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

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  • 1 Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey;
  • 2 Department of Neurosurgery, University of North Carolina at Chapel Hill, North Carolina;
  • 3 Department of Otolaryngology–Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois;
  • 4 Department of Neurosurgery, Robert Wood Johnson Barnabas Health, Livingston, New Jersey; and
  • 5 Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida
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OBJECTIVE

Current 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.

METHODS

The 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.

RESULTS

Of 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).

CONCLUSIONS

Women 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.

ABBREVIATIONS AANS = American Association of Neurological Surgeons; CMS = Centers for Medicare and Medicaid Services.

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Contributor Notes

Correspondence Anil Nanda: Rutgers New Jersey Medical School and Robert Wood Johnson Medical School, Livingston, NJ. ananda.27@rutgers.edu.

INCLUDE WHEN CITING Published online August 28, 2020; DOI: 10.3171/2020.5.JNS20577.

Disclosures Dr. Mammis reports being a consultant to Medtronic, Boston Scientific, Nevro, and Abbott.

  • 1

    Abosch A, Rutka JT. Women in neurosurgery: inequality redux. J Neurosurg. 2018;129(2):277281.

  • 2

    Bean J. Women in neurosurgery. J Neurosurg. 2008;109(3):377.

  • 3

    Benzil DL, Abosch A, Germano I, The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery. J Neurosurg. 2008;109(3):378386.

    • Search Google Scholar
    • Export Citation
  • 4

    Corley J, Kim E, Philips CA, One hundred years of neurosurgery: contributions of American women. J Neurosurg. Published online February 14, 2020. doi: 10.3171/2019.12.JNS192878

    • Search Google Scholar
    • Export Citation
  • 5

    Corley J, Williamson T. Women in neurosurgery: final frontier of career women’s movement. World Neurosurg. 2018;111:130131.

  • 6

    Dossani RH, Terrell D, Kosty JA, Gender disparities in academic rank achievement in neurosurgery: a critical assessment. J Neurosurg. Published online November 8, 2019. doi: 10.3171/2019.8.JNS191219

    • Search Google Scholar
    • Export Citation
  • 7

    Durham SR, Donaldson K, Grady MS, Benzil DL. Analysis of the 1990–2007 neurosurgery residency match: does applicant gender affect neurosurgery match outcome? J Neurosurg. 2018;129(2):282289.

    • Search Google Scholar
    • Export Citation
  • 8

    Renfrow JJ, Rodriguez A, Liu A, Positive trends in neurosurgery enrollment and attrition: analysis of the 2000–2009 female neurosurgery resident cohort. J Neurosurg. 2016;124(3):834839.

    • Search Google Scholar
    • Export Citation
  • 9

    Silva N, Cerasiello S, Semonche A, Gender representation at neurological surgery conferences. World Neurosurg. 2019;129:453459.

  • 10

    Spetzler RF. Progress of women in neurosurgery. Asian J Neurosurg. 2011;6(1):612.

  • 11

    Zanon N. Women in neurosurgery: a challenge to change history—Brazil, São Paulo. Childs Nerv Syst. 2011;27(3):337340.

  • 12

    Dixon A, Silva NA, Sotayo A, Mazzola CA. Female medical student retention in neurosurgery: a multifaceted approach. World Neurosurg. 2019;122:245251.

    • Search Google Scholar
    • Export Citation
  • 13

    Lauretti L. Letter: Tracking career paths of women in neurosurgery. Neurosurgery. 2019;84(1):E92E93.

  • 14

    Kato Y. Women in neurosurgery: a new paradigm of thought will emerge. World Neurosurg. 2016;86:A16A17.

  • 15

    Hu YY, Ellis RJ, Hewitt DB, Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):17411752.

    • Search Google Scholar
    • Export Citation
  • 16

    Moe TG. Pregnancy in fellowship: building a career and family. J Am Coll Cardiol. 2014;64(7):734736.

  • 17

    Viola KV, Bucholz E, Yeo H, Impact of family and gender on career goals: results of a national survey of 4586 surgery residents. Arch Surg. 2010;145(5):418424.

    • Search Google Scholar
    • Export Citation
  • 18

    Lee TT, Klose JL. Survey on neurosurgery subspecialty fellowship training. Surg Neurol. 1999;52(6):641645.

  • 19

    Mazzola CA, Lobel DA, Krishnamurthy S, Efficacy of neurosurgery resident education in the new millennium: the 2008 Council of State Neurosurgical Societies post-residency survey results. Neurosurgery. 2010;67(2):225233.

    • Search Google Scholar
    • Export Citation
  • 20

    Renfrow JJ, Rodriguez A, Wilson TA, Tracking career paths of women in neurosurgery. Neurosurgery. 2018;82(4):576582.

  • 21

    Yang G, Villalta JD, Weiss DA, Gender differences in academic productivity and academic career choice among urology residents. J Urol. 2012;188(4):12861290.

    • Search Google Scholar
    • Export Citation
  • 22

    Cannada LK. Women in orthopaedic fellowships: What is their match rate, and what specialties do they choose? Clin Orthop Relat Res. 2016;474(9):19571961.

    • Search Google Scholar
    • Export Citation
  • 23

    Vick LR, Borman KR. Instability of fellowship intentions during general surgery residencies. J Surg Educ. 2008;65(6):445452.

  • 24

    Akinboyewa I, Cabrera-Muffly C. Association of fellowship training with otolaryngology training examination scores. JAMA Otolaryngol Head Neck Surg. 2016;142(3):274277.

    • Search Google Scholar
    • Export Citation
  • 25

    Lawton MT, Narvid J, Quiñones-Hinojosa A. Predictors of neurosurgical career choice among residents and residency applicants. Neurosurgery. 2007;60(5):934939.

    • Search Google Scholar
    • Export Citation
  • 26

    Acai A, Steyn C, Reid SE, Sonnadara RR. A solution to gender inequity in surgery? Better caregiving policies. Can J Surg. 2018;61(1):67.

    • Search Google Scholar
    • Export Citation
  • 27

    Juengst SB, Royston A, Huang I, Wright B. Family leave and return-to-work experiences of physician mothers. JAMA Netw Open. 2019;2(10):e1913054.

    • Search Google Scholar
    • Export Citation
  • 28

    Sharma B, Boet S, Grantcharov T, The h-index outperforms other bibliometrics in the assessment of research performance in general surgery: a province-wide study. Surgery. 2013;153(4):493501.

    • Search Google Scholar
    • Export Citation
  • 29

    Svider PF, Lopez SA, Husain Q, The association between scholarly impact and National Institutes of Health funding in ophthalmology. Ophthalmology. 2014;121(1):423428.

    • Search Google Scholar
    • Export Citation
  • 30

    Lee J, Kraus KL, Couldwell WT. Use of the h index in neurosurgery. Clinical article. J Neurosurg. 2009;111(2):387392.

  • 31

    Svider PF, Husain Q, Folbe AJ, Assessing National Institutes of Health funding and scholarly impact in neurological surgery. J Neurosurg. 2014;120(1):191196.

    • Search Google Scholar
    • Export Citation
  • 32

    Eloy JA, Bobian M, Svider PF, Association of gender with financial relationships between industry and academic otolaryngologists. JAMA Otolaryngol Head Neck Surg. 2017;143(8):796802.

    • Search Google Scholar
    • Export Citation
  • 33

    Eloy JA, Kilic S, Yoo NG, Is industry funding associated with greater scholarly impact among academic neurosurgeons? World Neurosurg. 2017;103:517525.

    • Search Google Scholar
    • Export Citation
  • 34

    Ngaage LM, Harris C, Gao C, Investigating the gender pay gap in industry contributions to academic neurosurgeons. World Neurosurg. 2019;130:516522.e1.

    • Search Google Scholar
    • Export Citation
  • 35

    Agarwal N, Clark S, Svider PF, Impact of fellowship training on research productivity in academic neurological surgery. World Neurosurg. 2013;80(6):738744.

    • Search Google Scholar
    • Export Citation
  • 36

    Myers SP, Hill KA, Nicholson KJ, A qualitative study of gender differences in the experiences of general surgery trainees. J Surg Res. 2018;228:127134.

    • Search Google Scholar
    • Export Citation
  • 37

    Waisbren SE, Bowles H, Hasan T, Gender differences in research grant applications and funding outcomes for medical school faculty. J Womens Health (Larchmt). 2008;17(2):207214.

    • Search Google Scholar
    • Export Citation
  • 38

    Achkar E. Will women ever break the glass ceiling in medicine? Am J Gastroenterol. 2008;103(7):15871588.

  • 39

    Amrein K, Langmann A, Fahrleitner-Pammer A, Women underrepresented on editorial boards of 60 major medical journals. Gend Med. 2011;8(6):378387.

    • Search Google Scholar
    • Export Citation
  • 40

    Awad AJ, Sarkiss CA, Kellner CP, Impact of neurosurgery medical student research grants on neurosurgery residency choice. World Neurosurg. 2016;92:349352.

    • Search Google Scholar
    • Export Citation
  • 41

    Sexton KW, Hocking KM, Wise E, Women in academic surgery: the pipeline is busted. J Surg Educ. 2012;69(1):8490.

  • 42

    Shaikh AT, Farhan SA, Siddiqi R, Disparity in leadership in neurosurgical societies: a global breakdown. World Neurosurg. 2019;123:95102.

    • Search Google Scholar
    • Export Citation
  • 43

    Surawicz CM. Women in leadership: why so few and what to do about it. J Am Coll Radiol. 2016;13(12 Pt A):14331437.

  • 44

    Lerchenmueller MJ, Sorenson O, Jena AB. Gender differences in how scientists present the importance of their research: observational study. BMJ. 2019;367:l6573.

    • Search Google Scholar
    • Export Citation

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