experience to be brought forward, there is also debate that, at the end of the day, “science is science”, as stated by an audience member. Does it really matter who performs the review, as long as they are qualified to do the job and to do it well? Is this lack of diversity a case of excluding certain individuals or is it that those who are being chosen are simply the best person for the job, regardless of gender, country of origin, or ethnicity?

Here, we will look at the major points and ideas voiced at the event, highlighting and evaluating the issues surrounding diversity and inclusion in peer review.


“Equality and diversity are the right things to do.”

– Dr Jim Smith, Director of Science, Wellcome


When researching the issues surrounding gender differences in peer review, the Wellcome Trust found that, generally, there is an approximate split of two-thirds males to one-third females regarding the individuals taking part in peer review. The Wellcome Trust have their own scheme, termed ‘The Wellcome Open Research peer review selection model’, enabling authors to suggest and select reviewers for their own articles. When assessing this model, researchers found that male authors were more likely to suggest male reviewers and female authors were more likely to suggest female reviewers; this created an automatic case of bias.

In addition, the Wellcome Trust research found that although individuals from developing countries show interest in reviewing articles, they are often not selected, suggesting bias lies not only in gender but also in geographical location. The reasons behind this, however, are not clear and require further investigation.

Including a vast range of individuals in the peer review process of articles inevitably means that a broader range of opinions and expertise are being brought to the authors, allowing improvement for those individuals and for the future of scientific research in general.


“The problem is bigger than just gender.”

– Gemma Tracey, Diversity and Inclusion Team Member, Wellcome


The results from the Welcome Trust study simply reflect the fact that there are more males in the science sector than there are women: 76.9% of UK professors are male, leaving only 23.1% being women. In a recent interview for EMG GOLD, Laurie P. Cooke, President and CEO of the Healthcare Businesswomen’s Association, commented on the state of gender parity in biopharmaceuticals; only 17% of senior executives in the top 20 pharmaceutical companies were women in 2017. This revelation is even more surprising knowing that there is an equal split of males and females beginning careers in this industry, as discussed in an earlier blog by the EMJ.

Evidence has shown that individuals in the early stages of their career do a good, if not better, job at reviewing articles than those in senior positions. The reason being, early career individuals are up-to-date with the latest research to improve themselves and these individuals willingly take on new opportunities, such as peer review, and do a good job in order to build a career and establish a name for themselves. Despite these factors, such individuals in the early stages of their career are commonly not chosen to review articles based on the concept that they are not yet an ‘expert’, as those in senior positions are considered.

Mentoring schemes should be developed to improve this situation, to bring together senior and less-experienced individuals in a collaboration where both parties can benefit. Co-reviewing schemes already exist, in which senior and less-experienced individuals work together to conduct reviews. These schemes should be encouraged more because they are an ideal opportunity for each party to learn from the other and develop themselves and their reviewing techniques, improving the peer review process in the long term.


“By being more self-critical and looking more inwards, we can begin to find the solution.”

– Jocalyn Clark, Executive Editor, The Lancet


There are many social norms surrounding the differences between genders, which can affect both career progression and personal life. In general, women are more likely to sacrifice their careers to start and bring up a family. In coming back to work, women are likely to experience an element of discrimination due to having taken a gap in their careers and may therefore be considered unreliable, lacking skills and potential, and unable to progress. Perhaps this explains the low number of female professors and females in senior management positions. In order to eliminate this discrimination, these social norms should be disrupted. The question is, how?

Research has shown that women are less likely to take on a task if they do not feel they can fully commit and perform the task to the best of their ability. With ‘spare time’ taken up by family life, this leaves little time to dedicate to undertaking peer review. Extensions should be given in advance to those who are wanting to review but simply do not have the time. Education should also be improved for employers to highlight that a level of compassion and understanding should be given to individuals, both male and female, coming back to work after having taken time off to raise a family, or indeed any other well-justified reason.

Funding should be available and knowledge spread of its availability for those wishing to return to work, helping employees improve skills and regain confidence in themselves. In the case of a woman, this will mean that those wishing to become professors will have a better chance of success and, in the long term, more female experts will be chosen to review articles, improving the ratio of male to female reviewers and reducing the difference in numbers of male and female professors.


“Diversity needs to not only be present, it needs to be represented”

– Sonia Gandhi, Neurodegeneration Biology Laboratory,  The Francis Crick Institute, London, UK


It is not enough to simply include more women, ethnic minority groups, and people from developing countries within the peer review system. For there to be true diversity, these groups need to be represented equally. When including these groups of individuals, their ability to review and to review well should be recognised and celebrated.

Once a wide range of established reviewers have been confirmed, this pool can be utilised to ensure only the best reviews will emerge. To further this, education schemes, such as the aforementioned mentorships, should be encouraged to better peer review in the future.


“To exclude people from peer review suggests that they are not peers, that they are not scientists.”

– Victoria Male, Sir Henry Dale Fellow in Innate Lymphoid Cell Biology, University College London, London, UK


Excluding the Wellcome Open Research peer review selection model, peer reviewers are ultimately chosen by editors. Therefore, in order to improve diversity among peer reviewers, diversity should be improved among editors. The question is whether journals should be gathering data on their peer reviewers, including gender, ethnicity, and sexual orientation. Once gathered, should journals and editors be using these data to select individuals to review articles, based on the ultimate goal of improving diversity?

Excluding individuals from the peer review process is perhaps not a conscious decision, nor an act of malice. Instead, it may be a result of mantras that have been considered normal across the world for many centuries, as well as the added factor that those who are successful in their career are the ones who are better heard and well-known within the scientific community. To diversify, one must step outside of these mindsets and be more open to what else, and who else, the world has to offer.


“Better diversity will get us better results.”

Dr Jim Smith, Director of Science, Wellcome


The issues surrounding diversity and inclusion in peer review can be resolved, but it will undoubtedly be an uncomfortable process. To succeed, social norms must be disrupted, old mantras must be eliminated, and the process that has been accepted for decades must be stripped away to start afresh. Those returning from career gaps should be shown compassion and given support and additional training, while those in the early stages of their careers should be taken under the wing of senior researchers and professors to be mentored and guided to success. Potential reviewers from under-represented countries should be identified and given the opportunity to be involved. Ethnic minority groups should also be acknowledged and encouraged to put themselves forward as available to review. Finally, editors should identify flaws in their reviewing models and work to include a broader range of reviewers. Accomplishing these feats will bring forth the birth of an improved, more diversified, and more inclusive peer review system, which will better the future of scientific research for everyone.

Join our mailing list

To receive the EMJ updates straight to your inbox free of charge, please click the button below.
Join Now