Women in Neurosurgery Around the World: A Systematic Review and Discussion of Barriers, Training, Professional Development, and Solutions

Shi, Huaizhong; Westrup, Alison M.; O’Neal, Christen M.; Hendrix, Madeline C.; Dunn, Ian F.; Gernsback, Joanna E.

doi:10.1016/j.wneu.2021.07.037

Cited by 12 publications

(10 citation statements)

References 34 publications

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“…145 The 3 main reasons to leave surgical careers are overall stress, work time demands, and personal time requirements according to a recent survey conducted by Mahoney et al, 145 and for this reason, a greater flexibility during training and subsequent careers might represent an important option to consider. [146][147][148] Implementation of gender diversity within surgical teams is also important to improve learning and working environment, as it has been demonstrated that diverse thinkers might increase the solution to a variety of problems. 149 Furthermore, mentorship and network through social media might reveal solutions to sustain women in surgery from recruitment through career progression.…”

Section: Discussionmentioning

confidence: 99%

“…The same obstacles described during surgical training are present during career advancement and result in female surgeons to consider leaving the practice of surgery 145. The 3 main reasons to leave surgical careers are overall stress, work time demands, and personal time requirements according to a recent survey conducted by Mahoney et al,145 and for this reason, a greater flexibility during training and subsequent careers might represent an important option to consider 146–148. Implementation of gender diversity within surgical teams is also important to improve learning and working environment, as it has been demonstrated that diverse thinkers might increase the solution to a variety of problems 149…”

Section: Discussionmentioning

confidence: 99%

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Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them

et al. 2022

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Objective: This study aims to summarize the evidence concerning the barriers that exist to the career progression of women in surgery and to provide potential solutions to overcome these obstacles. Background: Visible and invisible impediments can hinder female doctors’ pursuit of a surgical career, from choosing a surgical specialty to training opportunities and all the way through career progression. Methods: Database search of original studies about barriers for female surgeons during choice of surgical career, residency, and career progression. A query including possible solutions such as mentorship and network was included. Results: Of 4618 total articles; 4497 were excluded as duplicates, having incorrect study focus, or not being original studies; leaving 120 studies meeting the inclusion criteria. Of the articles included, 22 (18%) focused on factors affecting the pursuit of a surgical career, such as surgical work hours and limited time for outside interests, 55 (46%) analyzed the main barriers that exist during surgical residency and fellowship training, such as discrimination and sexual harassment, 27 (23%) focused on barriers to career advancement, heavy workloads, ineffective mentorship, unclear expectations for advancement, inequality in pay or work-home conflicts. Among studies reporting on possible solutions, 8 (6.5%) articles reported on the role of effective mentorship to support career advancement and to provide moral support and 8 (6.5%) on the emerging role of social media for networking. Our analysis showed how different impediments hinder surgical career progression for women, with notable consequences on burnout and attrition. Conclusions: Identification and recognition of obstacles to career progression is the first step to addressing the gender gap in surgery. Active strategies should be improved to promote a culture of diversity and to create equal opportunity for women in surgery, while implementing structured mentoring programs and investing on an adequate communication on social media to engage the future generations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them

et al. 2022

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“…Based on their professional value, the contribution of female neurosurgeons should be fully integrated in the scientific program of each conference; professionalism and merit are the only features that should attract attention. Young neurosurgeons of both genders living in low-and middle-income countries should be equally supported through scholarships in order to have access to scientific events The importance of mentorship has been highlighted (26,27,(55)(56)(57); in this regard, women in leadership positions, aware of the difficulties that young females in their early career may experience, might be particularly committed to offer guidance to young professionals and help them to fully express their potential.…”

Section: The Role Of Wins Todaymentioning

confidence: 99%

“…In a survey on the status of women neurosurgeons in India, 72.68% of the participants reported that they had been discouraged before joining neurosurgical residency (24). Women also frequently have to choose between family and career; female neurosurgeons are less likely to be married and to have children than their male counterparts (22)(23)(24)(25)(26)(27). There is also evidence that they experience higher rate of failed births during residency (26).…”

Section: Introductionmentioning

confidence: 99%

“…Many of those who persist experience difficulties in career progression and receive unequal treatment in comparison with their male counterparts ( 26 , 27 , 30 , 31 ), garnering less trust and respect from patients and colleagues ( 22 , 26 , 27 ); there is also a lack of acceptance of female leadership ( 22 , 27 , 32 , 33 ).…”

Section: Introductionmentioning

confidence: 99%

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Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future

et al. 2022

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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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The Importance of Representation and Gender Valuation in the Field of Neurological Surgery

Narvaez,

Wolfe,

Freischlag

2024

JAMA Surg

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The article by Oshinowo et al 1 provides unexpected and striking insight into gender disparities in clinical practice patterns and Medicare reimbursement, which requires a heightened awareness of gender differences in unanticipated aspects of surgical practice with implications across surgical specialties. Understanding the impact of gender disparities is essential to creating approaches to advocate for women surgeon populations, as patients benefit from a diverse physician population. 2 Despite efforts to enhance the representation of women in neurosurgery, it remains an ongoing challenge. Of 6052 neurosurgeons billing Medicare, 512 were female (8.46%), with an increase from 268 to 408 from 2013 through 2020. 1 This increase mirrors the slowly increasing trend of women matching into neurosurgery residency, now over 20% of incoming neurosurgical interns.Using Medicare data across practice settings, this study 1 demonstrated patterns of significant disparity in procedural volume and payments. Female neurosurgeons submitted a staggering 48.32% less in annual Medicare charges, a difference which persisted after controlling for volume, experience, and service type. 1 Males performed more highreimbursement services. Female neurosurgeons submitted and were paid significantly less per service. This may represent divergence in billing and coding practices among men and women, also seen among operative coding in plastic surgeons, with women using fewer codes per case. 1 Women may be less likely to use codes that reflect greater complexity, technical difficulty, or work intensity.

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Women in Neurosurgery Around the World: A Systematic Review and Discussion of Barriers, Training, Professional Development, and Solutions

Cited by 12 publications

References 34 publications

Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them

Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them

Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future

The Importance of Representation and Gender Valuation in the Field of Neurological Surgery

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