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Shakir M, Irshad HA, Altaf A, Ladak S, Aziz HF, Enam SA. Does gender disparity exist in neurosurgery training? Evidence from a nationwide survey from Pakistan. MEDICAL EDUCATION ONLINE 2024; 29:2310385. [PMID: 38290059 PMCID: PMC10829840 DOI: 10.1080/10872981.2024.2310385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
Gender disparities are prevalent in the neurosurgical field, particularly for female trainees, despite the growing demand for neurosurgeons. The situation is bleaker in low-and middle-income countries, where gender disparities among neurosurgical trainees have not been evaluated. We aimed to gauge the gender differences in opportunities and perceptions of neurosurgery training in Pakistan by comparing responses between males and females. A nationwide web-based survey was conducted in Pakistan, covering 22 College of Physicians and Surgeons of Pakistan (CPSP) accredited neurosurgery training programs. Convenience sampling was used with a pilot-tested questionnaire. Data analysis was performed using SPSS version 26. A total of 120 trainees participated in our survey. The mean age of the participants was 30.4 ± 4.1 years, with 29.2% females and 70.8% males. Concerns about gender equity were more among females (34.3%) than males (27.1%). Poor work-life balance was reported by more females (34.3%) than males (30.6%). Burnout due to working hours was strongly agreed by more females (54.3%) than males (35.3%). More females (40%) acknowledged sufficient mentorship opportunities versus males (25%). Female respondents (65.7%) worked 50-100 hours per week, less than males (69.4%). Satisfaction with surgical exposure was lower among females (2.9%) compared to males (18.8%). More females reported access to teaching courses (82.9% vs. 77.6% males) and neurosurgical conferences (85.7% vs. 80.0% males), cadaver workshops (17.1% vs. 12.9% males), morbidity and mortality meetings (88.6% vs. 82.4% males), case-based sessions (82.9% vs. 75.3% males), and radiology discussions (82.9% vs. 74.1% males). Our study highlights substantial gender gaps in neurosurgical training, concerns over working hours, burnout, mentorship, work-life balance, and gender equity. These findings underscore the necessity for interventions to rectify these disparities and foster gender equity in neurosurgical training.
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Affiliation(s)
- Muhammad Shakir
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Hammad Atif Irshad
- Medical Student, Medical College, Aga Khan University, Karachi, Pakistan
| | - Ahmed Altaf
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Shamila Ladak
- Medical Student, Medical College, Aga Khan University, Karachi, Pakistan
| | - Hafiza Fatima Aziz
- Neuro-oncology Fellow, Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Ather Enam
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Campbell TJ, Greige N, Yan Y, Lu YH, Ricci JA, Weichman KE. Women in Microsurgery Fellowships: Trends and Impact on Future Practice Patterns. J Reconstr Microsurg 2024; 40:357-362. [PMID: 37751878 DOI: 10.1055/a-2182-0902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND While the number of female plastic surgeons has continued to increase over time, plastic surgery has historically been a male-dominated profession with only 15% of practicing plastic surgeons being female. Microsurgery, as a subspecialty, has been long perceived as an even more male-centric career path. The objective of this study was to determine the representation of females in the subspecialty field of microsurgery and the impact of microsurgical fellowship training. METHODS A review of all microsurgery fellowship programs participating in the microsurgery fellowship match from 2010 to 2019 were analyzed. Fellows were identified through fellowship Web site pages or direct contact with fellowship program coordinators and directors. The current type of practice and performance of microsurgery were also identified through a Web search and direct contact with fellowship program coordinators and directors. RESULTS A total of 21 programs and 317 fellows over a 10-year period were analyzed. Over this 10-year period, there was a total of 100 (31.5%) female microsurgery fellows and 217 (68.5%) male microsurgery fellows. There was a small, statistically insignificant increase in the yearly percentage of female microsurgery fellows over this 10-year period with an average yearly increase of 2.7% (p = 0.60; 95% confidence interval: -6.9 to 13.2%). There were significantly fewer females who continued to practice microsurgery compared to males (75 [75.0%] vs. 186 [85.7%], p = 0.02). There was no significant difference in the current practice types (academic, private, and nonacademic hospital) between females and males (p = 0.29). CONCLUSION Women are underrepresented in the field of microsurgery to a similar extent as they are underrepresented in overall plastic surgery. While there is a small insignificant increase in the number of female microsurgery fellows every year, a significantly smaller proportion of females continue to practice microsurgery compared to males.
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Affiliation(s)
- Tessa J Campbell
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, Bronx, New York
| | - Nicolas Greige
- Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Yufan Yan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, Bronx, New York
| | - Yi-Hsueh Lu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, Bronx, New York
| | - Joseph A Ricci
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwell Health, Great Neck, New York
| | - Katie E Weichman
- Hangjorg Wyss Department of Plastic Surgery, NYU Langone Health, New York City, New York
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Ong V, Harary M, Mozaffari K, Mekonnen M, Hwang L, Patel S, Mahgerefteh N, Nayeri D, Chandla A, Duong C, Yang I, Aghi MK. Gender-Based Disparities in Academic Productivity Arise During Neurosurgery Residency: A Systematic Review. Neurosurgery 2023; 93:971-978. [PMID: 37283523 DOI: 10.1227/neu.0000000000002547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/06/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Although female neurosurgery residents are increasing, women remain underrepresented in academic leadership. OBJECTIVES To assess academic productivity differences between male and female neurosurgery residents. METHODS We used the Accreditation Council for Graduate Medical Education records to obtain 2021-2022 recognized neurosurgery residency programs. Gender was dichotomized into male/female by male-presenting/female-presenting status. Extracted variables included degrees/fellowships from institutional websites, number of preresidency and total publications from PubMed, and h -indices from Scopus. Extraction occurred from March to July 2022. Residency publication number and h- indices were normalized by postgraduate year. Linear regression analyses were conducted to assess factors associated with numbers of in-residency publications. P < .05 was considered statistically significant. RESULTS Of 117 accredited programs, 99 had extractable data. Information from 1406 residents (21.6% female) was successfully collected. 19 687 and 3261 publications were evaluated for male residents and female residents, respectively. Male and female residents' median preresidency publication numbers did not significantly differ (M:3.00 [IQR 1.00-8.50] vs F:3.00 [IQR 1.00-7.00], P = .09), nor did their h -indices. However, male residents had significantly higher median residency publications than female residents (M:1.40 [IQR 0.57-3.00] vs F:1.00 [IQR 0.50-2.00], P < .001). On multivariable linear regression, male residents (odds ratio [OR] 2.05, 95% CI 1.68-2.50, P < .001) and residents with more preresidency publications (OR 1.17, 95% CI 1.16-1.18, P < .001) had higher likelihood of publishing more during residency, controlling for other covariates. CONCLUSION Without publicly available, self-identified gender designation for each resident, we were limited to review/designate gender based on male-presenting/female-presenting status from gender conventions of names/appearance. Although not an ideal measurement, this helped show that during neurosurgical residency, male residents publish significantly more than female counterparts. Given similar preresidency h- indices and publication records, this is unlikely explained by differences in academic aptitude. In-residency gender barriers to academic productivity must be acknowledged and addressed to improve female representation within academic neurosurgery.
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Affiliation(s)
- Vera Ong
- John A. Burns School of Medicine, University of Hawaii, Honolulu , Hawaii , USA
| | - Maya Harary
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
| | - Khashayar Mozaffari
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
| | - Mahlet Mekonnen
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
| | - Leslie Hwang
- Department of Head and Neck Surgery, University of California, Los Angeles , California , USA
| | - Shravan Patel
- Department of Head and Neck Surgery, University of California, Los Angeles , California , USA
| | - Natalie Mahgerefteh
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
| | - Diba Nayeri
- Department of Head and Neck Surgery, University of California, Los Angeles , California , USA
| | - Anubhav Chandla
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
| | - Courtney Duong
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
| | - Isaac Yang
- Department of Neurological Surgery, University of California, Los Angeles , California , USA
- Department of Head and Neck Surgery, University of California, Los Angeles , California , USA
- Department of Radiation Oncology, University of California, Los Angeles , California , USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles , California , USA
- Los Angeles Biomedical Research Institute, University of California, Los Angeles , California , USA
- Harbor-UCLA Medical Center, University of California, Los Angeles , California , USA
| | - Manish K Aghi
- Department of Neurological Surgery, University of California, San Francisco , California , USA
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Kabangu JLK, Heskett CA, Bhargav AG, Yekzaman BR, Morey K, Rouse AG, Chamoun RB. Evaluating Match and Attrition Rates for Women and African Americans in Neurosurgery. Neurosurgery 2023; 92:695-702. [PMID: 36700685 DOI: 10.1227/neu.0000000000002257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/22/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Previous efforts to increase diversity in neurosurgery have been aimed primarily at female inclusion while little analysis of other under-represented groups has been performed. OBJECTIVE To evaluate match and retention rates of under-represented groups in neurosurgery, specifically Black and female applicants compared with non-Black and male applicants. METHODS Match lists, Electronic Residency Application Service data, and National Resident Matching Program data were retrospectively reviewed along with publicly available residency program information for successful matriculants from 2017 to 2020. Residents were classified into demographic groups, and analysis of match and retention rates was performed. RESULTS For 1780 applicants from 2017 to 2020, 439 identified as female while 1341 identified as male. Of these 1780 applicants, 128 identified as Black and 1652 identified as non-Black. Male and female applicants matched at similar rates ( P = .76). Black applicants matched at a lower rate than non-Black applicants ( P < .001). From 2017 to 2020, neither race nor sex was associated with retention as 94.1% of male applicants and 93.2% of female applicants were retained ( P = .63). In total, 95.2% of Black residents and 93.9% of non-Black residents were retained ( P = .71). No intraregional or inter-regional differences in retention were found for any group. CONCLUSION Although sex parity has improved, Black applicants match at lower rates than non-Black applicants but are retained after matriculation at similar rates. Neurosurgery continues to recruit fewer female applicants than male applicants. More work is needed to extend diversity to recruit under-represented applicants. Future studies should target yearly follow-up of retention and match rates to provide trends as a measure of diversification progress within the field.
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Affiliation(s)
- Jean-Luc K Kabangu
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Cody A Heskett
- University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Adip G Bhargav
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Bailey R Yekzaman
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kennedy Morey
- University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Adam G Rouse
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Roukoz B Chamoun
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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Haruno LS, Chen X, Metzger M, Lin CA, Little MT, Kanim LE, Poon SC. Racial and Sex Disparities in Resident Attrition in Orthopaedic Surgery. JB JS Open Access 2023; 8:e22.00148. [PMID: 37351087 PMCID: PMC10284323 DOI: 10.2106/jbjs.oa.22.00148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Studies have suggested that female individuals and individuals from backgrounds under-represented in medicine (URiM) are at increased risk of attrition during residency. This likely exacerbates the lack of diversity in our field. The aims of this study were to (1) characterize demographic composition in orthopaedic residency from 2001 to 2018 and (2) determine the race/ethnicity and identify any disparities. Methods Demographic and attrition data from 2001 to 2018 were obtained from the Association of American Medical Colleges. Attrition data comprised the following categories: withdrawals, dismissals, and transfers to another specialty. Analysis compared demographic composition and determined attrition rates with subgroup analysis by race/ethnicity and sex. Results From 2001 to 2018, female orthopaedic residents increased from 8.77% to 15.54% and URiM residents from 9.49% to 11.32%. The overall and unintended attrition rates in orthopaedic surgery were 3.20% and 1.15%, respectively. Among female residents, the overall and unintended attrition rates were 5.96% and 2.09% compared with 2.79% and 1.01%, respectively, in male residents. URiM residents had overall and unintended attrition rates of 6.16% and 3.11% compared with 2.71% and 0.83%, respectively, for their White counterparts. Black/African American residents had an attrition rate of nearly 10%. Female residents averaged 12.9% of all residents but 24% of those leaving orthopaedics. URiM residents were 10.14% of all residents but 19.51% of those experiencing attrition. In logistic regression models, female residents had a relative risk (RR) of 2.20 (p < 0.001) for experiencing all-cause attrition and 2.09 (p < 0.001) for unintended attrition compared with male residents. Compared with their White male counterparts, URiM residents had a RR for overall and unintended attrition of 2.36 and 3.84 (p < 0.001), respectively; Black/African American residents had a RR for the same of 3.80 and 7.20 (p < 0.001), respectively. Conclusion Although female resident percentage has increased, orthopaedics continues to train fewer female surgeons than all other fields. Female and URiM residents in orthopaedic surgery are disproportionately affected by attrition. While recruitment has been the primary focus of diversity, equity, and inclusion efforts, this study suggests that resident retention through appropriately supporting residents during training is equally critical.
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Affiliation(s)
- Lee S. Haruno
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
| | - Xi Chen
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Melodie Metzger
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
| | - Carol A. Lin
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
| | - Milton T.M. Little
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
| | - Linda E.A. Kanim
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
- Cedars Sinai Medical Center Spine Center, Los Angeles, California
| | - Selina C. Poon
- Shriners Children's Southern California, Pasadena, California
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Samuel N, McQueen SA, Barnett RR, Everson MC, Fiala C, Lau R, Zadeh G. Parenting and Childbearing in Neurosurgical Residency: Perspectives from the United States and Canada. JOURNAL OF SURGICAL EDUCATION 2023; 80:572-580. [PMID: 36737307 DOI: 10.1016/j.jsurg.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/27/2022] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Despite growing interest in family planning alongside surgical training, significant barriers exist including time constraints, stigma, and lack of paid leave and formal policies. We currently lack a deep understanding of the challenges residents face and how practice cultures may prohibit successful policy enactment. OBJECTIVE To investigate residents' perspectives surrounding parenting and childbearing during neurosurgical residency in the United States and Canada. METHODS A cross-sectional, qualitative study methodology was used, including focus groups with neurosurgical residents. Purposive sampling was employed to capture a broad range of perspectives including stage of training, geographical location, and gender. Data collection and analysis occurred in parallel, using a thematic analysis approach. Data collection continued until no new themes relating to the research questions were identified. RESULTS Notable challenges included lack of formal family leave policies, time constraints, insufficient clinical human resources, physical health concerns, lack of lactation accommodations, and lack of mentorship. A subset of barriers were uncovered that stem specifically from workplace cultures, including gender norms, difficulty in asking for help, concerns for inconveniencing others, and pressures to time parental leave during research blocks. Several positive changes were identified including growing awareness and female representation, and benefits of the dual surgeon-parent identity. CONCLUSION While parenting during neurosurgery residency is becoming increasingly common, significant practical and cultural barriers persist including a marked absence of formal policies. Culture shifts are essential in ensuring opportunities for life outside of medicine for all residents, irrespective of family status.
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Affiliation(s)
- Nardin Samuel
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Sydney A McQueen
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Megan C Everson
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Clare Fiala
- Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ruth Lau
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
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Mulligan KM, Jella TK, Cwalina TB, Tsai EC, Parr AM, Woodrow SI, Wright JM, Wright CH. Projected timeline to achieve gender balance within the United States neurosurgical workforce exceeds 150 years: a National Plan and Provider Enumeration System analysis. J Neurosurg 2023; 138:1088-1097. [PMID: 35932267 DOI: 10.3171/2022.4.jns212968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite incremental progress in the representation and proportion of women in the field of neurosurgery, female neurosurgeons still represent an overwhelming minority of the current US physician workforce. Prior research has predicted the timeline by which the proportion of female neurosurgery residents may reach that of males, but none have used the contemporary data involving the entire US neurosurgical workforce. METHODS The authors performed a retrospective analysis of the National Plan and Provider Enumeration System (NPPES) registry of all US neurosurgeons to determine changes in the proportions of women in neurosurgery across states, census divisions, and census regions between 2010 and 2020. A univariate linear regression was performed to assess historical growth, and then Holt-Winter forecasting was used to predict in what future year gender parity may be reached in this field. RESULTS A majority of states, divisions, and regions have increased the proportion of female neurosurgeons from 2010. Given current growth rates, the authors found that female neurosurgeons will not reach the proportion of women in the overall medical workforce until 2177 (95% CI 2169-2186). Furthermore, they found that women in neurosurgery will not match their current proportion of the overall US population until 2267 (95% CI 2256-2279). CONCLUSIONS Whereas many studies have focused on the overall increase of women in neurosurgery in the last decade, this one is the first to compare this growth in the context of the overall female physician workforce and the female US population. The results suggest a longer timeline for gender parity in neurosurgery than previous studies have suggested and should further catalyze the targeted recruitment of women into the field, an overhaul of current policies in place to support and develop the careers of women in neurosurgery, and increased self-reflection and behavioral change from the entire neurosurgery community.
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Affiliation(s)
| | - Tarun K Jella
- 1Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Thomas B Cwalina
- 1Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Eve C Tsai
- 2Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Ann M Parr
- 3Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
| | - Sarah I Woodrow
- 4Department of Neurological Surgery, Cleveland Clinic, Akron, Ohio; and
| | - James M Wright
- 5Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
| | - Christina H Wright
- 5Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
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McAlpine H, Drummond KJ. Editorial. The 156-year journey to gender parity in neurosurgery: are we surprised? J Neurosurg 2023; 138:1085-1086. [PMID: 35932274 DOI: 10.3171/2022.5.jns22769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Heidi McAlpine
- 1Department of Neurosurgery, Royal Melbourne Hospital, Parkville
- 2Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville; and
| | - Katharine J Drummond
- 1Department of Neurosurgery, Royal Melbourne Hospital, Parkville
- 3Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
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Al-Habsi J, Alhabsi F, Al-Jahwari S, Al-Saadi T. Selection of Neurosurgical Applicants in the High-Income Developing Country Lacking Local Residency Program: A Cross-Sectional Study. Surg J (N Y) 2023; 9:e1-e7. [PMID: 36756197 PMCID: PMC9902197 DOI: 10.1055/s-0042-1758832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/13/2022] [Indexed: 02/08/2023] Open
Abstract
Background Neurosurgery residency became one of the most competitive specialties in the medical field worldwide, which is increasing with time in contrast to the limited positions. Therefore, the requirements for the program have increased. There are different criteria for each program, which are determined by specific factors. It has become increasingly important for medical students to be aware of the factors that affect their acceptance into the program. There was a lack of data regarding the factors that contribute to the selection of neurosurgery residents in Oman Methods A questionnaire composed of 14 questions was conducted, using the SurveyMonkey Web site, among neurosurgeons in Oman which was distributed to the five hospitals that have neurosurgery departments in Oman. SPSS software was used in the analysis of the collected data. Results Forty-four participants responded to the survey. Ninety-five percent of them answered all the questions. Out of all participants, only two were female participants. Standardized international exam scores, such as the United State Medical Licensing Examination and Medical Council of Canada Qualifying Examination, ranked as the most important factor with a percentage of 44, followed by interview performance with a percentage of 33. While the least important factor was the age of applicants, which 46% of the participants ranked 8. Conclusion Most of the participants agreed that standardized exams are the most important factor in the selection of neurosurgery residents followed by interview performance, although there was no significant statistical difference between the two.
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Affiliation(s)
- Jehad Al-Habsi
- College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Fatema Alhabsi
- College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Sara Al-Jahwari
- College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Tariq Al-Saadi
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada,Department of Neurosurgery, Khoula Hospital, Muscat, Sultanate of Oman,Address for correspondence Tariq Al-Saadi, MD Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill UniversityQCCanada
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Behmer Hansen RT, Behmer Hansen RA, Gold JL, Batchu S, Lozada RD, Palma SD, Susman SJ, Blocher WA, Richardson AM. Neuro-oncology authorship trends in gender since 1944: a systematic review of 14,020 articles from five top-tier academic journals. J Neurosurg 2022:1-10. [DOI: 10.3171/2022.10.jns221183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
This study was performed to compare authorship trends, by gender, in the neurosurgical oncology literature.
METHODS
Complete author listings for neurosurgical oncology articles published between 1944 and 2021 in five top neuro-oncology journals were extracted from the PubMed database and journal websites on December 2, 2021. Author gender was characterized with the web application programming interface (API) genderize.io. The statistical significance (p < 0.05) of time-, journal-, and gender-based differences was determined by independent-samples t-test, chi-square test, and/or Fisher’s exact test.
RESULTS
A total of 14,020 articles were written by 67,115 unique authors occupying 97,418 authorship spots. The gender for 80,030 authorship positions (82.2%) was successfully characterized. Male authors were significantly more likely than the female authors to have a first-author publication, have a last-author publication, and have authored multiple articles within the data set. Among authors who published in multiple different years (n = 11,532), women had a shorter time window of publishing (5.46 vs 6.75 years between first and last publication: mean difference [MD] 1.28 [95% CI 1.06–1.50] years, p < 0.001). During this window, however, they were slightly more productive than the men, based on the mean number of publications per year (1.06 vs 1.01 articles: MD 0.05 [95% CI 0.02–0.09] articles, p = 0.002). The percentage of female authors on each neuro-oncology research team has increased by 3.3% (95% CI 2.6%–3.9%) per decade to a mean of 26.5% in the 2020s. Having a female last author was positively associated with having a female first author (OR 2.57 [95% CI 2.29–2.89]) and a higher proportion of women on the research team overall. The percentages of female first and last authors increased at significantly higher rates in medically oriented journals than in surgically oriented journals (first authors: 0.72% [95% CI 0.58%–0.87%] vs 0.36% [95% CI 0.30%–0.42%] per year, p < 0.001; and last authors: 0.50% [95% CI 0.38%–0.62%] vs −0.03% [95% CI −0.10% to 0.05%] per year, p < 0.001).
CONCLUSIONS
Female authorship in top neuro-oncology journals has increased since the 1940s, with female-led teams showing greater gender diversity. However, female researchers lag behind their male counterparts in quantity of published research and are less likely to hold first or last authorship positions. This difference is more pronounced in the three neurosurgical oncology journals than in the two medical neuro-oncology journals, which may reflect the relatively low female representation in neurosurgery relative to medical oncology. Collectively, these trends have meaningful implications for career advancement, which is often dependent on academic productivity.
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Affiliation(s)
| | - Ryan A. Behmer Hansen
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Justin L. Gold
- Department of Neurosurgery, Cooper Medical School of Rowan University, Camden, New Jersey
| | | | - Rebecca D. Lozada
- Department of Medicine, Hackensack Meridian School of Medicine, Nutley, New Jersey; and
| | - Samantha D. Palma
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stephen J. Susman
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - William A. Blocher
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Angela M. Richardson
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
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Ares WJ, Jankowitz BT, Kan P, Spiotta AM, Nakaji P, Wilson JD, Fargen KM, Ramos E, Leonardo J, Grandhi R. The neurosurgical marriage: evaluating the interplay of work life and home life from the perspective of partners of neurosurgical residents. J Neurosurg 2022; 138:1139-1146. [PMID: 36087329 DOI: 10.3171/2022.7.jns221493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/15/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Burnout and work-life balance have been noted to be problems for residents across all fields of medicine, including neurosurgery. No studies to date have evaluated how these factors may contribute to issues outside of the hospital, specifically residents' home lives. This study aimed to evaluate the interplay between home life and work life of neurosurgical residents, specifically from the point of view of residents' significant others. METHODS Online surveys were distributed to the significant others of neurosurgical residents at 12 US neurosurgery residencies. Residents' partners were asked about relationship dynamics, their views on neurosurgery residency (work-life balance and burnout), and their views of neurosurgery as a career. RESULTS The majority of residents' significant others (84%) reported being satisfied with their relationship. Significant others who reported dissatisfaction with their relationship were more likely to report frustration with work-life balance and more likely to report their resident partner as having higher levels of burnout. CONCLUSIONS From the perspective of neurosurgery residents' significant others, higher perceived levels of burnout and lower satisfaction with work-life balance are correlated with lower levels of relationship satisfaction. These findings speak to the complex interplay of work life and home life and can be used to inform future interventions into improving the quality of life for both the resident and the significant other.
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Affiliation(s)
- William J Ares
- 1Department of Neurosurgery, Northshore University HealthSystem, Evanston, Illinois
| | - Brian T Jankowitz
- 2Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Peter Kan
- 3Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas
| | - Alejandro M Spiotta
- 4Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina
| | - Peter Nakaji
- 5Department of Neurosurgery, Banner University Medical Center, Phoenix, Arizona
| | - Jason D Wilson
- 6Department of Neurosurgery, Louisiana State University Health, New Orleans, Louisiana
| | - Kyle M Fargen
- 7Department of Neurosurgery, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Edwin Ramos
- 8Division of Neurosurgery, University of Chicago Medicine, Chicago, Illinois
| | - Jody Leonardo
- 9Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania; and
| | - Ramesh Grandhi
- 10Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah
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Alnaami I, Ahmad MT, Khan MA, Amer KA, Alsaedan A, Alanazi A, Alkhonizy S, Alamri A. Perceptions of Neurosurgery among Medical Students and Interns: A National Cross-Sectional Study. Medicina (B Aires) 2022; 58:medicina58081120. [PMID: 36013587 PMCID: PMC9412531 DOI: 10.3390/medicina58081120] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Neurosurgery is considered one of the most admired surgical specializations. Still, as evidenced by observations over the years, it is not amongst the top choices of medical students in Saudi Arabia. This study will help in understanding the perception and attitudes of medical students and interns toward the neurosurgery specialization, which will aid in developing strategies to increase the interest of undergraduates in neurosurgery specialization and bridge the human resource gap in this vital specialty. Objectives: This study aimed to assess perceptions, attitudes, and gender differences of medical students and interns toward neurosurgery. The influence of demographic factors on perceptions of neurosurgery of interns and senior medical students in Saudi Arabia was also investigated. Methodology: We conducted a cross-sectional study on a convenience sample of medical students (clinical years) and interns studying in different colleges of medicine in Saudi Arabia. A total of 1014 responses were included in this study (518 males and 496 females). The questionnaire comprised of two parts: the first part carried general descriptive questions, while the second part had 24-item Likert scale-based questions. Results: Around 40% of medical students and 26% of interns agreed or strongly agreed to the statement ‘I would consider a career in neurosurgery. Around 70% of both interns and students agreed or strongly agreed with the statement ‘Huge prestige is attached to neurosurgery’. The responses to the statement ‘Neurosurgery is a male specialty’ was significantly different between genders, as 36.5% of the male respondents agreed or strongly agreed with the statement while just 12.5% of the females responded likewise (p = 0.000). Only 23% of participants reported having completed a rotation in neurosurgery. About 44.7% of respondents were interested in taking an elective rotation in neurosurgery, while the remaining respondents (55.3%) responded with a negative answer. Only 23% of participants had completed an undergraduate rotation in neurosurgery. More males (65.3%) agreed or strongly agreed with the statement ‘Work as a neurosurgery specialist can impede family life as compared to females (57.5%), which was highly significant (p = 0.000). More medical students (45.1%) responded in the agreement or strong agreement in response to the statement’ Neurosurgery should be a compulsory rotation during internship’ as compared to interns (25.8%). Around 65% of the respondents agreed or strongly agreed that teachers/seniors have a great influence on students’ specialization choices. Around 67% of the respondents foresaw a purely clinical role for themselves after graduation, while 17% were interested in a clinical–academician role. Conclusions: The study reflected a generally positive attitude towards neurosurgery amongst medical students and interns. Interest in neurosurgery as a specialization can be strengthened by enhancing the exposure of students and interns to the specialty. Teachers and seniors can be useful influencers to motivate students to consider neurosurgery specialization.
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Affiliation(s)
- Ibrahim Alnaami
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
- Correspondence: or
| | - Mohammad Tauheed Ahmad
- Department of Medical Education, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
| | - Mohammed Abid Khan
- Department of Medical Education, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
| | - Khaled A. Amer
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
| | | | - Abdulaziz Alanazi
- College of Medicine, Alqassim University, Alqassim 52571, Saudi Arabia
| | - Sarah Alkhonizy
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Abdulaziz Alamri
- Department of Surgery, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
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13
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Garozzo D, Rispoli R, Graziano F, Gerardi RM, Grotenhuis A, Jenkins A, Sammons V, Visocchi M, Pinazzo S, Lima R, Martinez F, Emamhadi M, Pedro MT, Shirwari HS, Guedes F, Bhagavatula ID, Shukla DP, Bhat ID, Ojo OA, Tirsit A, Gonzales-Gonzales ME, Luna F, Kretschmer T, Benzel E, Cappelletto B. Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future. Front Surg 2022; 9:908540. [PMID: 35836607 PMCID: PMC9274114 DOI: 10.3389/fsurg.2022.908540] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Despite the rising percentage of women accessing the medical profession over the last few decades, surgical specialties are still largely male-dominated; in particular, a remarkable gender disparity is evident in neurosurgery, where only 19% of practitioners are females. Although women may be reluctant to choose a challenging specialty like neurosurgery due to concerns around how to balance family and career, it must be admitted that prejudices against female neurosurgeons have been deeply rooted for long, prompting many to give up and switch track to less demanding subspecialties. Among those who have persisted, many, if not most, have experienced difficulties in career progression and received unequal treatment in comparison with their male counterparts. In 1989, a group of 8 female neurosurgeons founded Women in Neurosurgery (WINS), an organization that aimed to guarantee inclusivity in neurosurgery, encouraging a better and more egalitarian working environment. Thereafter, WINS sessions were regularly promoted at international conferences, offering female neurosurgeons a platform to report issues related to gender discrimination. Over recent years, the mission of WINS sessions in national and international conferences has taken an unexpected deviation; they have progressively become supplementary scientific sessions with only women neurosurgeons as speakers, thus paving the road to a form of self-segregation. This tendency has also resulted in the establishment of sections of only female neurosurgeons within some national societies. Although there remains a faction that fiercely supports the WINS mindset of reserved spaces for women, such segregation is an upsetting prospect for those who believe that science and professionalism have no gender; a growing part of the global neurosurgical community believes that the conception of a “female neurosurgery” and a “male neurosurgery” is misguided and counterproductive and consider the existence of the WINS as anachronistic and no longer necessary.
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Affiliation(s)
- D Garozzo
- Department of Neurosurgery, Mediclinic Parkview Hospital, Dubai, UAE
| | - R Rispoli
- SOC Chirurgia Vertebro-Midollare, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Universitario Santa Maria della Misericordia di Udine, Udine, Italy
| | - F Graziano
- Department of Neurosurgery, ARNAS Garibaldi Hospital, Catania, Italy
| | - R M Gerardi
- Department of Neurosurgery, University Hospital, Palermo, Italy
| | - A Grotenhuis
- Department of Neurosurgery, Radboud UMC, Nijmegen, The Netherlands
| | - A Jenkins
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - V Sammons
- Department of Neurosurgery, North Shore Private Hospital, Sydney, Australia
| | - M Visocchi
- Department of Neurosurgery, Agostino Gemelli IRCCS, Rome, Italy
| | - S Pinazzo
- Department of Neurosurgery, Hospital Maciel, Montevideo, Uruguay
| | - R Lima
- Department of Neurosurgery, Hospital de Clínicas, Montevideo, Uruguay
| | - F Martinez
- Department of Neurosurgery, Hospital de Clínicas, Montevideo, Uruguay
| | - M Emamhadi
- Brachial plexus and peripheral nerve injury center, Guilan University of Medical Sciences, Rasht, Iran
| | - M T Pedro
- Peripheral Nerve Unit, Department of Neurosurgery, BKH Günzburg at Ulm University, Günzburg, Germany
| | - H S Shirwari
- Department of Neurosurgery, Dawodzai Medical Complex, Jalalabad, Afghanistan
| | - F Guedes
- Division of Neurosurgery, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - D P Shukla
- Department of Neurosurgery, NIMHANS, Bangalore, India
| | - I D Bhat
- Department of Neurosurgery, RV Astor Hospital Sarakki Jp Nagar, Bengaluru, India
| | - O A Ojo
- Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A Tirsit
- Department of Neurosurgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - M E Gonzales-Gonzales
- Department of Neurosurgery, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
| | - F Luna
- Departament of Neurosurgery, Hospital Clínico Regional de Concepción, Universidad de Concepción. Concepcion, Chile
| | - T Kretschmer
- Dept. of Neurosurgery & Neurorestoration, Neurosurgical Intensive Care, Neurooncological Centre (DKG) Klinikum Klagenfurt, Klagenfurt, Austria
| | - E Benzel
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, United States of America
| | - B Cappelletto
- SOC Chirurgia Vertebro-Midollare, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Universitario Santa Maria della Misericordia di Udine, Udine, Italy
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14
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Barrie U, Williams M, Nguyen M, Kenfack YJ, Mason H, Ata A, Aoun SG, Pilitsis JG. Characteristics of graduating medical students interested in neurosurgery with intention to practice in underserved areas: Implications for residency programs. Clin Neurol Neurosurg 2022; 218:107293. [DOI: 10.1016/j.clineuro.2022.107293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
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15
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Asfaw ZK, Soto E, Yaeger K, Feng R, Carrasquilla A, Barthélemy EJ, Tabani H, Berkalieva A, Mazumdar M, McNeill IT, Germano IM. Racial and Ethnical Diversity Within the Neurosurgery Resident and Faculty Workforce in the United States. Neurosurgery 2022; 91:72-79. [PMID: 35384926 DOI: 10.1227/neu.0000000000001920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/24/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Promoting workplace diversity leads to a variety of benefits related to a broader range of perspectives and insights. Underrepresented in medicine (URiM), including African Americans, Latinx, and Natives (Americans/Alaskan/Hawaiians/Pacific Islanders), are currently accounting for approximately 40% of the US population. OBJECTIVE To establish a snapshot of current URiM representation within academic neurosurgery (NS) programs and trends within NS residency. METHODS All 115 NS residencies and academic programs accredited by the Accreditation Council for Graduate Medical Education in 2020 were included in this study. The National Residency Matching Program database was reviewed from 2011 to 2020 to analyze URiM representation trends over time within the NS resident workforce. The academic rank, academic and clinical title(s), subspecialty, sex, and race of URiM NS faculty (NSF) were obtained from publicly available data. RESULTS The Black and Latinx NS resident workforce currently accounts for 4.8% and 5.8% of the total workforce, respectively. URiM NSF are present in 71% of the Accreditation Council for Graduate Medical Education-accredited NS programs and account for 8% (148 of 1776) of the workforce. Black and Latinx women comprise 10% of URiM NSF. Latinx NSFs are the majority within the URiM cohort for both men and women. URiM comprise 5% of all department chairs. All are men. Spine (26%), tumor (26%), and trauma (17%) were the top 3 subspecialties among URiM NSF. CONCLUSION NS has evolved, expanded, and diversified in numerous directions, including race and gender representation. Our data show that ample opportunities remain to improve URiM representation within NS.
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Affiliation(s)
- Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Elizabeth Soto
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kurt Yaeger
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rui Feng
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alejandro Carrasquilla
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ernest J Barthélemy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Halima Tabani
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Asem Berkalieva
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Madhu Mazumdar
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ian T McNeill
- Division of Neurosurgery, Department of Surgery, University of Connecticut, Farmington, Connecticut, USA
| | - Isabelle M Germano
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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16
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Ekhator C, Rak R. The Need for Improved Recruitment to Neurosurgery Training: A Systematic Review of Enrollment Strategies. Cureus 2022; 14:e26212. [PMID: 35891848 PMCID: PMC9307286 DOI: 10.7759/cureus.26212] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/08/2022] Open
Abstract
Neurosurgery is one of the cornerstones corresponding to a large scope of clinical pathologies and is a highly-regarded surgical specialty. However, there has been a decline in recruits into the neurosurgical residency due to many factors derailing the interest of medical students with an ambition to become neurosurgeons. Some of these issues encompass little or lack of early exposure to neurosurgery, lack of quality mentorship programs, and institutional curriculum entailing prolonged periods of training and study in neurosurgery. Therefore, this systematic review and meta-analysis aim to establish some strategic methodologies for increasing the recruitment to neurological surgery. Neurosurgery is an interestingly exciting specialty that integrates cutting-edge technology allowing for diversified subspecialization with an exceptional degree of variety. Nevertheless, several factors such as the duration of the required training, the kind of lifestyle, lack of early exposure to neurosurgery, and lack of mentors to a vast of medical students across the globe have curtailed the recruitment to neurological surgery. Despite an increased number of female representations in medical surgery, there has been a reported increase in students matching into neurosurgery, although the number is relatively below the expectation due to the factors highlighted earlier. As a result, many studies and surveys have been conducted to identify ways of improving neurosurgical recruitment. Five electronic databases, including PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, MEDLINE, and Cochrane Library, were searched to provide pertinent information to the topic of study in strict compliance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) guidelines. Meta-analysis was then conducted on the included studies to determine their correlations based on the individual outcomes of each study. A total of 2,134 search results were obtained, screened, and reviewed against the exclusion and inclusion criteria to remain with 12 included studies detailing improving the recruitment to neurosurgical residency. The 12 studies were retrieved for their study characteristics based on the PICO (predetermined patient, intervention, control, and outcome) standards. Most of the studies were surveys (n = 8), retrospective and prospective studies (n = 2), and pilot and multifocal studies making up for the rest (n = 2). Several neurosurgery aspects need consideration to improve the recruitment of medical students to neurosurgical fields. Medical institutions, specialists, and other stakeholders should consider reconstructing the neurosurgical curriculum to ease the prolonged study time as well as to create and encourage structural programs aimed at acquainting medical students in neurosurgery and involving the students in conducting other research projects. In addition, mentorship programs and early exposure of medical students to neurological surgery play a key role in influencing the medical students' interest in choosing neurosurgical career paths.
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Affiliation(s)
- Chukwuyem Ekhator
- Neuro-oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Ramin Rak
- Neurosurgery, Rockville Center, New York, USA
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Kuzucu P, Evleksiz D, Gökalp E, Özışık P, Güngör A. Women in neurosurgery: perspectives from a developing country; Turkey. Neurosurg Rev 2022; 45:2333-2338. [PMID: 35157165 DOI: 10.1007/s10143-022-01730-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/21/2021] [Accepted: 01/03/2022] [Indexed: 11/27/2022]
Abstract
Although at least half of medical students are women, neurosurgery is not often preferred by women, and the proportion of female neurosurgeons who can participate in the academic platform is very low. In this study, we aimed to show the role of female neurosurgeons in the Turkish Neurosurgical Society and to describe the number and the location of female neurosurgeons in Turkey. We examined the age, academic rank, years of work in the profession, membership rate in society subgroups, h-index parameters, and relationships of certificated female neurosurgeons registered in the Turkish Neurosurgical Society. We examined gender rate differences between society subgroups using chi-square tests. A P value < 0.05 was considered statistically significant. According to the year-end 2020 data of the Turkish Neurosurgery Society, 94 (5.5%) of the 1699 neurosurgery specialists registered in Turkey are women. There are currently 94 board-certified female neurosurgeons between the ages of 31 and 92 years; 10 are full professors (10.6%), 16 are associate professors (17%), 5 are assistant professors (5.3%), and 63 are neurosurgery specialist physicians (67%). Female neurosurgeons are present among six of the subfields categorized by the Turkish Neurosurgical Society: 7 in pediatric neurosurgery (11.47%); 8 in spinal and peripheral nerve surgery (2.4%); 3 in neurovascular surgery (2.02%); 7 in functional neurosurgery (5.8%); 11 in neuroanatomy (9.2%); and 23 in neurooncology (6.9%). The number of female neurosurgeons in Turkey continues to grow each year. To increase the proportion of women in this field, it is important to support female neurosurgeons and enable them to take on more tasks.
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Affiliation(s)
- Pelin Kuzucu
- Department of Neurosurgery, Ankara City Hospital, Ankara, Turkey.
| | - Demet Evleksiz
- Department of Neurosurgery, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Elif Gökalp
- Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Pınar Özışık
- Department of Neurosurgery, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
- Yeditepe University Kosuyolu Hospital, Uskudar, Istanbul, Turkey
| | - Abuzer Güngör
- Department of Neurosurgery, Umraniye Teaching and Research Hospital, Health Sciences University, Istanbul, Turkey
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Plonsker JH, Benzil D, Air EL, Woodrow S, Stippler M, Ben-Haim S. Gender Equality in Neurosurgery and Strategic Goals Toward a More Balanced Workforce. Neurosurgery 2022; 90:642-647. [PMID: 35311744 DOI: 10.1227/neu.0000000000001910] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
The Women in Neurosurgery (WINS) and the American Association of Neurological Surgeons published a white paper in 2008 setting an ambitious goal for women to comprise 20% of neurosurgery residents by 2012 and 20% of practicing neurosurgeons by 2020. Although there has been steady progress, we have fallen short of these benchmarks. We take this opportunity to look back at the accomplishments made over the past decade and provide an update on our present status. We evaluate current barriers toward progress and propose new goals, highlighting the systemic changes necessary to accomplish them. We propose the following updated recommendations to recruit and retain diverse talent into the neurosurgical workforce. (1) Neurosurgical departments and societies should provide diverse, early formal mentorship opportunities for medical students, residents, and junior faculty members. (2) Parental leave policies must be delineated, promoted, and enforced for all neurosurgeons, with greater awareness of internal discrimination and normalization of the discussion surrounding this topic. (3) We need to strive for compensation equity, with transparency in compensation mechanisms and regular assessment of compensation metrics. (4) Departments and institutions must have a zero-tolerance policy for sexual harassment and discrimination and establish a safe reporting structure. Finally, we propose attainable benchmarks toward achieving gender balance in the neurosurgical workforce, with a goal for women to comprise 30% of the entering residency class by 2030 and to comprise 30% of practicing neurosurgeons by 2038. We hope that this will guide further progress toward our future of building a balanced workforce.
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Affiliation(s)
| | - Deborah Benzil
- Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ellen L Air
- Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Sarah Woodrow
- Department of Neurosurgery, Cleveland Clinic Akron General, Akron, Ohio, USA
| | - Martina Stippler
- Division of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Sharona Ben-Haim
- Department of Neurosurgery, UC San Diego, San Diego, California, USA
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19
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Jain A, Nichols G, Tarabishy S, Scomacao I, Herrera FA. A Comparison of Applicant and Resident Physician Demographics Among Surgical Subspecialties From 2009 to 2019: Trends in Gender and Underrepresented Minorities in Medicine. Ann Plast Surg 2022; 88:451-459. [PMID: 34711732 DOI: 10.1097/sap.0000000000003041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purposes of this study were to compare applicant statistics to resident physician demographics among several surgical subspecialties (SSSs), to identify trends of gender and underrepresented minorities in medicine (UIM), and to evaluate current diversity among these specialties. METHODS Graduate medical education reports from 2009 to 2019 were queried to determine trends among programs. Further identification of gender and UIM statistics was obtained in 4 several SSSs: integrated plastic surgery, orthopedic surgery (OS), otolaryngology surgery (ENT), and neurosurgery (NS). These were compared with Association of American Medical Colleges data of residency applicants for the respective years. RESULTS Significant differences were seen among gender and UIM(s) of the applicant pool when compared with resident data. All specialties had significantly fewer American Indian and African American residents compared with applicants. Significant differences between applicants and residents were also found among Hispanic, Native Hawaiian, and female demographics. All SSSs had a significant positive trend for the percentage of female residents. Significant differences between specialties were identified among African American, Hispanic, and female residents. Orthopedic surgery and NS had significantly higher percentage of African American residents compared with ENT and integrated plastic surgery. Neurosurgery had significantly higher percentage of Hispanic residents compared with OS and ENT. Integrated plastic surgery and ENT had significantly higher percentage of female residents compared with OS and NS. CONCLUSIONS There has been significant increase in number of residency programs and resident positions since 2009. However, increase in female residents and UIM(s) among SSSs has not matched the pace of growth.
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Affiliation(s)
| | - Georgina Nichols
- Division of Plastic Surgery, Medical University of South Carolina
| | - Sami Tarabishy
- Division of Plastic Surgery, Medical University of South Carolina
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20
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Zeitlberger AM, Baticam NS, Sprenger L, Tizi K, Schaller K, Stienen MN. Gender disparity in neurosurgery: A multinational survey on gender-related career satisfaction. BRAIN AND SPINE 2022; 2:100890. [PMID: 36248166 PMCID: PMC9560587 DOI: 10.1016/j.bas.2022.100890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/02/2022] [Accepted: 04/20/2022] [Indexed: 11/18/2022]
Abstract
Introduction Women continue to be underrepresented in the majority of surgical specialties, including neurosurgery. Research question In this multinational survey, we aimed to assess current gender disparities in neurosurgery focusing on job satisfaction and inequity/discrimination at work. Material and methods Female and male members of the European Association of Neurosurgical Societies were asked to complete an electronic survey (Google Forms, Mountain View) containing demographic baseline data and questions on attitudes regarding gender disparity, personal experience with gender inequity and career satisfaction/work-life balance. Quantitative analyses were performed to analyse the responses, including summary and comparative statistics. Results We received 168 responses from 40 different countries. Survey responders had a mean age of 40.8 ± 11.5 years; 29.8% were female. There were significant more male than female residents and attending surgeons per department. Eighty-eight percent of female and 38.1% of male responders experienced gender inequity or discrimination at work (adjusted OR 10.8, 95%CI 4.2–27.8, p<0.001). Female neurosurgeons were more likely to be discriminated by colleagues (aOR 4.32, 95%CI 2.1–9.1, p<0.001) and by patients/relatives (aOR 3.65, 95%CI 1.77–7.54, p<0.001). There was a trend towards lower job satisfaction (p=0.012), less satisfaction with career goals (p=0.035) and worse work-life balance (p=0.0021) in female surgeons. Discussion and conclusion This survey underlines that a significant proportion of neurosurgeons – in particular females – continue to experience gender inequity & discrimination at work, which may translate into lower work-related satisfaction. A better understanding of the gender-related aspects of job satisfaction is an important step to improving gender equity in our profession. Women continue to be underrepresented in clinical and academic neurosurgery. The most common source of discrimination are patients/relatives and colleagues. Women generally report lower job satisfaction in neurosurgery. Progress towards gender equity has been made in the last decade.
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Affiliation(s)
| | - Nalla Silva Baticam
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Lima Sprenger
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Karima Tizi
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Karl Schaller
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Martin N. Stienen
- Department of Neurosurgery, Kantonsspital St.Gallen, St.Gallen, Switzerland
- Corresponding author. Department of Neurosurgery Kantonsspital St.Gallen, Rorschacher Str. 95, 9007, St.Gallen, Switzerland.
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21
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Hernández-Durán S, Drummond K, Karekezi C, Murphy M, Nejat F, Zanon N, Rosseau G. International Women in Neurosurgery. Adv Tech Stand Neurosurg 2022; 45:1-33. [PMID: 35976446 DOI: 10.1007/978-3-030-99166-1_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The history of women in neurosurgery worldwide has been characterized by adversity and hardships in a male-dominated field, where resilient, tenacious, and ingenious women have nevertheless left their mark. The first women in neurosurgery appeared in Europe at the end of the 1920s, and since then have emerged in all continents in the world. Women neurosurgeons all over the globe have advanced the field in numerous directions, introducing neurosurgical subspecialties to their countries, making scientific and technical advances, and dedicating themselves to humanitarian causes, to name a few. The past 30 years, in particular, have been a period of increasing involvement and responsibility for women in neurosurgery. We must now focus on continual system improvements that will promote a diverse and talented workforce, building a welcoming environment for all aspiring neurosurgeons, in order to advance the specialty in the service of neurosurgical patients.
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Affiliation(s)
- Silvia Hernández-Durán
- Department of Neurological Surgery, Universitätsmedizin Göttingen, Göttingen, Germany.
- European Association of Neurosurgical Societies, Diversity Task Force, Brussels, Belgium.
| | - Katharine Drummond
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Mary Murphy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Farideh Nejat
- Tehran University of Medical Science, Children's Medical Center, Tehran, Iran
| | - Nelci Zanon
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
- CENEPE Centro de Neurocirurgia pediátrica (Pediatric Neurosurgical Center), São Paulo, Brazil
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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22
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Lambrianou X, Tzerefos C, Janssen IK, Mihaylova S, Aydin AE, Al-Ahmad S, Broekman MLD, Gazioglu N, Duran SH, Ivan DL, Karampouga M, Magnadottir HB, Pajaj E, Rodríguez-Hernández A, Rosseau G, Salokorpi N, Tsianaka E, Vayssiere P, Murphy M, Tasiou A. Gender differences in work-life balance of European neurosurgeons. BRAIN AND SPINE 2022; 2:101100. [PMID: 36248165 PMCID: PMC9562249 DOI: 10.1016/j.bas.2022.101100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Xanthoula Lambrianou
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Christos Tzerefos
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Insa K. Janssen
- Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Stiliana Mihaylova
- Clinic of Neurosurgery, Sv. Ivan Rilski University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | | | - Selma Al-Ahmad
- Neurosurgery Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - Marike LD. Broekman
- Department of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden, the Netherlands
| | - Nurperi Gazioglu
- Istinye University, Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
| | | | - Daniela Luminita Ivan
- Department of Neurosurgery, Bucharest Emergency University Hospital, Carol Davila University of Medicine, Bucharest, Romania
| | - Maria Karampouga
- Neurosurgery Department, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Ermira Pajaj
- Department of Neurosurgery, Spitali Rajonal Memorial Fier, Fier, Albania
| | - Ana Rodríguez-Hernández
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Universidad Autónoma, Barcelona, Spain
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Niina Salokorpi
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland and Research Unit of Clinical Neuroscience, Medical Research Center, Oulu University, Oulu, Finland
| | - Eleni Tsianaka
- Neurosurgery Department, International Hospital, Salmiya, Kuwait
| | - Pia Vayssiere
- Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Mary Murphy
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Anastasia Tasiou
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Corresponding author. Department of Neurosurgery, Building A, 3rd Floor, University Hospital of Larissa, Biopolis, Larissa, 41110, Greece.
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Algahtani AY, Jamjoom AB, Al Rabie A, Jamjoom ZAB. Attrition and Success Rates in the Saudi Board of Neurosurgery: Analysis of 115 Consecutive Residents Who Started Training From 2001 to 2014. Cureus 2021; 13:e18235. [PMID: 34712523 PMCID: PMC8542259 DOI: 10.7759/cureus.18235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives At present, the literature lacks data on the outcome of neurosurgery training programs in the Middle East. In this study we aim to assess the attrition, completion of training and success rates in the Saudi Board of Neurosurgery (SBNS). Methods A cohort of 115 trainees who started SBNS training during 2001-2014 was reviewed. The outcome was the rate of attrition, completion of training, and success in the final examination of the SBNS. Results Attrition rate was 29% (14% to neurosurgery training elsewhere and 15% to non-neurosurgery). Completion of training rate was 71%. Success in the final examination rate was 74% (60% on the first attempt). Attrition rate was significantly influenced by being sponsored by University Hospitals. Success rate was impacted positively by being sponsored by King Fahad Medical City and negatively by Ministry of Health Hospitals. Trainees who started during 2011-2014 had a significantly better success rate in the final examination. Conclusions SBNS attrition rate was high due to access to training opportunities abroad, particularly for university-sponsored trainees. Success rate in the final examination was considered comparable to some other neurosurgical qualifications. The first attempt pass rate was significantly impacted by being sponsored by certain hospitals. Factors contributing to attrition and failure should be identified and addressed during the selection process and during training.
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Affiliation(s)
- Abdulhadi Y Algahtani
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Abdulhakim B Jamjoom
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
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Bauman MMJ, Wang K, Bhandarkar AR, Scheitler KM, Clarke MJ. A step toward equal representation? A cross-sectional analysis of the gender composition of neurosurgical editorial boards from 2000 to 2020. J Neurosurg 2021:1-8. [PMID: 34678785 DOI: 10.3171/2021.6.jns21474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE At present, females constitute less than 10% of neurosurgeons in the US, despite representing approximately half of all medical students. Multiple barriers have been described for females entering the neurosurgical field, particularly academic neurosurgery. Understanding the environment that female neurosurgeons face and any potential barriers preventing career advancement is needed to recruit, promote, and retain females in neurosurgery. METHODS The gender composition of editorial boards for 5 high-impact neurosurgery journals was analyzed from 2000 to 2020. The names of editorial board members were obtained directly from the journal administration, physical copies of the published journal, or publicly available data through each journal's website. The gender, degrees, academic titles, H-index, and country were determined for each individual and statistical tests were performed to identify significant differences. RESULTS Of the 466 identified individuals that served on at least one editorial board between 2000 and 2020, there were 36 females (7.7%) and 430 males (92.3%). There were no significant differences between males and females serving on multiple editorial boards. Most females possessed an additional graduate degree (58.3%), while only one-third of males (33.5%) obtained such a degree (p = 0.002). In addition, males had significantly higher average H-indices than females (p = 0.002). These trends were also observed when analyzing only US-based editorial board members. Although females were more likely overall to be identified as associate professors, males were more likely to be appointed as full professors (p = 0.001); this trend did not remain true in the US-based cohort. When analyzing the editorial boards for individual journals, all 5 journals experienced an increase of female representation since 2000 or since their inception after 2000. The highest proportion of females for a single journal was 27.3% in 2020. All other journals ranged from 11.0% to 13.5% in 2020. CONCLUSIONS When entering the field of neurosurgery, females continue to face significant social and academic barriers. While the proportion of females on editorial boards for neurosurgery journals in 2020 is consistent with the proportion of practicing female neurosurgeons, there is a statistically significantly higher likelihood that females possess additional graduate degrees and lower H-indices compared to their male counterparts. The authors encourage neurosurgical journals to continue expanding female representation on editorial boards.
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Affiliation(s)
- Megan M J Bauman
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Kimberly Wang
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Archis R Bhandarkar
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | | | - Michelle J Clarke
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and
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A National Survey Evaluating the Impact of the COVID-19 Pandemic on Students Pursuing Careers in Neurosurgery. NEUROSCI 2021; 2:320-333. [PMID: 36091326 PMCID: PMC9457230 DOI: 10.3390/neurosci2040023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The COVID-19 pandemic has profoundly disrupted medical education and the residency application process. Methods: We conducted a descriptive observational study in April 2020 of medical students and foreign medical graduates considering or pursuing careers in neurosurgery in the United States to examine the impact of the pandemic. Results: A total of 379 respondents from 67 medical schools completed the survey. Across all participants, 92% (n = 347) stopped in-person didactic education, and 43% (n = 161) experienced basic science and 44% (n = 167) clinical research delays. Sixty percent (n = 227) cited a negative impact on academic productivity. Among first year students, 18% (n = 17) were less likely to pursue a career in neurosurgery. Over half of second year and third year students were likely to delay taking the United States Medical Licensing Examination Steps I and II. Among third year students, 77% (n = 91) reported indefinite postponement of sub-internships, and 43% (n = 53) were unsatisfied with communication from external programs. Many fourth-year students (50%, n = 17) were graduating early to participate in COVID-19-related patient care. Top student-requested support activities included access to student-focused educational webinars and sessions at upcoming conferences. Conclusions: Medical students pursuing careers in neurosurgery faced unique academic, career, and personal challenges secondary to the pandemic. These challenges may become opportunities for new initiatives guided by professional organizations and residency programs.
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Davis MJ, Luu BC, Cole SH, Abu-Ghname A, Winocour S, Reece EM. Employment as a Plastic Surgeon: A Review of Trends and Demand Across the Field. Ann Plast Surg 2021; 87:377-383. [PMID: 34117135 DOI: 10.1097/sap.0000000000002780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Intrinsic to the field of plastic surgery, constant changes in health care policy, consumer demands, and medical technology necessitate periodic evaluation of trends in employment over time. In this article, we review the existing literature to report the current state of plastic surgery employment in the United States with regards to compensation, practice patterns, subspecialty trends, contract negotiation, representation of women in the field of plastic surgery, burnout and job satisfaction, and retirement. Understanding how the plastic surgery job market is changing not only serves as a valuable tool for the individual plastic surgeon regarding the navigation of his or her own career but also offers insight into the future of the field as a whole.
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Affiliation(s)
| | - Bryan C Luu
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine
| | - Samuel H Cole
- Section of Plastic and Reconstructive Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Sebastian Winocour
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine
| | - Edward M Reece
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine
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27
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Field NC, Pilitsis JG, Paul AR. The Role of Gender in Neurosurgical Residency Applicants' Letters of Recommendation. Neurosurgery 2021; 89:504-508. [PMID: 34131761 PMCID: PMC8364822 DOI: 10.1093/neuros/nyab223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/22/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Letters of recommendation (LORs) are one of the most important components of the neurosurgical residency application. Studies in other fields and surgical subspecialties have found gender bias. OBJECTIVE To determine whether neurosurgical LORs contain significant linguistic gendered differences. METHODS We performed a retrospective review and linguistic analysis of all LORs submitted on behalf of applicants offered an interview invitation to a single neurosurgical residency program at an academic medical center between 2015-2016 and 2018-2019. RESULTS A total of 599 letters from 156 applicants (120 males and 36 females) were included. Background demographics, including United States Medical Licensing Examination (USMLE) Step 1 score and publications, were not significantly different between applicants. Male faculty authored 93% of all letters. Female faculty were more likely to write letters for female applicants than male applicants (12.1% vs 5.5%, P < .001). Letters for women were significantly longer (334 words vs 277 words, P < .001). Overall, 1754 agentic terms and 854 communal terms were coded. Letters for men contained significantly fewer agentic terms (10.7 vs 13.1, per applicant, P < .01) and communal terms (5.2 vs 6.4, P < .034). This difference, however, is nonsignificant when word count was used as a covariate. Female applicants were more significantly likely to be labeled "Outstanding" (2.4 vs 1.6 mentions per applicant). CONCLUSION Overall, there are more similarities than differences between genders in LORs for neurosurgical applicants. This finding is at odds with what has previously been reported in most other surgical specialties.
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Affiliation(s)
- Nicholas C Field
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
| | - Julie G Pilitsis
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Alexandra R Paul
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
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Benzil DL, Muraszko KM, Soni P, Air EL, Orrico KO, Rutka JT. Toward an understanding of sexual harassment in neurosurgery. J Neurosurg 2021; 135:342-351. [PMID: 33171438 DOI: 10.3171/2020.6.jns201649] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/30/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The goal of this study was the creation and administration of a survey to assess the depth and breadth of sexual harassment across neurosurgery. METHODS A survey was created to 1) assess perceived attitudes toward systemic issues that might be permissive of sexual harassment; 2) measure the reported prevalence and severity of sexual harassment; and 3) determine the populations at highest risk and those most likely to perpetrate sexual harassment. Demographic information was also included to facilitate further analysis. The SurveyMonkey platform was used, and a request to complete the survey was sent to all Society of Neurological Surgeons and Congress of Neurological Surgeons (CNS) active and resident members as well as CNS transitional, emeritus, and inactive members. Data were analyzed using RStudio version 1.2.5019. RESULTS Nearly two-thirds of responders indicated having witnessed sexual harassment in some form (62%, n = 382). Males were overwhelmingly identified as the offenders in allegations of sexual harassment (72%), with individuals in a "superior position" identified as offenders in 86%. Less than one-third of responders addressed the incidents of sexual harassment when they happened (yes 31%, no 62%, unsure 7%). Of those who did report, most felt there was either no impact or a negative one (negative: 34%, no impact: 38%). Almost all (85%) cited barriers to taking action about sexual harassment, including retaliation/retribution (87%), impact on future career (85%), reputation concerns (72%), and associated stress (50%). Female neurosurgeons were statistically more likely than male neurosurgeons to report witnessing or experiencing sexual harassment, as well as assessing it as a problem. CONCLUSIONS This study demonstrates that neurosurgeons report significant sexual harassment across all ages and practice settings. Sexual harassment impacts both men and women, with more than half personally subjected to this behavior and two-thirds having witnessed it. Male dominance, a hierarchical environment, and a permissive environment remain prevalent within the neurosurgical community. This is not just a historical problem, but it continues today. A change of culture will be required for neurosurgery to shed this mantle, which must include zero tolerance of this behavior, new policies, awareness of unconscious bias, and commitment to best practices to enhance diversity. Above all, it will require that all neurosurgeons and neurosurgical leaders develop an awareness of sexual harassment in the workplace and establish consistent mechanisms to mitigate against its highly deleterious effects in the specialty.
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Affiliation(s)
| | - Karin M Muraszko
- 2Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Pranay Soni
- 1Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio
| | - Ellen L Air
- 3Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan
| | - Katie O Orrico
- 4Washington Office, American Association of Neurological Surgeons/Congress of Neurological Surgeons, Washington, DC; and
| | - James T Rutka
- 5Department of Neurosurgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada
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Mackel CE, Nelton EB, Reynolds RM, Fox WC, Spiotta AM, Stippler M. A Scoping Review of Burnout in Neurosurgery. Neurosurgery 2021; 88:942-954. [PMID: 33471896 DOI: 10.1093/neuros/nyaa564] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/04/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Burnout is a negative workplace syndrome of emotional exhaustion, cynicism, and perceived professional inefficacy that risks the patient-provider relationship, patient care, and physician well-being. OBJECTIVE To assimilate the neurosurgical burnout literature in order to classify burnout among domestic and international neurosurgeons and trainees, identify contributory factors, and appraise the impact of wellness programs. METHODS A scoping review identified the available literature, which was reviewed for key factors related to burnout among neurosurgeons. Two researchers queried PubMed, Embase, Google Scholar, Cochrane, and Web of Science for articles on burnout in neurosurgery and reduced 1610 results to 32 articles. RESULTS A total of 32 studies examined burnout in neurosurgery. A total of 26 studies examined prevalence and 8 studies detailed impact of wellness programs. All were published after 2011. Burnout prevalence was measured mostly through the Maslach Burnout Inventory (n = 21). In 4 studies, participants defined their own understanding of "burnout." Domestically, burnout prevalence was 11.2% to 67% among residents and 15% to 57% among attendings. Among trainees, poor operative experience, poor faculty relationships, and social stressors were burnout risks but not age, sex, or marital status. Among attendings, the literature identified financial or legal concerns, lack of intellectual stimulation, and poor work-life balance as risks. The impact of wellness programs on trainees is unclear but group exercises may offer the most benefit. CONCLUSION Noticeable methodological differences in studies on trainee and attending burnout contribute to a wide range of neurosurgery burnout estimates and yield significant knowledge gaps. Environment may have greater impact on trainee burnout than demographics. Wellness programs should emphasize solidarity.
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Affiliation(s)
- Charles E Mackel
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Emmalin B Nelton
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Renée M Reynolds
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | | | - Alejandro M Spiotta
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina
| | - Martina Stippler
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Behmer Hansen RT, Silva NA, Cuevas R, Cerasiello SY, Richardson AM, Mammis A, Nanda A. Fellowship, gender, and scholarly productivity: trends among academic neurosurgeons in the US. J Neurosurg 2021; 135:185-193. [PMID: 32858514 DOI: 10.3171/2020.5.jns20577] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/14/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Current data on fellowship choice and completion by neurosurgical residents are limited, especially in relation to gender, scholarly productivity, and career progression. The objective of this study was to determine gender differences in the selection of fellowship training and subsequent scholarly productivity and career progression. METHODS The authors conducted a quantitative analysis of the fellowship training information of practicing US academic neurosurgeons. Information was extracted from publicly available websites, the Scopus database, and the Centers for Medicare and Medicaid Services Open Payments website. RESULTS Of 1641 total academic neurosurgeons, 1403 (85.5%) were fellowship trained. There were disproportionately more men (89.9%) compared to women (10.1%). A higher proportion of women completed fellowships than men (p = 0.004). Proportionally, significantly more women completed fellowships in pediatrics (p < 0.0001), neurooncology (p = 0.012), and critical care/trauma (p = 0.001), while significantly more men completed a spine fellowship (p = 0.012). Within those who were fellowship trained, the academic rank of professor was significantly more commonly held by men (p = 0.001), but assistant professor was held significantly more often by women (p = 0.017). The fellowships with the largest mean h-indices were functional/stereotactic, pediatrics, and critical care/trauma. Despite more women completing neurooncology and pediatric fellowships, men had significantly greater h-indices in these subspecialties compared to women. Women had more industry funding awards than men in pediatrics (p < 0.0001), while men had more in spine (p = 0.023). CONCLUSIONS Women were found to have higher rates for fellowship completion compared with their male counterparts, yet had lower scholarly productivity in every subspecialty. Fellowship choice remains unequally distributed between genders, and scholarly productivity and career progression varies between fellowship choice.
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Affiliation(s)
| | - Nicole A Silva
- 2Department of Neurosurgery, University of North Carolina at Chapel Hill, North Carolina
| | - Rebecca Cuevas
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Samantha Y Cerasiello
- 3Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois
| | - Angela M Richardson
- 5Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Antonios Mammis
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Anil Nanda
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey
- 4Department of Neurosurgery, Robert Wood Johnson Barnabas Health, Livingston, New Jersey; and
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Servito M, Ouzounian M, Chung J, Yanagawa B. Trends in female cardiac surgery trainees and staff in Canada: 1998 to 2020. J Thorac Cardiovasc Surg 2021; 163:e203-e206. [PMID: 34238596 DOI: 10.1016/j.jtcvs.2021.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/23/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Maria Servito
- Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Maral Ouzounian
- Division of Cardiac Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Chung
- Division of Cardiac Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Bobby Yanagawa
- Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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Parker SL, Conner CR, Mata DA, Zima LA, Chen A, McCormack R, Bindal S, Stark JR. Factors Associated With Pregnancy and Perinatal Outcomes in Female Neurosurgeons: A Cross-Sectional Study. Neurosurgery 2021; 88:884-889. [PMID: 33471903 DOI: 10.1093/neuros/nyaa533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/04/2020] [Indexed: 11/14/2022] Open
Abstract
Neurosurgery is male dominated with women representing only 12% of residents and 5% of practicing neurosurgeons. The conflicting demands of training versus pregnancy and motherhood are significant deterrents to women entering the field. We examined pregnancy incidence and timing, perinatal complications, and the perceived career impact of motherhood on female neurosurgeons using an anonymous survey of 643 training, practicing, and retired female neurosurgeons from the United States. Among 260 respondents, 50.8% (132/260) reported pregnancies, with an average age at first pregnancy that was significantly higher than the national average (32.1 vs 26.3 yr). In all, 40.1% (53/132) of respondents reported perinatal complications in at least one of their pregnancies. Only 25% (33/132) of respondents noted designated program maternity allowances. The most significant challenges associated with being a mother and neurosurgeon reported were issues relating to work/life balance, "mommy guilt," and sleep deprivation. A majority of respondents, 70.1% (82/116), reported fear of backlash from co-residents, partners, and staff, as well as hindered career advancement related to childbearing. Female neurosurgeons face challenges surrounding family planning different from those faced by male practitioners. Higher perinatal and fetal complications, backlash from colleagues, and demanding workload are significant issues. Progress requires institutional support and mentorship for women to create a more diverse field of practitioners.
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Affiliation(s)
- Samantha L Parker
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Christopher R Conner
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Douglas A Mata
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Laura A Zima
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Amber Chen
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Ryan McCormack
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Shivani Bindal
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Jessica R Stark
- Department of Neurosurgery, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
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Yaeger KA, Munich SA, Byrne RW, Germano IM. Trends in United States neurosurgery residency education and training over the last decade (2009-2019). Neurosurg Focus 2021; 48:E6. [PMID: 32114562 DOI: 10.3171/2019.12.focus19827] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/24/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Postgraduate training in medicine has been under scrutiny in the last 10 years, with a focus on improving residents' education. The aim of this study was to quantify trends in neurosurgery residency (NSR) training and education over the last 10 years. METHODS The authors assessed Accreditation Council for Graduate Medical Education (ACGME), National Resident Matching Program, and American Board of Neurological Surgeons records and searched PubMed to collate 2009-2019 data. Analyzed trends included residents' demographic data, programs' characteristics, graduation and attrition rates, match data, resident case logs, and qualitative educational curriculum changes. RESULTS Significant increases in residents' demographic data (p < 0.05) included the number of female residents (from 12.7% to 17.6%) and the absolute number of residents (from 1112 to 1462). Age (mean 28.8 years), ethnicity, and number of residents per program (mean 13 residents per program) were unchanged. There were 16 new ACGME NSR programs, with currently 115 programs nationwide. The number of applicants per year (324 applicants per year) and the matching rate (mean 64%) remained stable. The mean attrition rate of 2.6% (range 2%-4%) was higher than the mean 2.1% ACGME attrition rate, a rate that decreased from 3% in 2009 to 1.6% in 2019. Education curriculum changes aimed at the standardization of training across the US included residents' boot camp (2009), the Milestones project (2012), and mandatory 7-year training initiated in 2013. An increase in endovascular, functional, trauma, and spine resident caseload was noted. The number of yearly publications about US NSR education has significantly increased (p < 0.05). CONCLUSIONS NSR education has received greater attention over the last decade in the US. Standardization of training has been implemented. A steady number of students remain interested in neurosurgery, with an increased number of women entering the field. Attention to wellness, in addition to high-quality education, should be further assessed as a factor to improve the overall NSR training and retention rate.
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Affiliation(s)
- Kurt A Yaeger
- 1Department of Neurological Surgery, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; and
| | - Stephan A Munich
- 2Department of Neurological Surgery, Rush Medical College, Chicago, Illinois
| | - Richard W Byrne
- 2Department of Neurological Surgery, Rush Medical College, Chicago, Illinois
| | - Isabelle M Germano
- 1Department of Neurological Surgery, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; and
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Junior LSB, Lemos NB, Vianna JDA, Silva JG, Sanchez LMF, Silva ACV, de Azevedo HRC. Female insertion in neurosurgery: Evolution of a stigma break. Surg Neurol Int 2021; 12:76. [PMID: 33767880 PMCID: PMC7982110 DOI: 10.25259/sni_817_2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Utilizing the Brazilian Medical Demography analysis and a literature review, we evaluated how women choose to become neurosurgeons in Brazil and around the world, specifically citing the Europe, the USA, India, and Japan. METHODS We utilized the Brazilian Medical Demography prepared by the Federal Council of Medicine and the Regional Council of Medicine of the State of São Paulo (2011, 2013, 2015, and 2018). We also included an evaluation of 20 articles from PubMed, the Scientific Electronic Library Online, and National Health Library databases (e.g., using descriptors "Women in neurosurgery" and "Career"). RESULTS In Brazil in 2017, women comprised 45.6% of active doctors, but only 8.6% of all neurosurgeons. Of 20 articles identified in the literature, 50% analyzed the factors that influenced how women choose neurosurgery, 40% dealt with gender differences, while just 10% included an analysis of what it is like to be a female neurosurgeon in different countries/continents. CONCLUSION The participation of women in neurosurgery has increased in recent years despite the persistence of gender inequality and prejudice. More women need to be enabled to become neurosurgeons as their capabilities, manual dexterity, and judgment should be valued to improve the quality of neurosurgical health-care delivery.
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Affiliation(s)
| | - Nilson Batista Lemos
- Unifacisa University Center, College of Medical Sciences, Campina Grande, Brazil
| | | | | | | | - Ana Cristina Veiga Silva
- Department of Neurological Surgery, Hospital da Restauração Governador Paulo Guerra, Recife, Brazil
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Thum JA, Chang D, Tata N, Liau LM. Neurosurgeons in 2020: the impact of gender on neurosurgical training, family planning, and workplace culture. Neurosurg Focus 2021; 50:E11. [PMID: 33789233 DOI: 10.3171/2020.12.focus20965] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/16/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In 2008, a Women in Neurosurgery Committee white paper called for increased women applicants and decreased women's attrition in neurosurgery. However, contributing factors (work-life balance, lack of female leadership, workplace gender inequality) have not been well characterized; therefore, specific actions cannot be implemented to improve these professional hurdles. This study provides an update on the experiences of neurosurgeons in 2020 with these historical challenges. METHODS An anonymous online survey was sent to all Accreditation Council for Graduate Medical Education (ACGME)-accredited US neurosurgical programs, examining demographics and experiences with mentorship, family life, fertility, and workplace conduct. RESULTS A total of 115 respondents (64 men, 51 women; age range 25-67 years) had trained at 49 different US residencies. Mentorship rates were very high among men and women in medical school and residency. However, women were significantly more likely than men to have a female mentor in residency. During residency, 33% of women versus 44% of men had children, and significantly fewer women interested in having a child were able to do so in residency, compared to men. Significantly more women than men had a child only during a nonclinical year (56.3% vs 19.0%, respectively). Thirty-nine percent of women and 25% of men reported difficulty conceiving. The major difficulty for men was stress, whereas women reported the physical challenges of pregnancy itself (workplace teratogens, morning sickness, etc.). Failed birth rates peaked during residency (0.33) versus those before (0.00) and after residency (0.25).Women (80%) experience microaggressions in the workplace significantly more than men (36%; p < 0.001). Ninety-five percent of macro-/microaggressions toward female neurosurgeons were about their gender, compared to 9% of those toward men (p < 0.001). The most common overall perpetrators were senior male residents and attendings, followed by male patients (against women) and female nurses or midlevel providers (against men). CONCLUSIONS Accurate depictions of neurosurgery experiences and open discussions of the potential impacts of gender may allow for 1) decreased attrition due to more accurate expectations and 2) improved characterization of gender differences in neurosurgery so the profession can work to address gender inequality.
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Affiliation(s)
- Jasmine A Thum
- 1Department of Neurosurgery, University of California, Los Angeles
| | - Diana Chang
- 2Department of Neurosurgery, UCSF School of Medicine, University of California, San Francisco, California; and
| | - Nalini Tata
- 3Department of Neurosurgery, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Linda M Liau
- 1Department of Neurosurgery, University of California, Los Angeles
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Hdeib A, Elder T, Krivosheya D, Ojukwu DI, Wijesekera O, Defta D, Ben-Haim S, Benzil DL. History of Women in Neurosurgery (WINS). Neurosurg Focus 2021; 50:E16. [PMID: 33789228 DOI: 10.3171/2020.12.focus20944] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 12/22/2020] [Indexed: 11/06/2022]
Abstract
In 2020, the Women in Neurosurgery (WINS) organization, a joint section of the AANS and Congress of Neurological Surgeons, celebrated 30 years since its inception. In this paper, the authors explore the history of WINS from its beginnings through its evolution over the past three decades. The achievements of the group are highlighted, as well as the broader achievements of the women in the neurosurgical community over this time period.
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Affiliation(s)
- Alia Hdeib
- 1University Hospitals, Case Western Reserve University, Cleveland, Ohio
| | - Theresa Elder
- 1University Hospitals, Case Western Reserve University, Cleveland, Ohio
| | - Daria Krivosheya
- 2Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Disep I Ojukwu
- 3St. George's University School of Medicine, St. George, Grenada; and
| | - Olindi Wijesekera
- 1University Hospitals, Case Western Reserve University, Cleveland, Ohio
| | - Dana Defta
- 1University Hospitals, Case Western Reserve University, Cleveland, Ohio
| | | | - Deborah L Benzil
- 2Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio
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Pastor-Cabeza M, Torné R, García-Armengol R, Menéndez-Osorio B, Mosteiro-Cadaval A, Bollar A, Rimbau JM, Sarabia R, Rodríguez-Hernández A. Women's role in neurosurgical research: is the gender gap improving? Neurosurg Focus 2021; 50:E6. [PMID: 33789230 DOI: 10.3171/2020.12.focus20911] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The percentage of women publishing high-impact neurosurgical research might be perceived as a representation of our specialty and may influence the perpetuation of the existing gender gap. This study investigated whether the trend in women taking lead roles in neurosurgical research has mirrored the increase in female neurosurgeons during the past decade and whether our most prestigious publications portray enough female role models to stimulate gender diversity among the new generation of neurosurgeons. METHODS Two of the most prominent neurosurgical journals-Journal of Neurosurgery and Neurosurgery-were selected for this study, and every original article that was published in 2009 and 2019 in each of those journals was investigated according to the gender of the first and senior authors, their academic titles, their affiliations, and their institutions' region. RESULTS A total of 1328 articles were analyzed. The percentage of female authors was significantly higher in Europe and Russia compared with the US and Canada (first authors: 60/302 [19.9%] vs 109/829 [13.1%], p = 0.005; and senior authors: 32/302 [10.6%] vs 57/829 [6.9%], p = 0.040). Significantly increased female authorship was observed from 2009 to 2019, and overall numbers of both first and senior female authors almost doubled. However, when analyzing by regions, female authorship increased significantly only in the US and Canada. Female authors of neurosurgical research articles were significantly less likely to hold an MD degree compared with men. Female neurosurgeons serving as senior authors were represented in only 3.6% (48/1328) of articles. Women serving as senior authors were more likely to have a female colleague listed as the first author of their research (29/97 [29.9%] vs 155/1231 [12.6%]; χ2 = 22.561, p = 0.001). CONCLUSIONS Although this work showed an encouraging increase in the number of women publishing high-impact neurosurgical research, the stagnant trend in Europe may suggest that a glass ceiling has been reached and further advances in equity would require more aggressive measures. The differences in the researchers' profiles (academic title and affiliation) suggest an even wider gender gap. Cultural unconscious bias may explain why female senior authors have more than double the number of women serving as their junior authors compared with men. While changes in the workforce happen, strategies such as publishing specific issues on women, encouraging female editorials, and working toward more gender-balanced editorial boards may help our journals to portray a more equitable specialty that would not discourage bright female candidates.
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Affiliation(s)
- Marta Pastor-Cabeza
- 1Department of Neurosurgery, Germans Trias i Pujol University Hospital, Barcelona
| | - Ramon Torné
- 2Department of Neurosurgery, Hospital Clinic de Barcelona, Universidad de Barcelona
| | | | | | | | - Alicia Bollar
- 3Department of Neurosurgery, Donostia University Hospital, Guipúzcoa; and
| | - Jordi M Rimbau
- 1Department of Neurosurgery, Germans Trias i Pujol University Hospital, Barcelona
| | - Rosario Sarabia
- 4Department of Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain
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Ganju A, Mahajan UV, Kemeny H, Frankel HG, Benzil DL. Slow progress in the visibility of women in neurosurgery in the United States: opportunity for improvement. Neurosurg Focus 2021; 50:E10. [PMID: 33789226 DOI: 10.3171/2020.12.focus20919] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/16/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The goal of this study was to analyze the visibility of women within organized neurosurgery, including leadership positions, lectureships, and honored guest/award recipients at neurosurgical conferences. METHODS A cross-sectional study was used to analyze the gender demographics within the five major national neurosurgical societies (Congress of Neurological Surgeons [CNS], American Association of Neurological Surgeons [AANS], Society of Neurological Surgeons [SNS], American Board of Neurological Surgery [ABNS], and Council of State Neurosurgical Societies [CSNS]) from 2000 to 2020. Data for top leadership positions, keynote speakers, honored guests, and invited lectureships at these neurosurgical societies were reviewed. Additionally, national neurosurgical residency match data from 2018 to 2020 were collected. For each aforementioned data point, gender was determined and confirmed via publicly available data. Data from the US News and World Report best hospitals publication for 2020 were applied for analyzing gender trends within neurosurgical residencies specifically. RESULTS In the past 2 decades (2000-2020), top leadership positions across the neurosurgical organizations were held by 45 individuals, of whom 5 (11.1%) were women. Spanning from 2000 to 2018, just 8.1% (50 of 618) of guests/honored speakers on the national neurosurgical stage of the CNS, AANS, SNS, and CSNS meetings have been female. Excluding the Louise Eisenhardt Lecture (honoring women), the percentage of female guests/honored speakers at the AANS meeting was just 5% (17 of 367). For the CNS annual meetings, 13.4% (20 of 149) of the speakers were women from 2000 to 2018, whereas the CSNS annual meeting data from 2001 to 2018 found that 11.9% (7 of 59) of speakers were women. From 1952 to the present, there have been no female honored guests at the CNS annual meeting. Across the residency match cycles from 2018 to 2020, the percentages of matched applicants identifying as female have been 22.7%, 28.1%, and, most recently, 25.3%. The percentage of female residents is 28.5% (top 20 program) versus 24.3% (non-top 20 program) (p = 0.267). CONCLUSIONS This study found that for all the data points surveyed, including leadership positions, invited lectureships at national neurosurgical meetings, and successful neurosurgical residency applicants, disproportionate female underrepresentation was evident. Consistent lack of visibility leads to a negative impact on progress in the recruitment and retention of women in neurosurgery. Visibility, mentorship, role models, and sponsorship are highly interrelated processes and are essential for meaningful progress.
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Affiliation(s)
- Aruna Ganju
- 1Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - Uma V Mahajan
- 2Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland; and.,3Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Hanna Kemeny
- 1Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - H Gregory Frankel
- 1Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - Deborah L Benzil
- 2Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland; and
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Lulla T, Behmer Hansen RT, Smith CA, Silva NA, Patel NV, Nanda A. Women neurosurgeons around the world: a systematic review. Neurosurg Focus 2021; 50:E12. [PMID: 33789239 DOI: 10.3171/2020.12.focus20902] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Gender disparities in neurosurgery have persisted even as the number of female medical students in many countries has risen. An understanding of the current gender distribution of neurosurgeons around the world and the possible factors contributing to country-specific gender disparities is an important step in improving gender equity in the field. METHODS The authors performed a systematic review of studies pertaining to women in neurosurgery. Papers listed in PubMed in the English language were collected. A modified grounded theory approach was utilized to systematically identify and code factors noted to contribute to gender disparities in neurosurgery. Statistical analysis was performed with IBM SPSS Statistics for Windows. RESULTS The authors identified 39 studies describing the density of women neurosurgeons in particular regions, 18 of which documented the proportion of practicing female neurosurgeons in a single or in multiple countries. The majority of these studies were published within the last 5 years. Eight factors contributing to gender disparity were identified, including conference representation, the proverbial glass ceiling, lifestyle, mentoring, discrimination, interest, salary, and physical burden. CONCLUSIONS The topic of women in neurosurgery has received considerable global scholarly attention. The worldwide proportion of female neurosurgeons varies by region and country. Mentorship was the most frequently cited factor contributing to noted gender differences, with lifestyle, the glass ceiling, and discrimination also frequently mentioned. Future studies are necessary to assess the influence of country-specific sociopolitical factors that push and pull individuals of all backgrounds to enter this field.
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Affiliation(s)
- Tina Lulla
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | | | - Cynthia A Smith
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Nicole A Silva
- 2Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina
| | - Nitesh V Patel
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Anil Nanda
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
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Woodfield J, Copley PC, Hughes M, Edlmann E. The gender gap in European neurosurgical conference presentations. Neurosurg Focus 2021; 50:E7. [PMID: 33789241 DOI: 10.3171/2020.12.focus20885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Within neurosurgery, there are fewer women than men at all levels. The authors aimed to assess whether opportunities and representation within neurosurgery are proportional to the existing gender gap. METHODS The authors analyzed the program of the 2019 joint European Association of Neurosurgical Societies (EANS)/Society of British Neurological Surgeons (SBNS) conference to assess the proportions of presentations given through abstract submission and invitation by men and women. They compared proportions to the previous joint conference in 2007 and to the gender proportions of board-certified European neurosurgeons. RESULTS Women delivered 75/577 (13%) presentations at the 2019 EANS/SBNS conference: 54/283 (19%) abstract submissions and 21/294 (7%) invited presentations. Fifteen of 152 (10%) session chairs were women. This increased significantly from 4/121 (3%) presentations delivered by women in 2007. When only presentations given by neurosurgeons (residents or consultants) were analyzed, the proportion of female speakers increased from 1/111 (1%) in 2007 to 60/545 (11%) in 2019. Pediatrics was the subspecialty with the highest proportion of invited female speakers. Across subspecialties, there were no differences in gender proportions for presentations from abstract submissions. Across the top 5 participating European countries, the proportion of female invited speakers (8%) and chairs (8%) was half the proportion of female board-certified neurosurgeons (16%). CONCLUSIONS The proportion of women delivering invited presentations and chairing sessions at a European neurosurgical conference is lower than expected from the available pool of board-certified neurosurgeons. The proportion of women participating is higher through application (abstract submission) than through invitation. The higher proportion of presentations from abstract submission may reflect submission from a pool of trainees with a higher proportion of women. The authors suggest implementation of strategies that increase invited speakers from minority groups and have been shown to be effective in other disciplines, such as improving minority group representation in organizing committees.
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Affiliation(s)
- Julie Woodfield
- 1Department of Clinical Neurosciences, NHS Lothian, Edinburgh.,2Centre for Clinical Brain Sciences, University of Edinburgh
| | | | - Mark Hughes
- 1Department of Clinical Neurosciences, NHS Lothian, Edinburgh.,2Centre for Clinical Brain Sciences, University of Edinburgh
| | - Ellie Edlmann
- 3Southwest Neurosurgical Centre, Derriford Hospital, Plymouth; and.,4University of Plymouth Faculty of Health: Medicine, Dentistry and Human Sciences, Plymouth, United Kingdom
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Amarouche M, Uberti M, Evans GYHR, Singh N. Women in neurosurgery: where does the United Kingdom stand? Neurosurg Focus 2021; 50:E14. [PMID: 33789224 DOI: 10.3171/2020.12.focus20957] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/28/2020] [Indexed: 11/06/2022]
Abstract
Despite over half of medical students in the United Kingdom (UK) being female, women represent only a small proportion of the workforce in the traditional "male" specialties, including neurosurgery. There is increasing global attention to and awareness of gender discrimination in the workplace across several industries, including health care. The authors set out to explore the opinions and attitudes of UK neurosurgeons and neurosurgery trainees on gender issues via a large-scale national survey. The results highlight key perceptions and gaps in mentorship and leadership and provide ideas for change. This should be used as a foundation to delve deeper and to address specific questions in order to achieve a fairer, more meritocratic environment in which neurosurgeons can thrive.
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Affiliation(s)
- Meriem Amarouche
- 1Department of Neurosurgery, John Radcliffe University Hospital, Oxford
| | - Micaela Uberti
- 2Department of Neurosurgery, St. George's University Hospital, London; and
| | | | - Navneet Singh
- 2Department of Neurosurgery, St. George's University Hospital, London; and
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Sadler SJ, Yuki Ip HK, Kim E, Karekezi C, Robertson FC. Investing in the future: a call for strategies to empower and expand representation of women in neurosurgery worldwide. Neurosurg Focus 2021; 50:E8. [PMID: 33789242 DOI: 10.3171/2020.12.focus20963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
As progress is gradually being made toward increased representation and retention of women in neurosurgery, the neurosurgical community should elevate effective efforts that may be driving positive change. Here, the authors describe explicit efforts by the neurosurgery community to empower and expand representation of women in neurosurgery, among which they identified four themes: 1) formal mentorship channels; 2) scholarships and awards; 3) training and exposure opportunities; and 4) infrastructural approaches. Ultimately, a data-driven approach is needed to improve representation and empowerment of women in neurosurgery and to best direct the neurosurgical community's efforts across the globe.
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Affiliation(s)
| | - Ho Kei Yuki Ip
- 2Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eliana Kim
- 3University of California, San Francisco School of Medicine, San Francisco, California
| | - Claire Karekezi
- 4Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda; and
| | - Faith C Robertson
- 5Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
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McClelland Iii S, Huang CC, Zellars RC, Jaboin JJ. Gender-based analysis of the academic paediatric radiation oncology workforce. Postgrad Med J 2021; 98:e22. [PMID: 33541929 DOI: 10.1136/postgradmedj-2020-139543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Shearwood McClelland Iii
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Christina C Huang
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Richard C Zellars
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jerry J Jaboin
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon, USA
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Mittelman A, Palmer M, Dugas J, Spector JA, McCabe K, Sheng AY. A Nationwide Survey of Program Directors on Resident Attrition in Emergency Medicine. West J Emerg Med 2020; 22:86-93. [PMID: 33439812 PMCID: PMC7806332 DOI: 10.5811/westjem.2020.10.48286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Despite the burdens that resident attrition places upon programs and fellow trainees, emergency medicine (EM) as a specialty has only begun to explore the issue. Our primary objectives were to quantify attrition in EM residency programs and elucidate the reasons behind it. Our secondary objectives were to describe demographic characteristics of residents undergoing attrition, personal factors associated with attrition, and methods of resident replacement. METHODS We conducted a national survey study of all EM program directors (PDs) during the 2018-2019 academic year. PDs were asked to identify all residents who had left their program prior to completion of training within the last four academic years (2015-2016 to 2018-2019), provide relevant demographic information, select perceived reasons for attrition, and report any resident replacements. Frequencies, percentages, proportions, and 95% confidence intervals were obtained for program- and resident-specific demographics. We performed Fisher's exact tests to compare reasons for attrition between age groups. RESULTS Of 217 PDs successfully contacted, 118 completed the questionnaire (response rate of 54%). A third of programs (39 of 118) reported at least one resident attrition. A total of 52 residents underwent attrition. Attrition was most likely to occur prior to completion of two years of training. Gender and underrepresented minority status were not associated with attrition. Older residents were more likely to leave due to academic challenges. The most common reported reason for attrition was to switch specialties. Resident replacement was found in 42% of cases. CONCLUSION One-third of programs were affected by resident attrition. Gender and underrepresented minority status were not associated with attrition.
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Affiliation(s)
- Andrew Mittelman
- Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Madeline Palmer
- Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Julianne Dugas
- Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Jordan A Spector
- Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Kerry McCabe
- Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Alexander Y Sheng
- Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts
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Sabourin S, Omoruan M, Khazen O, DiMarzio M, Sofatzis T, Staples S, Feustel PJ, Petersen E, Casini G, Spinoza ZT, Pilitsis JG. Diversity in Neuromodulators: Where We Are and Where We Need to Go. Neuromodulation 2020; 23:145-149. [PMID: 32103592 DOI: 10.1111/ner.13114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shelby Sabourin
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Moje Omoruan
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Olga Khazen
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Marisa DiMarzio
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Tia Sofatzis
- International Neuromodulation Society, San Francisco, CA, USA
| | - Sarah Staples
- International Neuromodulation Society, San Francisco, CA, USA.,Staples, Etc., LLC, Kalamazoo, MI, USA
| | - Paul J Feustel
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Erika Petersen
- International Neuromodulation Society, San Francisco, CA, USA.,Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Gianna Casini
- International Neuromodulation Society, San Francisco, CA, USA.,Department of Pain Management, Parkview Physician's Group, Fort Wayne, IN, USA
| | - Zulma T Spinoza
- International Neuromodulation Society, San Francisco, CA, USA.,Department of Neurosurgery, Upstate University Hospital, Syracuse, NY, USA
| | - Julie G Pilitsis
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA.,International Neuromodulation Society, San Francisco, CA, USA.,Department of Neurosurgery, Albany Medical Center, Albany, NY, USA
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Dossani RH, Terrell D, Kosty JA, Ross RC, Demand A, Wild E, Peterson R, Ngwenya LB, Benzil DL, Notarianni C. Gender disparities in academic rank achievement in neurosurgery: a critical assessment. J Neurosurg 2020; 133:1922-1927. [PMID: 31703191 DOI: 10.3171/2019.8.jns191219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/28/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate whether there are disparities in academic rank and promotion between men and women neurosurgeons. METHODS The profiles of faculty members from 50 academic neurosurgery programs were reviewed to identify years in practice, number of PubMed-indexed publications, Doctor of Philosophy (PhD) attainment, and academic rank. The number of publications at each academic rank was compared between men and women after controlling for years in practice by using a negative binomial regression model. The relationship between gender and each academic rank was also determined after controlling for clustering at the institutional level, years in practice, and number of publications. RESULTS Of 841 faculty members identified, 761 (90%) were men (p = 0.0001). Women represented 12% of the assistant and associate professors but only 4% of the full professors. Men and women did not differ in terms of the percentage holding a PhD, years in practice, or number of publications at any academic rank. After controlling for years in practice and clustering at the facility level, the authors found that men were twice as likely as women to be named full professor (OR 2.2, 95% CI 1.09-4.44, p = 0.03). However, when institution, years in practice, PhD attainment, h-index, and number of publications were considered, men and women were equally likely to attain full professorship (OR 0.9, 95% CI 0.42-1.93). CONCLUSIONS Data analysis of the top neurosurgery programs suggests that although there are fewer women than men holding positions in academic neurosurgery, faculty rank attainment does not seem to be influenced by gender.
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Affiliation(s)
- Rimal H Dossani
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Danielle Terrell
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Jennifer A Kosty
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Robert C Ross
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Audrey Demand
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Elizabeth Wild
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Racheal Peterson
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Laura B Ngwenya
- 2Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio; and
| | - Deborah L Benzil
- 3Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Christina Notarianni
- 1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
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Crammond MBiostat BR, Janakiramanan N, Ganau M, Verran D, Lippa L, Braman J, Rabiei K. Letter to the Editor. Academic rank achievement by gender. J Neurosurg 2020; 133:1973-1976. [PMID: 32217796 DOI: 10.3171/2020.1.jns2052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Mario Ganau
- 3Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | | | | | - Jonathan Braman
- 6University of Minnesota Medical School, Minneapolis, MN; and
| | - Katrin Rabiei
- 7Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
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Mahajan UV, Wadhwa H, Fatemi P, Xu S, Shan J, Benzil DL, Zygourakis CC. Does double-blind peer review impact gender authorship trends? An evaluation of two leading neurosurgical journals from 2010 to 2019. J Neurosurg 2020; 135:352–360. [PMID: 33186905 DOI: 10.3171/2020.6.jns20902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Publications are key for advancement within academia. Although women are underrepresented in academic neurosurgery, the rates of women entering residency, achieving board certification, and publishing papers are increasing. The goal of this study was to assess the current status of women in academic neurosurgery publications. Specifically, this study sought to 1) survey female authorship rates in the Journal of Neurosurgery (JNS [not including JNS: Spine or JNS: Pediatrics]) and Neurosurgery from 2010 to 2019; 2) analyze whether double-blind peer review (started in Neurosurgery in 2011) altered female authorship rates relative to single-blind review (JNS); and 3) evaluate how female authorship rates compared with the number of women entering neurosurgery residency and obtaining neurosurgery board certification. METHODS Genders of the first and last authors for JNS and Neurosurgery articles from 2010 to 2019 were obtained. Data were also gathered on the number and percentage of women entering neurosurgery residency and women obtaining American Board of Neurological Surgeons (ABNS) certification between 2010 and 2019. RESULTS Women accounted for 13.4% (n = 570) of first authors and 6.8% (n = 240) of last authors in JNS and Neurosurgery publications. No difference in rates of women publishing existed between the two journals (first authors: 13.0% JNS vs 13.9% Neurosurgery, p = 0.29; last authors: 7.3% JNS vs 6.0% Neurosurgery, p = 0.25). No difference existed between women first or last authors in Neurosurgery before and after initiation of double-blind review (p = 0.066). Significant concordance existed between the gender of first and last authors: in publications with a woman last author, the odds of the first author being a woman was increased by twofold (OR 2.14 [95% CI 1.43-3.13], p = 0.0001). Women represented a lower proportion of authors of invited papers (8.6% of first authors and 3.1% of last authors were women) compared with noninvited papers (14.1% of first authors and 7.4% of last authors were women) (first authors: OR 0.576 [95% CI 0.410-0.794], p = 0.0004; last authors: OR 0.407 [95% CI 0.198-0.751], p = 0.001). The proportion of women US last authors (7.4%) mirrors the percentage of board-certified women neurosurgeons (5.4% in 2010 and 6.8% in 2019), while the percentage of women US first authors (14.3%) is less than that for women entering neurosurgical residency (11.2% in 2009 and 23.6% in 2018). CONCLUSIONS This is the first report of female authorship in the neurosurgical literature. The authors found that single- versus double-blind peer review did not impact female authorship rates at two top neurosurgical journals.
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Affiliation(s)
- Uma V Mahajan
- 1School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Harsh Wadhwa
- 2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Parastou Fatemi
- 2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Samantha Xu
- 1School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Judy Shan
- 3University of California at Berkeley, California; and
| | | | - Corinna C Zygourakis
- 2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
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Hope C, Reilly JJ, Griffiths G, Lund J, Humes D. Factors Associated with Attrition and Performance Throughout Surgical Training: A Systematic Review and Meta-Analysis. World J Surg 2020; 45:429-442. [PMID: 33104833 PMCID: PMC7773620 DOI: 10.1007/s00268-020-05844-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 11/18/2022]
Abstract
Background Attrition within surgical training is a challenge. In the USA, attrition rates are as high as 20–26%. The factors predicting attrition are not well known. The aim of this systematic review is to identify factors that influence attrition or performance during surgical training. Method The review was performed in line with PRISMA guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched for articles. Risk of bias was assessed using the Newcastle–Ottawa scale. Pooled estimates were calculated using random effects meta-analyses in STATA version 15 (Stata Corp Ltd). A sensitivity analysis was performed including only multi-institutional studies. Results The searches identified 3486 articles, of which 31 were included, comprising 17,407 residents. Fifteen studies were based on multi-institutional data and 16 on single-institutional data. Twenty-nine of the studies are based on US residents. The pooled estimate for overall attrition was 17% (95% CI 14–20%). Women had a significantly higher pooled attrition than men (24% vs 16%, p < 0.001). Some studies reported Hispanic residents had a higher attrition rate than non-Hispanic residents. There was no increased risk of attrition with age, marital or parental status. Factors reported to affect performance were non-white ethnicity and faculty assessment of clinical performance. Childrearing was not associated with performance. Conclusion Female gender is associated with higher attrition in general surgical residency. Longitudinal studies of contemporary surgical cohorts are needed to investigate the complex multi-factorial reasons for failing to complete surgical residency. Electronic supplementary material The online version of this article (10.1007/s00268-020-05844-0) contains supplementary material, which is available to authorised users.
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Affiliation(s)
- Carla Hope
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK.
| | - John-Joe Reilly
- Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | | | - Jon Lund
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK
| | - David Humes
- Division of Epidemiology and Public Health, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK
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Abstract
The number of women entering medicine significantly increased over the last decades. Currently, over half of the medical students are women but less than half are applying to surgery and even less go on to surgical specialties. Even fewer women are seen in leadership roles throughout the profession of surgery and surgical residency. Our purpose of the literature review is to identify any themes, which would provide insight to the current phenomenon. We used the Preferred Reporting Items for Systemic Reviews and Meta-Analyses method for a systematic review of the literature over a 20-year period (1998–2018). Five broad themes were identified: education and recruitment, career development, impact of/on life around the globe and surgical subspecialties as areas of barriers for women entering or considering surgery. The systematic review suggests there are opportunities to improve and encourage women entering the profession of surgery as well as the quality of life for surgeons. Creating systems for mentorship across programmes, having policies to support work–life balance and recognising surgical training overlaps with childbearing years are key opportunities for improvement. Improving the current status in surgery will require direction from leadership.
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