Trends in authorship in medical teacher: A 20-year review of regionality and gender indicates slow and unsteady progress

INTRODUCTION: data to identify geographic and gender differences in representation among the journal authorship, and to identify any visible impacts of relevant editorial policy changes. METHODS: December 2025, for a total of 5,590 total records. We then applied the United Nations Trade and Development (UNCTAD) definition of 'global north' (GN) membership to identify the location of authors and used genderize.io to predict the gender of first authors. We then examined trends (in percentages) over time for geographic region and gender. RESULTS: The share of authors from the global south, and the share of first authors who are women, has been rising slowly for twenty years. However, progress is both localised and unsteady: much of the increase in global south authorship is driven by Asia (and within that, Singapore), and a gap remains whereby GN publications are more likely to have women as first authors. Since 2019, women are the majority of first authors. DISCUSSION: Progress in diversifying medical education scholarship is being made, but it is slow, geographically localised, and does not seem responsive to journal policies to increase fairness and representation. However, the analysis here shows that such bibliometric reviews can be done in a cost-effective and routinised way, allowing journals to iterate on their attempts to expand diversity with evidence.