The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery

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Preface

The leadership of Women in Neurosurgery (WINS) has been asked by the Board of Directors of the American Association of Neurological Surgeons (AANS) to compose a white paper on the recruitment and retention of female neurosurgical residents and practitioners.

Introduction

Neurosurgery must attract the best and the brightest. Women now constitute a larger percentage of medical school classes than men, representing approximately 60% of each graduating medical school class. Neurosurgery is facing a potential crisis in the US workforce pipeline, with the number of neurosurgeons in the US (per capita) decreasing.

Women in the Neurosurgery Workforce

The number of women entering neurosurgery training programs and the number of board-certified female neurosurgeons is not increasing. Personal anecdotes demonstrating gender inequity abound among female neurosurgeons at every level of training and career development. Gender inequity exists in neurosurgery training programs, in the neurosurgery workplace, and within organized neurosurgery.

Obstacles

The consistently low numbers of women in neurosurgery training programs and in the workplace results in a dearth of female role models for the mentoring of residents and junior faculty/practitioners. This lack of guidance contributes to perpetuation of barriers to women considering careers in neurosurgery, and to the lack of professional advancement experienced by women already in the field. There is ample evidence that mentors and role models play a critical role in the training and retention of women faculty within academic medicine. The absence of a critical mass of female neurosurgeons in academic medicine may serve as a deterrent to female medical students deciding whether or not to pursue careers in neurosurgery. There is limited exposure to neurosurgery during medical school. Medical students have concerns regarding gender inequities (acceptance into residency, salaries, promotion, and achieving leadership positions). Gender inequity in academic medicine is not unique to neurosurgery; nonetheless, promotion to full professor, to neurosurgery department chair, or to a national leadership position is exceedingly rare within neurosurgery. Bright, competent, committed female neurosurgeons exist in the workforce, yet they are not being promoted in numbers comparable to their male counterparts. No female neurosurgeon has ever been president of the AANS, Congress of Neurological Surgeons, or Society of Neurological Surgeons (SNS), or chair of the American Board of Neurological Surgery (ABNS). No female neurosurgeon has even been on the ABNS or the Neurological Surgery Residency Review Committee and, until this year, no more than 2 women have simultaneously been members of the SNS. Gender inequity serves as a barrier to the advancement of women within both academic and community-based neurosurgery.

Strategic Approach to Address Issues Identified.

To overcome the issues identified above, the authors recommend that the AANS join WINS in implementing a strategic plan, as follows: 1) Characterize the barriers. 2) Identify and eliminate discriminatory practices in the recruitment of medical students, in the training of residents, and in the hiring and advancement of neurosurgeons. 3) Promote women into leadership positions within organized neurosurgery. 4) Foster the development of female neurosurgeon role models by the training and promotion of competent, enthusiastic, female trainees and surgeons.

Abbreviations used in this paper: AANS = American Association of Neurological Surgeons; ABNS = American Board of Neurological Surgery; CNS = Congress of Neurological Surgeons; RRC = Neurological Surgery Residency Review Committee of the Accreditation Council for Graduate Medical Education; SNS = Society of Neurological Surgeons; WINS = Women in Neurosurgery.

Article Information

Address correspondence to: Deborah L. Benzil, M.D., 280 North Central Avenue, Suite 235, Hartsdale, New York 10530. email: benzilneurosurg@aol.com.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Line graph showing the percentage of women in the population of neurosurgery residents from 1989 through 2003.

  • View in gallery

    Line graph showing the number of female graduates from neurosurgery residencies by year.

  • View in gallery

    Bar graph showing the number of ABNS-certified female neurosurgeons by decade.

References

  • 1

    Andrews N: Climbing through medicine's glass ceiling. N Engl J Med 357:188718892007

  • 2

    Ash ASCarr PLGoldstein RFriedman RH: Compensation and advancement of women in academic medicine: is there equity?. Ann Intern Med 141:2052122004

    • Search Google Scholar
    • Export Citation
  • 3

    Association of American Medical Colleges (US): AAMC Professional Development Seminars Washington, DCAAMC2007. (http://aamc.org/members/wim/meetings/start.htm) [Accessed 15 October 2007]

    • Search Google Scholar
    • Export Citation
  • 4

    Benzil DLvon der Schmidt E III: Toward harnessing forces of change: assessing the neurosurgical workforce. AANS Bulletin 15:7112006

    • Search Google Scholar
    • Export Citation
  • 5

    Bickel JBrown AJ: Generation X: implications for faculty recruitment and development in academic health centers. Acad Med 80:2052102005

    • Search Google Scholar
    • Export Citation
  • 6

    Bickel JCroft KMarshall R: Enhancing the Environment for Women in Academic Medicine Washington, DCAAMC1996

  • 7

    Bickel JWara DAtkinson BFCohen LSDunn MHostler S: Increasing women's leadership in academic medicine: report of the AAMC project implementation committee. Acad Med 77:104310612002

    • Search Google Scholar
    • Export Citation
  • 8

    Blakemore LCHall JMBiermann JS: Women in surgical residency training programs. J Bone Joint Surg Am 85-A:247724802003

  • 9

    Bland KI: The recruitment of medical students to careers in general surgery: emphasis on the first and second years of medical education. Surgery 134:4094132003

    • Search Google Scholar
    • Export Citation
  • 10

    Borman KR: Gender issues in surgical training: from minority to mainstream. Am Surg 73:1611652007

  • 11

    British Medical Association (UK): Women in Academic Medicine Report July 2007 London, UKBritish Medical Association2007. (http://www.bma.org.uk/ap.nsf/content/wam2007) [Accessed 21 December 2007]

    • Search Google Scholar
    • Export Citation
  • 12

    Daniell E: Every Other Thursday: Stories and Strategies from Successful Women Scientists New HavenYale University Press2006

  • 13

    Darves B: New England Journal of Medicine:. Women in medicine force change in workforce dynamics Boston, MANEJM Career Resources2005. (http://www.nejmjobs.org/career-resources/women-in-medicine.aspx) [Accessed 21 December 2007]

    • Search Google Scholar
    • Export Citation
  • 14

    De Angelis CD: Women in academic medicine: new insights, same sad news. N Engl J Med 342:4264272000

  • 15

    Dorrance ANash T: Training Soccer Champions Fort Collins, COJTC Sports, Inc.1996

  • 16

    Etzkowitz HKemelgor CNeuschatz MUzzi BAlonzo J: The paradox of critical mass for women in science. Science 266:51541994

  • 17

    Government Affairs Program/American Geological Institute: Women and Minorities in Science Washington, DCAGI2002. (http://www.agiweb.org/gap/legis107/womenscience.html) [Accessed 21 December 2007]

    • Search Google Scholar
    • Export Citation
  • 18

    Hamel MBIngelfinger JRPhimister ESolomon CG: Women in academic medicine—progress and challenges. N Engl J Med 355:3103122006

    • Search Google Scholar
    • Export Citation
  • 19

    Holdcroft A: Academic medicine: time for reinvention: academic medicine is failing women. BMJ 328:462004

  • 20

    Jagsi RGuancial EAWorobey CCHenault LEChang YStarr R: The “gender gap” in authorship of academic medical literature—a 35-year perspective. N Engl J Med 355:2812872006

    • Search Google Scholar
    • Export Citation
  • 21

    Jonasson O: Leaders in American surgery: where are the women?. Surgery 131:6726752002

  • 22

    Mayer KLPerez RVHo HS: Factors affecting choice of surgical residency training program. J Surg Res 98:71752001

  • 23

    Morahan PSVoytko MLAbbuhl SMeans LJWara DWThorson J: Ensuring the success of women faculty at AMCs: lessons learned from the National Centers of Excellence in Women's Health. Acad Med 76:19312001

    • Search Google Scholar
    • Export Citation
  • 24

    Morton MJSonnad SS: Women on professional society and journal editorial boards. J Natl Med Assoc 99:7647712007

  • 25

    Nonnemaker L: Women physicians in academic medicine: new insights from cohort studies. N Engl J Med 342:3994052000

  • 26

    Stratton TDMcLaughlin MAWitte FMFosson SENora LM: Does students' exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection?. Acad Med 80:4004082005

    • Search Google Scholar
    • Export Citation
  • 27

    Venes JLParent AD: Women in neurological surgery. Matson Memorial Lecture. J Neurosurg 104:2272322006

  • 28

    Wendel TMGodellas CVPrinz RA: Are there gender differences in choosing a surgical career?. Surgery 134:5915982003

  • 29

    Woodrow SIGilmer-Hill HRutka JT: The neurosurgical workforce in North America: a critical review of gender issues. Neurosurgery 59:7497582006

    • Search Google Scholar
    • Export Citation
  • 30

    Wright ALRyan KSt Germain PSchwindt LSager RReed KL: Compensation in academic medicine: progress toward gender equity. J Gen Intern Med 22:139814022007

    • Search Google Scholar
    • Export Citation
  • 31

    Wright ALSchwindt LABassford TLReyna VFShisslak CMSt Germain PA: Gender differences in academic advancement: patterns, causes, and potential solutions in one US College of Medicine. Acad Med 78:5005082003

    • Search Google Scholar
    • Export Citation

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