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Weiss M, Dogan R, Jeltema HR, Hatipoglu Majernik G, Venturini S, Ryang YM, Darie L, Engel D, Ferreira A, Ilic T, Lawson McLean AC, Malli A, Mielke D, Vanchaze K, Hernández-Durán S. Women in leadership positions in European neurosurgery - Have we broken the glass ceiling? BRAIN & SPINE 2023; 3:101777. [PMID: 37701290 PMCID: PMC10493481 DOI: 10.1016/j.bas.2023.101777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 09/14/2023]
Abstract
Introduction The proportion of male neurosurgeons has historically been higher than of women, although at least equal numbers of women have been entering European medical schools. The Diversity Committee (DC) of the European Association of Neurosurgical Societies (EANS) was founded recently to address this phenomenon. Research question In this cross-sectional study, we aimed to characterize the status quo of female leadership by assessing the proportion of women heading European neurosurgical departments. Material and methods European neurosurgical departments were retrieved from the EANS repository. The gender of all department chairs was determined via departmental websites or by personal contact. The proportion of females was stratified by region and by type of hospital (university versus non-university). Results A total of 41 (4.3%) female department chairs were identified in 961 neurosurgery departments in 41 European countries. Two thirds (68.3%) of European countries do not have a female neurosurgery chair. The highest proportion of female chairs was found in Northern Europe (11.1%), owing to four female chairs in a relatively small number of departments (n = 36). The proportions were considerably smaller in Western Europe (n = 17/312 (5.5%)), Southern Europe (n = 14/353 (4.0%)) and Central and Eastern Europe (n = 6/260 (2.3%)) (p = 0.06). The distribution of female chairs in university (n = 19 (46.3%)) versus non-university departments (n = 22 (53.7%)) was even. Discussion and Conclusion There is a significant gender imbalance with 4% of all European neurosurgery departments headed by women. The DC intends to develop strategies to support equal chances and normalize the presence of female leaders in European neurosurgery.
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Affiliation(s)
- Miriam Weiss
- Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Rabia Dogan
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Gökce Hatipoglu Majernik
- Department of Neurosurgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sara Venturini
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Yu-Mi Ryang
- Department of Neurosurgery & Center for Spine Therapy, HELIOS Hospital Berlin Buch, Berlin, Germany
- Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Lucia Darie
- Department of Neurosurgery, University College London Hospitals, London, United Kingdom
| | - Doortje Engel
- Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen, Germany
| | - Anna Ferreira
- Department of Clinical Neuroscience and Mental Health, Faculdade de Medicina da Universidade Do Porto, Portugal
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Tijana Ilic
- Department of Neurosurgery, Centre Hospitalier Du Luxembourg, Luxembourg
| | | | - Antonia Malli
- Department of Neurosurgery, The National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Dorothee Mielke
- Department of Neurosurgery, University Medical Center Göttingen, Germany
| | | | | | - for the European Association of Neurosurgical Societies' Diversity Committee
- Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
- Department of Neurosurgery, University Medical Center Groningen, Groningen, the Netherlands
- Department of Neurosurgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Department of Neurosurgery & Center for Spine Therapy, HELIOS Hospital Berlin Buch, Berlin, Germany
- Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Department of Neurosurgery, University College London Hospitals, London, United Kingdom
- Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen, Germany
- Department of Clinical Neuroscience and Mental Health, Faculdade de Medicina da Universidade Do Porto, Portugal
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Neurosurgery, Centre Hospitalier Du Luxembourg, Luxembourg
- Department of Neurosurgery, Jena University Hospital, Jena, Germany
- Department of Neurosurgery, The National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
- Department of Neurosurgery, University Medical Center Göttingen, Germany
- Department of Neurosurgery, St Lucas Hospital, Ghent, Belgium
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Forster MT, Behrens M, Lawson McLean AC, Nistor-Gallo DI, Weiss M, Maurer S. Gender disparity in German neurosurgery. J Neurosurg 2022; 136:1141-1146. [PMID: 34507274 DOI: 10.3171/2021.3.jns21225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/16/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite the rising number of women in higher education and leadership positions, the proportional rise of female neurosurgeons still lags behind these fields. This study evaluates the gender distribution in German neurosurgical departments across all career levels, and is aimed at heightening the awareness of gender disparity and the need for improving gender equality and its related opportunities. METHODS Data on gender distribution across all professional levels in German neurosurgical departments were obtained from departmental websites as well as by email and telephone request. Results were additionally analyzed in reference to hospital ownership type of the neurosurgical departments. RESULTS A total of 140 German neurosurgical departments employing 2324 neurosurgeons were evaluated. The analysis revealed a clear preponderance of men in leadership positions. Only 9 (6.3%) of 143 department heads were women, and there were only 1 (2.4%), 17 (14.5%), and 4 (12.5%) women among 42 vice-directors, 117 chief senior physicians, and 32 managing senior physicians, respectively. Senior physicians not holding a leadership position were female in 23.1%, whereas board-certified neurosurgeons not holding a senior physician position and residents were female in 33.6% and 35.0%, respectively. Of note, the highest proportion of female department heads (15.6%) was found in private hospitals. CONCLUSIONS The number of women in leadership positions in German neurosurgical departments is dramatically low, and with increasing leadership status gender disparity increases. Mentorship, recruitment, the perception of benefits offered by diversity and programs facilitating gender equality, job sharing, parental leave policies, and onsite childcare programs are needed to turn German neurosurgical departments into modern medical departments reflecting the gender profile of the general patient population.
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Affiliation(s)
- Marie-Therese Forster
- 1Department of Neurosurgery, Goethe University Hospital, Frankfurt am Main
- 2University Cancer Center Frankfurt (UCT), Goethe University Hospital, Frankfurt
| | - Marion Behrens
- 3Department of Neurology, Goethe University Hospital, Frankfurt am Main
| | | | | | - Miriam Weiss
- 6Department of Neurosurgery, University Hospital Aachen; and
| | - Stefanie Maurer
- 7Department of Neurosurgery, Vivantes Klinikum Neukölln, Berlin, Germany
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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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Stumpo V, Staartjes VE, Klukowska AM, Golahmadi AK, Gadjradj PS, Schröder ML, Veeravagu A, Stienen MN, Serra C, Regli L. Global adoption of robotic technology into neurosurgical practice and research. Neurosurg Rev 2021; 44:2675-2687. [PMID: 33252717 PMCID: PMC8490223 DOI: 10.1007/s10143-020-01445-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/23/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
Recent technological advancements have led to the development and implementation of robotic surgery in several specialties, including neurosurgery. Our aim was to carry out a worldwide survey among neurosurgeons to assess the adoption of and attitude toward robotic technology in the neurosurgical operating room and to identify factors associated with use of robotic technology. The online survey was made up of nine or ten compulsory questions and was distributed via the European Association of the Neurosurgical Societies (EANS) and the Congress of Neurological Surgeons (CNS) in February and March 2018. From a total of 7280 neurosurgeons who were sent the survey, we received 406 answers, corresponding to a response rate of 5.6%, mostly from Europe and North America. Overall, 197 neurosurgeons (48.5%) reported having used robotic technology in clinical practice. The highest rates of adoption of robotics were observed for Europe (54%) and North America (51%). Apart from geographical region, only age under 30, female gender, and absence of a non-academic setting were significantly associated with clinical use of robotics. The Mazor family (32%) and ROSA (26%) robots were most commonly reported among robot users. Our study provides a worldwide overview of neurosurgical adoption of robotic technology. Almost half of the surveyed neurosurgeons reported having clinical experience with at least one robotic system. Ongoing and future trials should aim to clarify superiority or non-inferiority of neurosurgical robotic applications and balance these potential benefits with considerations on acquisition and maintenance costs.
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Affiliation(s)
- Vittorio Stumpo
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
- School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Victor E Staartjes
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
- Amsterdam UMC, Neurosurgery, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | | | - Aida Kafai Golahmadi
- HARMS (Human-centered Automation, Robotics and Monitoring for Surgery) Laboratory, Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Pravesh S Gadjradj
- Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Neurosurgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Marc L Schröder
- Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands
| | - Anand Veeravagu
- Neurosurgery AI Lab, Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Martin N Stienen
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - Carlo Serra
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - Luca Regli
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
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5
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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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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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Stienen MN, Freyschlag CF, Schaller K, Meling T. Procedures performed during neurosurgery residency in Europe. Acta Neurochir (Wien) 2020; 162:2303-2311. [PMID: 32803372 PMCID: PMC7496021 DOI: 10.1007/s00701-020-04513-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022]
Abstract
Background In a previous article (10.1007/s00701-019-03888-3), preliminary results of a survey, aiming to shed light on the number of surgical procedures performed and assisted during neurosurgery residency in Europe were reported. We here present the final results and extend the analyses. Methods Board-certified neurosurgeons of European Association of Neurosurgical Societies (EANS) member countries were asked to review their residency case logs and participate in a 31-question electronic survey (SurveyMonkey Inc., San Mateo, CA). The responses received between April 25, 2018, and April 25, 2020, were considered. We excluded responses that were incomplete, from non-EANS member countries, or from respondents that have not yet completed their residency. Results Of 430 responses, 168 were considered for analysis after checking in- and exclusion criteria. Survey responders had a mean age of 42.7 ± 8.8 years, and 88.8% were male. Responses mainly came from surgeons employed at university/teaching hospitals (85.1%) in Germany (22.0%), France (12.5%), the United Kingdom (UK; 8.3%), Switzerland (7.7%), and Greece (7.1%). Most responders graduated in the years between 2011 and 2019 (57.7%). Thirty-eight responders (22.6%) graduated before and 130 responders (77.4%) after the European WTD 2003/88/EC came into effect. The mean number of surgical procedures performed independently, supervised or assisted throughout residency was 540 (95% CI 424–657), 482 (95% CI 398–568), and 579 (95% CI 441–717), respectively. Detailed numbers for cranial, spinal, adult, and pediatric subgroups are presented in the article. There was an annual decrease of about 33 cases in total caseload between 1976 and 2019 (coeff. − 33, 95% CI − 62 to − 4, p = 0.025). Variables associated with lesser total caseload during residency were training abroad (1210 vs. 1747, p = 0.083) and female sex by trend (947 vs. 1671, p = 0.111), whereas case numbers were comparable across the EANS countries (p = 0.443). Conclusion The final results of this survey largely confirm the previously reported numbers. They provide an opportunity for current trainees to compare their own case logs with. Again, we confirm a significant decline in surgical exposure during training between 1976 and 2019. In addition, the current analysis reveals that female sex and training abroad may be variables associated with lesser case numbers during residency. Electronic supplementary material The online version of this article (10.1007/s00701-020-04513-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Martin N Stienen
- Department of Neurosurgery, University Hospital Zürich, Zürich, Switzerland.
- Clinical Neuroscience Center, University of Zürich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
- Department of Neurosurgery, Kantonsspital St.Gallen, St.Gallen, Switzerland.
| | | | - Karl Schaller
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Torstein Meling
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Gnanakumar S, Abou El Ela Bourquin B, Robertson FC, Solla DJF, Karekezi C, Vaughan K, Garcia RM, Hassani FD, Alamri A, Höhne J, Mentri N, Stienen M, Laeke T, Moscote-Salazar LR, Al-Ahmari AN, Al-Jehani H, Nicolosi F, Samprón N, Adelson PD, Servadei F, Esene IN, Al-Habib A, Kolias AG. The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education. World Neurosurg X 2020; 8:100083. [PMID: 33103109 PMCID: PMC7573644 DOI: 10.1016/j.wnsx.2020.100083] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/23/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Providing a comprehensive and effective neurosurgical service requires adequate numbers of well-trained, resourced, and motivated neurosurgeons. The survey aims to better understand 1) the demographics of young neurosurgeons worldwide; 2) the challenges in training and resources that they face; 3) perceived barriers; and 4) needs for development. METHODS This was a cross-sectional study in which a widely disseminated online survey (April 2018-November 2019) was used to procure a nonprobabilistic sample from current neurosurgical trainees and those within 10 years of training. Data were grouped by World Bank income classifications and analyzed using χ2 tests because of its categorical nature. RESULTS There were 1294 respondents, with 953 completed responses included in the analysis. Of respondents, 45.2% were from high-income countries (HICs), 23.2% from upper-middle-income countries, 26.8% lower-middle-income countries, and 4.1% from low-income countries. Most respondents (79.8%) were male, a figure more pronounced in lower-income groups. Neuro-oncology was the most popular in HICs and spinal surgery in all other groups. Although access to computed tomography scanning was near universal (98.64%), magnetic resonance imaging access decreased to 66.67% in low-income countries, compared with 98.61% in HICs. Similar patterns were noted with access to operating microscopes, image guidance systems, and high-speed drills. Of respondents, 71.4% had dedicated time for neurosurgical education. CONCLUSIONS These data confirm and quantify disparities in the equipment and training opportunities among young neurosurgeons practicing in different income groups. We hope that this study will act as a guide to further understand these differences and target resources to remedy them.
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Affiliation(s)
- Sujit Gnanakumar
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Bilal Abou El Ela Bourquin
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Faith C. Robertson
- Department. of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Claire Karekezi
- Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Kerry Vaughan
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Roxanna M. Garcia
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Fahd Derkaoui Hassani
- Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco
| | - Alexander Alamri
- Department of Neurosurgery, The Royal London Hospital, London, United Kingdom
| | - Julius Höhne
- Department of Neurosurgery, University Medical Center Regensburg, Regensburg, Germany
| | - Nesrine Mentri
- Department of Neurosurgery, Bejaia University Hospital, Bejaia, Algeria
| | - Martin Stienen
- Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Switzerland
| | - Tsegazeab Laeke
- Department of Surgery, Neurosurgery Unit, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | | | - Ahmed Nasser Al-Ahmari
- Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hosam Al-Jehani
- Department of Neurosurgery, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia
- Neuroscience Center, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Federico Nicolosi
- Department of Neurosurgery, Humanitas University and Research Hospital, Rozzano, Milan, Italy
| | - Nicolás Samprón
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain
| | - P. David Adelson
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Franco Servadei
- Department of Neurosurgery, Humanitas University and Research Hospital, Rozzano, Milan, Italy
| | - Ignatius N. Esene
- Neurosurgery Division, Department of Surgery, University of Bamenda, Bamenda, Cameroon
| | - Amro Al-Habib
- Division of Neurosurgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Angelos G. Kolias
- National Institute for Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge and Addenbrooke's Hospital, Cambridge, United Kingdom
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Demetriades AK, Durán SH, Aldea CC, Gandía-González ML, Broekman MLD, Schaller K. Diversity and equality in neurosurgery. Lancet Neurol 2020; 19:645-646. [PMID: 32702328 DOI: 10.1016/s1474-4422(20)30226-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - Cristina C Aldea
- Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania; Department of Neurosurgery, Cluj County Emergency Hospital, Cluj-Napoca, Romania
| | | | - Marike L D Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Karl Schaller
- Department of Neurosurgery, Geneva University Medical Center and Faculty of Medicine, 1205 Geneva, Switzerland
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Response to: neurosurgical procedures performed during residency in Europe-preliminary numbers and time trends. Acta Neurochir (Wien) 2019; 161:1977-1979. [PMID: 31463709 DOI: 10.1007/s00701-019-04048-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
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Stienen MN, Bartek J, Czabanka MA, Freyschlag CF, Kolias A, Krieg SM, Moojen W, Renovanz M, Sampron N, Adib SD, Schubert GA, Demetriades AK, Ringel F, Regli L, Schaller K, Meling TR. Neurosurgical procedures performed during residency in Europe—preliminary numbers and time trends. Acta Neurochir (Wien) 2019; 161:843-853. [PMID: 30927157 DOI: 10.1007/s00701-019-03888-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/20/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Martin N Stienen
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
- Clinical Neuroscience Center, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
| | - Jiri Bartek
- Department of Clinical Neuroscience and Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Marcus A Czabanka
- Department of Neurosurgery, Charité University Hospital, Berlin, Germany
| | | | - Angelos Kolias
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Wouter Moojen
- HAGA Teaching Hospital and Medical Center Haaglanden, The Hague & Leiden University Medical Center, Leiden, Netherlands
| | - Mirjam Renovanz
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | - Nicolas Sampron
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | - Sasan D Adib
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | | | | | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - Karl Schaller
- Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Torstein R Meling
- Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Geisseler OA, Bigi S, Baumann PS, Bölsterli BK, El Rahal A, d’Honincthun P, Hainc N, Hench J, Kurmann R, Piguet C, Reimann RR, Stienen MN, Tyndall A, Sokolov AA. The SFCNS Young Clinical Neuroscientists Network Cultivating ties across clinical neuroscience disciplines. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2018. [DOI: 10.1177/2514183x18785340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Olivia A Geisseler
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Sandra Bigi
- Department of Neuropediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp S Baumann
- Department of Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP) and Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Bigna K Bölsterli
- Department of Neuropediatrics, University Children’s Hospital, Zurich, Switzerland
| | - Amir El Rahal
- Department of Neurosurgery, University Hospital Geneva, Geneva, Switzerland
| | - Peggy d’Honincthun
- Service of Neuropsychology and Neurorehabilitation, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Nicolin Hainc
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Jürgen Hench
- Institute for Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Rebekka Kurmann
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Camille Piguet
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Regina R Reimann
- Institute of Neuropathology, University Hospital Zurich, Zurich, Switzerland
| | - Martin N Stienen
- Department of Neurosurgery, University Hospital Zurich & Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
| | - Anthony Tyndall
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Arseny A Sokolov
- Service of Neurology, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Stienen MN, Netuka D, Demetriades AK, Ringel F, Gautschi OP, Gempt J, Kuhlen D, Schaller K. Residency program trainee-satisfaction correlate with results of the European board examination in neurosurgery. Acta Neurochir (Wien) 2016; 158:1823-30. [PMID: 27517689 DOI: 10.1007/s00701-016-2917-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Substantial country differences in neurosurgical training throughout Europe have recently been described, ranging from subjective rating of training quality to objective working hours per week. The aim of this study was to analyse whether these differences translate into the results of the written and oral part of the European Board Examination in Neurological Surgery (EBE-NS). METHODS Country-specific composite scores for satisfaction with quality of theoretical and practical training, as well as working hours per week, were obtained from an electronic survey distributed among European neurosurgical residents between June 2014 and March 2015. These were related to anonymous country-specific results of the EBE-NS between 2009 and 2016, using uni- and multivariate linear regression analysis. RESULTS A total of n = 1025 written and n = 63 oral examination results were included. There was a significant linear relationship between the country-specific EBE-NS result in the written part and the country-specific composite score for satisfaction with quality of theoretical training [adjusted regression coefficient (RC) -3.80, 95 % confidence interval (CI) -5.43-7 -2.17, p < 0.001], but not with practical training or working time. For the oral part, there was a linear relationship between the country-specific EBE-NS result and the country-specific composite score for satisfaction with quality of practical training (RC 9.47, 95 % CI 1.47-17.47, p = 0.021), however neither with satisfaction with quality of theoretical training nor with working time. CONCLUSION With every one-step improvement on the country-specific satisfaction score for theoretical training, the score in the EBE-NS Part 1 increased by 3.8 %. With every one-step improvement on the country-specific satisfaction score for practical training, the score in the EBE-NS Part 2 increased by 9.47 %. Improving training conditions is likely to have a direct positive influence on the knowledge level of trainees, as measured by the EBE-NS. The effect of the actual working time on the theoretical and practical knowledge of neurosurgical trainees appears to be insignificant.
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Affiliation(s)
- Martin N Stienen
- Department of Neurosurgery and Faculté de Médicine, University Hospital of Geneva, Geneva, Switzerland.
- Service de Neurochirurgie, Département des Neurosciences Cliniques, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, 1205, Genève, Suisse.
| | - David Netuka
- Department of Neurosurgery, Charles University, 1st Medical Faculty, Central Military Hospital, Prague, Czech Republic
| | | | - Florian Ringel
- Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Department of Neurosurgery, Universitätsmedizin Mainz, Mainz, Germany
| | - Oliver P Gautschi
- Department of Neurosurgery and Faculté de Médicine, University Hospital of Geneva, Geneva, Switzerland
- Service de Neurochirurgie, Département des Neurosciences Cliniques, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, 1205, Genève, Suisse
| | - Jens Gempt
- Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Dominique Kuhlen
- Department of Neurosurgery, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Karl Schaller
- Department of Neurosurgery and Faculté de Médicine, University Hospital of Geneva, Geneva, Switzerland
- Service de Neurochirurgie, Département des Neurosciences Cliniques, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, 1205, Genève, Suisse
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