The last 2 years have taken their toll, more on some than others. Even before the beginning of the coronavirus 2019 (COVID-19) pandemic, pediatric radiologists experienced high rates of burnout, with work–life imbalance identified as a contributing stressor [1, 2]. Since the COVID-19 pandemic began, more radiologists now have the infrastructure to work from home, are expected to attend meetings from home (sometimes on days off or after hours) and are juggling additional responsibilities associated with day care closings, virtual schooling and ailing family members; the distinction between our work and home lives has become blurred and pre-pandemic work–life conflicts have been amplified. Among academic medicine faculty surveyed by Matulevicius et al. [3], more faculty considered leaving jobs since the COVID-19 pandemic than before, and faculty with children, especially women faculty with children, were more likely to consider leaving jobs since the pandemic.

In “Gender Trends in Authorship of Pediatric Radiology Publications and Impact of the COVID-19 Pandemic,” Ayyala and Trout [4] analyzed the gender of authors of unsolicited manuscripts to the journal over 2017–2020. Similar to other journals, the number of manuscripts submitted to Pediatric Radiology in the second quarter (Q2) of 2020 was nearly double compared to the same period in 2019 (105 versus 57). The authors found a corresponding statistically significant decline in the proportion of women last authors (30.3% in 2020 Q2 versus 50% in 2019 Q2). It is notable that although the proportion of women last authors decreased, the absolute number of women last authors was similar (n = 31 in 2020 Q2 versus n = 28 in 2019 Q2), indicating that the increased submissions were driven predominantly by male last authors. This is understandable because it corresponds to the time when clinical workload had decreased, work-from-home options were being implemented to increase flexibility in scheduling, and evolving understanding of the novel coronavirus and its implications on radiology workflow provided abundant material for researchers. This was a conducive time to write and publish, especially for those with fewer childcare and eldercare responsibilities. A survey by Krukowski et al. [5] showed that faculty with 0–5-year-old children completed significantly fewer peer review assignments, attended fewer funding panel meetings and submitted fewer first authors' articles during the pandemic compared to the previous period while those without children or with children ages 6 years or older reported an increase or stable productivity.

As Drs. Ayyala and Trout [4] pointed out, the pandemic’s long-term effects on academic advancement of women in pediatric radiology will be seen in years to come, but analyses like theirs are a crucial starting point in transforming the status quo and preventing the loss of talented faculty from an already challenged workforce. The COVID-19 pandemic presents us with an opportunity to critically evaluate pre-pandemic practices, uncover unconscious biases and reimagine our work–life perspective.

Gender differences in publication rates are commonly ascribed to the “second shift” of household and childcare responsibilities that is disproportionately borne by women. Even Generation X female physician–researchers and pediatricians in the pre-pandemic world were subject to this “double burden” [6, 7]. However, such explanations are based on troublesome assumptions that people live in heterosexual households with two adults and that all people have binary gender identities [8]. Furthermore, while there is no doubt that this asymmetrical division of responsibilities exists in many households and impacts women’s careers, by focusing on the gendered division of labor outside of work, we risk minimizing the gendered division of labor that occurs inside the workplace. When “academic housework,” like taking faculty meeting minutes, overseeing students and serving on informal committees, is delegated disproportionately to women, it limits women’s time spent on research and writing [9, 10]. Instead, women should be invited equitably by colleagues to participate in research projects and by journal editors for invited contributions, without assuming that women are too busy with domestic tasks or overburdened by the pandemic. Although Drs. Ayyala and Trout [4] analyzed data for only unsolicited manuscripts, it is equally important for journals to track the number of invited contributions solicited from women to guard against such bias.

In the same vein, institutional views of academic productivity should be holistic and should encourage individuals to focus on their strengths and passions, even if these do not result in traditionally more heavily weighted original scientific publications. Appropriate value should be placed on work in areas such as teaching, mentoring, peer review, and diversity and equity because these are critical to our mission. It is particularly important to recognize such efforts now, given the work done in developing novel methods of education during the COVID-19 pandemic, and in advancing equity, diversity and inclusion, catalyzed by the social awakening of 2020. Drs. Ayyala and Trout [4] highlighted the higher proportion of educational articles contributed by women authors compared to other manuscript types. These women should be encouraged to work on their strengths, which will energize them and stem the tide of burnout. Educational endeavors include not only articles, but with mentorship can extend to educational grants and lectures, also considered important by academic promotion committees. This will empower future women leaders in the field of education and improve the pipeline for recruits.

The pandemic is far from over, and we will continue to experience new waves of COVID-19 with associated staffing shortages, family illness, day care closures, last-minute changes in schooling plans, increased clinical volumes, and challenges to our physical and mental health. The uneven effects of the pandemic on women threaten to have long-term negative consequences on their career advancement and, consequently, on our workforce. But awareness of these disparities can help us break out of an inequitable pre-pandemic status quo and catalyze sustained departmental and institutional initiatives toward gender equity.