Female Participation in Academic European Neurosurgery-A Cross-Sectional Analysis

Does gender diversity affect the number and impact of publications among major academic institutes in India? Barriers and opportunities

BACKGROUND

A glaring gender inequality persists in global neurosurgery, influenced by various factors, including the notion that female neurosurgeons have lower academic output. This study aims to compare the research output of female and male neurosurgeons at the leading academic institutions in India.

METHODS

The pertinent details regarding female neurosurgeons were collected from the Neurological Society of India (NSI) and Women In Neurosurgery (India) database. The institutes with at least five neurosurgery faculty recognised by the Medical Council of India (MCI) were included in the study. Various bibliometric parameters of male and female faculty at these academic centres were collected and compared using PubMed and Web of Science databases.

RESULTS

Among the 2643 neurosurgeons in NSI, 113 were females (4.27%). Out of 156 faculty members across eighteen academic institutions, only seven (4.7%) were female, with eleven institutions lacking female faculty. Female academic neurosurgeons had slightly higher h-index (9.57 vs. 9.56), citation per publication (8.82 vs. 8.54), and original article percentage (47.5 vs. 46.5) compared to males. They also had more citations per year (34.01 vs. 33.17), while males had more total publications (51.19 vs. 46.71) and citations (565.22 vs. 533.57), but these differences weren't statistically significant. Only 4.1% (327/7955) of neurosurgery research was contributed by females. Female neurosurgeons authored articles received 3735 citations (4.2%) out of 87,953 total citations.

CONCLUSION

Female academic neurosurgeons in India exhibit comparable or superior academic output compared to their male counterparts, suggesting gender equality or even superiority in certain aspects of academic performance.

Women in leadership positions in European neurosurgery - Have we broken the glass ceiling?

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.

Transnational Capacity Building Efforts in Global Neurosurgery: A Review and Analysis of Their Impact and Determinants of Success

BACKGROUND

Neurosurgical capacity building efforts attempt to address the shortage of neurosurgeons and lack of neurosurgical capacity in low- and middle-income countries. This review sought to characterize neurosurgical capacity building efforts in low- and middle-income countries and the challenges they face, and identify factors that predict higher engagement, better training, and performance of high-impact activities.

METHODS

A scoping review using PubMed and Embase databases was performed and relevant articles were identified. Programs were classified into 6 categories and the activities they performed were classified as having a high-, medium-, or mild impact on capacity. Programs were also classified using the Olivieri engagement and training criteria.

RESULTS

Fifty-seven articles representing 42 unique efforts were included. The most important determinant of impact was a program's design and intent. Furthermore, 91% of training and twinning programs received high (class 2 or 3) engagement classifications compared to 17% of mission trips and training camps (P < 0.001); 91% of training and twinning programs received high training classifications compared to 64% of mission trips and training camps (P = 0.015); and 91% of training and twinning programs reported performing high-impact activities compared to 29% of mission trips and training camps (P < 0.001).

CONCLUSIONS

Training and twinning programs are more engaged, offer better training, and are more likely to perform high-impact activities compared to mission trips and training camps, suggesting that these types of programs offer the greatest chance of producing substantial and sustainable improvements to neurosurgical capacity.

Women in Neurosurgery: A PRISMA-Compliant Systematic Review of Where We Stand and a Pilot Study on How to Move Forward

BACKGROUND

Surgical specialties struggle to recruit women. In this study, the authors performed a systematic review to describe progress of women in neurosurgery and highlight areas where further research is needed.

METHODS

PubMed, Embase, and Cochrane Library were queried with "women in neurosurgery" OR "female neurosurgeon," and publications with empiric research were included. Bias was assessed on the basis of study designs.

RESULTS

We found 127 papers, and 36 met inclusion criteria. Much of this research is recent-85% has been published within the past 3 years. These papers detail differences between genders and examine possible causes, but they do not test interventions to remedy inequities. The authors designed an intervention focusing on medical students' perceptions of gender issues within neurosurgery. A seminar was designed with 2 objectives: inform medical students about changes within neurosurgery and introduce them to a female neurosurgery attending who could serve as a potential future mentor. Student attitudes were assessed before and after the seminar by survey. Fourteen students completed both surveys: 10 females and 4 males.

CONCLUSIONS

The 1-hour seminar significantly reduced the mean perceived difficulty to enter neurosurgery from 4.4 to 4.1 (P = 0.014); additionally, the mean perceived additional difficulty for career advancement faced by women in neurosurgery decreased from 3.6 to 2.8 (P = 0.026). Much research has gone into documenting the advancement and potential impediments for women in neurosurgery. Less research has tested solutions. Our pilot was small and susceptible to bias, but given that some results achieved significance, it merits more rigorous study.