Fellowship, gender, and scholarly productivity: trends among academic neurosurgeons in the US

Abstract

OBJECTIVECurrent 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.METHODSThe 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.RESULTSOf 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).CONCLUSIONSWomen 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.

International trends in grant and fellowship funding awarded to women in neurosurgery

“…Additionally, men had higher scholarly productivity in every subspecialty of neurosurgery despite proportionally more females completing neurosurgical fellowships and having similar or higher levels of research output later in their careers. 22 Within other specialties, such as otolaryngology, male PIs were found to have higher average NIH funding totals compared to female PIs, even when adjusted for academic rank and active years. 23 Men also tended to receive more prestigious grants or grants with more funding compared to women in several specialties.…”

A step toward equal representation? A cross-sectional analysis of the gender composition of neurosurgical editorial boards from 2000 to 2020

“…20 In addition, researchers found that females had an overall lower H-index in every neurosurgical subspecialty, despite having higher rates of fellowship completion. 15 However, in reporting these differences in H-indices and additional graduate degrees, we cannot make a truly objective statement about these trends given that we were not able to control for length of practice or age of the individuals.…”

“…This trend may not be surprising as recent studies have found that significant barriers exist for females, especially in research productivity and academia. [13][14][15] Even though there was a significant increase in female first authorship for neurosurgery journals between 2013 and 2018, there was no increase in senior authorship, and there were significantly fewer publications by females than males overall. 13 This decreased productivity also manifests in neurological research conferences, where females constituted a minority of speakers from 2014 to 2018 and were generally underrepresented.…”

“…13 Compared to males, there are significantly fewer females who are promoted to full professorship, and some institutions do not have any full-time female neurosurgery faculty members. [14][15][16] Furthermore, of the females serving as faculty members, they are more likely to hold advanced degrees than their male counterparts. 17 In addition, most neurosurgery departments only have a small minority of females in leadership positions and even fewer females serving as department chairs.…”

Increases in female academic productivity and female mentorship highlight sustained progress in previously identified neurosurgical gender disparities

“…23 Furthermore, despite the fact that women had increased fellowship completion over their male counterparts, women still had lower scholarly productivity. 27 Mentorship, as described in this study, is to be distinguished from sponsorship. Sponsorship is the use of one's own advanced status to advocate for the advancements and opportunities for the mentee.…”