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

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.

Gender Differences in Medicare Practice and Payments to Neurosurgeons

“…Another potential etiology for poorer reimbursement for women is that they are more likely to be marginalized within the neurosurgical community . Lack of peer support may contribute to decreased leverage within a hospital community through less opportune block time, less administrative support, and ultimately reduced capacity for interaction and negotiation with public or private payers.…”

Most influential women neurosurgeons on Twitter

“…Their mission being to “educate, inspire, and encourage women neurosurgeons to realize their professional and personal goals, and to serve neurosurgery in addressing the issues inherent to training and maintaining a diverse and balanced workforce.” They have been specifically harnessing the power of social media to share women neurosurgeon's experiences, provide mentorship opportunities, highlight women neurosurgeons' accomplishments, as well as foster a supportive and inclusive community of attendings, residents, and medical students, both men and women. 13 …”

“…Suspected barriers that may dissuade women from entering neurosurgery are implicit and explicit gender discriminatory practices, extensive time commitment during years critical to family planning and fertility, the demanding nature of the field, perceived work-life sacrifices, stereotypes, male dominance, as well as lack of women guidance, representation, and mentorship due to the limited number of women neurosurgeons. 10 , 11 , 12 , 13 …”

A Scoping Review of Professionalism in Neurosurgery

“…[179][180][181][182][183][184][185][186] Several articles discussed the history of women in neurosurgery. [187][188][189] Lawson McLean and Johnson et al performed different analyses evaluating the representation of women neurosurgeons at national meetings in Germany and the United States. 190,191 Mulligan et al 192 published a projected timeline to achieving gender parity in neurosurgery.…”