Representation of Women in Neurosurgery

Written by Luiza Ghazaryan

Neurosurgery is a medical discipline that explores disorders of the brain, peripheral nerves, and the spinal cord. Becoming a neurosurgeon in the United States is a lengthy process, requiring four years of medical school education and 7-8 years of residency training. After completing the residency program, some surgeons choose to get board certified by the American Board of Neurological Surgery (ABNS), receiving the highest level neurosurgical qualification in the country. Compellingly, statistics convey that in the US, there are approximately 3500 board-certified neurosurgeons. This data sparks even more curiosity when we take a closer look at the number of ABNS-certified female neurosurgeons: 219! Only 5% of practicing certified neurosurgeons are women. These peculiarly small numbers raise questions about the factors that lead to such gender disparity, such as mentor scarcity, discrimination, and stereotypes based on gender roles.

ABNS certification requires great skills in the field and years of training, which is why a lack of mentorship is one of the top barriers for women pursuing certification. Due to men dominating most leadership positions, female candidates face more judgment and fewer opportunities to improve surgical skills. The doubts about female candidates’ working skills lead to women often being given administrative tasks, while men are given the chance to work in the operating room. This also creates a cycle: since there aren’t enough role models for female surgeons, female medical students think that they will be denied involvement in neurosurgery programs due to the greater number of male students, and neglect to apply or pursue this form of medicine. According to reports, 80% of women and 88% of men had concerns regarding their training program. However, for 12% of women, the biggest concern with residency was the ability to thrive in a field dominated by a male majority, which was not a reported concern among men. 

This coincides with how assumptions about gender roles make it difficult for women to grow in the field. When a young girl shares her goal to become a neurosurgeon, the most common response she hears is “Don’t you want to be a mom?” Women are expected to put their ambitions aside in order to form a family. The Journal of Neurosurgery surveyed 51 female and 64 male doctors about family planning and found that half of all surveyed women felt at least some pressure from programs or colleagues against starting a family, compared with only 6% of male respondents. Such external pressure discourages women from joining neurosurgery residency programs, as they are constantly told about the difficulty of balancing work and personal life. Women are usually considered to be the main caregivers, forcing them to choose between a career and a family, while men are less likely to face such complications. Instead, they are simply expected to contribute to family income. This expectation impacts joining mentorship programs as well, due to hiring prejudice stemming from the belief that female physicians may become a parent, and will therefore not be stable mentees. 

A neurosurgical journal has presented a recruitment target to advance gender equity in neurosurgery: (1) 30% of all neurosurgical trainees are women by 2030 and (2) 30% of practicing neurosurgeons are women by 2038. The way forward would entail determining systematic barriers and eliminating discriminatory practices when recruiting medical students for neurosurgery residency programs. Furthermore, women need a safe support system. Therefore, improved parental leave and harassment policies should be required and implemented, and educational institutions should foster more programs dedicated to mentoring female medical students. Women in medicine need support, representation, and inspiration in order to promote their research and contribute to the scientific achievements in the world.

Edited by Jenna Stutzman

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