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Alkahtani NA, Namer TS, AlKhotani A, Bensaeed NZ, Alsowailem MW. Saudi women pioneers in neurological surgery: Insights into progress and inclusion. World Neurosurg X 2024; 23:100376. [PMID: 38764856 PMCID: PMC11099319 DOI: 10.1016/j.wnsx.2024.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/28/2024] [Indexed: 05/21/2024] Open
Abstract
Forty years ago, General Professor Dr. Khalaf Al-Mouteary established the first neurosurgical department in the Kingdom of Saudi Arabia. Here, we explored various pieces of evidence on the progress and inclusion of Saudi female pioneers in the neurosurgical workforce of the Kingdom of Saudi Arabia. We gathered information data on the inclusion of women in neurological surgery retrieved from open-resource online documentation of the Ministry of Health and direct communication with Saudi Commission for Health Specialties (SCFHS) administrative services. Furthermore, regional neurosurgery program directors, four active registered consultants, were either interviewed live or through offline communications. Data on the current number of board-certified, active female neurosurgeons in either the government or private sectors, along with the number of current neurosurgery postgraduate residency program trainees, were obtained from the registered database of the SCFHS. Since 2002, 18 women (29 %) have graduated from the Saudi Neurosurgical Residency Training Program (SNRTP), in contrast,71 % of the graduates were male. The SNRTP is now training more than 34 females (30 %), who are progressing in their neurosurgical training across the country. The first Saudi woman to pursue neurosurgery was Dr Samia Abdel-Rahim Maimani, while the first woman to pass the Saudi Neurosurgery Board was Dr Aisha Al-Hajjaj in 2002. In 2021, board-certified female neurosurgeons in Saudi Arabia will represent approximately 3 % of all practicing neurosurgeons.
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Affiliation(s)
- Nada A. Alkahtani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Rimayah, Al Hars Al Watani, Riyadh, Saudi Arabia
| | - Thana S. Namer
- Division of Neurosurgery, King AbdulAziz Medical City, Ministry of National Guard Health Affairs, Prince Mutib Ibn Abdullah Ibn Abdulaziz Rd, Ar Rimayah, Riyadh, Saudi Arabia
| | - Afnan AlKhotani
- Division of Neurosurgery, King faisal Specialist Hospital & Research Center, P.O. Box 40047, Jeddah, 21499, Saudi Arabia
| | - Nora Z. Bensaeed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Rimayah, Al Hars Al Watani, Riyadh, Saudi Arabia
| | - Munira W. Alsowailem
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Rimayah, Al Hars Al Watani, Riyadh, Saudi Arabia
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Çalış F, Şimşek AT, İnan NG, Topyalın N, Adam BE, Elias Ç, Aksu ME, Aladdam M, Gültekin G, Sorkun MH, Tez M, Balak N. Factors Affecting Turkish Medical Students' Pursuit of a Career in Neurosurgery: A Single Center Survey Study. World Neurosurg 2024; 185:e926-e943. [PMID: 38460813 DOI: 10.1016/j.wneu.2024.02.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Statistics show that over the past 2 decades, even in high-income countries, fewer and fewer students have listed neurosurgery as their top career option. Literature on medical students' pursuit of neurosurgical careers in middle- and low-income countries are scarce. The aim of this research, conducted in Turkey with a middle-income economy, was to contribute insights relevant to medical education and neurosurgery across the world. METHODS A survey was conducted with a target sample of fourth-year (167 students), fifth-year (169 students), and sixth-year (140 students) medical students (476 in total) from the Medical School at Istanbul Medeniyet University in Turkey. The response rates of the fourth-, fifth-, and sixth-year students were 62% (104/167), 53% (90/169), and 50% (70/140), respectively (in total, 266, including 147 female and 119 male). RESULTS In terms of the genuine intention, only 2.5% of men and 2.7% of women were committed to specializing in neurosurgery. This study further revealed that possible reasons for these students' low motivation to specialize in neurosurgery were their beliefs that in neurosurgery, the physical and psychological demands were high, and the night shifts were intense, meaning they would not have a social life or spare time for their hobbies; that morbidity/mortality were high; and that financial incentives were insufficient, especially in public institutions. CONCLUSION Turkish medical students did not rank neurosurgery at the top of their career choices. Possible reasons for this are socioeconomic factors and the inadequate introduction of neurosurgery to medical students.
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Affiliation(s)
- Fatih Çalış
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | - Abdullah Talha Şimşek
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | | | - Nur Topyalın
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | - Baha E Adam
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | - Çimen Elias
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | - Muhammed Emin Aksu
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | - Mohammed Aladdam
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | - Güliz Gültekin
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye
| | | | - Müjgan Tez
- Department of Statistics, Faculty of Arts and Sciences, Marmara University, Istanbul, Türkiye
| | - Naci Balak
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Prof. Dr. SüleymanYalçın City Hospital, Istanbul, Türkiye.
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Hoskins M, Bhanja D, Piper M, Strausser SA, Mansfield K, Zheng A, McNutt S, Goss M, Lighthall JG, Burns AS. Training Program Factors Most Important to Women When Selecting an Otolaryngology Residency. Laryngoscope 2024; 134:600-606. [PMID: 37551878 DOI: 10.1002/lary.30877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/22/2023] [Accepted: 06/20/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES The aim of the study was to determine factors that female resident physicians find most influential when choosing an otolaryngology residency program. METHODS A three-part survey was sent to current female otolaryngology residents via email evaluating the importance of 19 characteristics impacting program choice. The 19 factors were scored from 1 (least important) to 5 (most important). The participants also ranked their personal top five most influential factors. Data were analyzed using descriptive statistics. RESULTS One-hundred and fifty of 339 contacted residents participated. Most were aged 30-39 (63%), white (70%), and married (43%). Eighty-five percent had no children, and 52% did not plan to have children during residency. The highest scoring factors derived from Likert scale ratings included resident camaraderie (4.5 ± 0.8), resident happiness (4.4 ± 0.8), and case variety/number (4.4 ± 0.8). The lowest scoring factors were number of fellows (2.9 ± 1.1), attitudes toward maternity leave (2.7 ± 1.3), and maternity leave policies (2.4 ± 1.2). The top five most influential factors and the percentage selecting this were resident camaraderie (57%), resident happiness (57%), academic reputation (51%), case variety/number (47%), and early surgical/clinical experience (44%). Gender-specific factors were infrequently selected. However, 51 (34%) ranked at least one gender-specific factor within their top five list. CONCLUSION Non-gender-related factors, like resident camaraderie and surgical experiences, were most valued by women. Conversely, gender-specific factors were less critical and infrequently ranked. Ninety-nine residents (64%) rated exclusively gender-neutral characteristics in their top five list of most influential factors. Our data offer insight into program characteristics most important to female otolaryngology residents, which may assist residency programs hoping to match female applicants. LEVEL OF EVIDENCE NA Laryngoscope, 134:600-606, 2024.
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Affiliation(s)
- Meloria Hoskins
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Debarati Bhanja
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Molly Piper
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Sarah A Strausser
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Kirsten Mansfield
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Amy Zheng
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Sarah McNutt
- Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Madison Goss
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A
| | - Jessyka G Lighthall
- Department of Otolaryngology-Head and Neck Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Amy S Burns
- Department of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A
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Pugazenthi S, Fabiano AS, Barpujari A, Vessell M, Reddy V, Adogwa O, Swartz KR. Sociodemographics Impact Competitiveness in the Neurosurgical Match: Survey Results. World Neurosurg 2024; 182:e308-e318. [PMID: 38008166 DOI: 10.1016/j.wneu.2023.11.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND The neurosurgical match involves selecting future neurosurgeons who will comprise the future national workforce, based on a competitive ranking process of applicants. We aimed to identify which sociodemographic and academic factors influence competitiveness and rank position in the match. METHODS A Council of State Neurosurgical Societies (CSNS) survey was distributed to current U.S. neurosurgical residents. The primary outcome measure was self-reported rank position of matched program. Variables included sociodemographic and academic metrics. Fisher exact, logistic regression, and t tests were performed. RESULTS Among the 72 respondents, median United States Medical Licensing Examination Step 1 score was 248, 34.7% were Alpha Omega Alpha inductees, 77.8% completed 1-3 sub-internship rotations, median number of publications was 5, and 13.9% had a Ph.D. Sociodemographic analysis demonstrated that 69.4% were male and 30.6% were female. Applicants with a home neurosurgery program or of female gender had statistically significantly higher odds of matching into a top 3 program on their rank list (odds ratio = 9 and odds ratio = 6, respectively). Female applicants exhibited similar mean, but less variance, compared with male respondents for United States Medical Licensing Examination Step 1 scores and number of publications. Respondents with a top 3 program match were more likely to agree that the home program supported their pursuance of neurosurgery. CONCLUSIONS Two sociodemographic factors were independently associated with high match rank: presence of home neurosurgery program and female gender. Female respondents reported consistently strong academic metrics (similar mean, but less variance, compared with male respondents).
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Affiliation(s)
- Sangami Pugazenthi
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alexander S Fabiano
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Awinita Barpujari
- Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Meena Vessell
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA; Department of Pediatric Neurosurgery, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Vamsi Reddy
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Owoicho Adogwa
- Department of Neurosurgery, Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Karin R Swartz
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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Strausser SA, Mansfield K, Zheng A, Bhanja D, Hoskins M, Piper M, Goss M, McNutt S, Raman JD, Burns AS. Urology Match: Important Factors Women Consider When Choosing a Residency Training Program. Urology 2024; 183:288-300. [PMID: 37926380 DOI: 10.1016/j.urology.2023.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To determine factors that women urology resident physicians rate as most influential when selecting residency programs. METHODS Surveys were emailed to female urology residents during the 2021-2022 academic year. Residents scored 19 factors influencing residency program choice from 1 "least" to 5 "most" important and ranked their top 5 most influential factors. Data were analyzed via descriptive statistics and quantile regression. RESULTS One hundred thirty-six (37%) of 367 female urology residents who received the survey participated. Eighty-two percent had no children and 57% did not plan to have children during residency. The three highest scoring factors derived from Likert scale ratings were resident camaraderie (4.6 ± 0.5 [mean ± SD]), resident happiness (4.6 ± 0.6), and case variety/number (4.4 ± 0.8). As a whole, the lowest scoring characteristics were attitudes toward maternity leave (2.6 ± 1.2) and maternity leave policies (2.5 ± 1.2). Married residents were more likely than those who were single and engaged/in a committed relationship to rank attitudes and policies toward maternity leave as more important (3 vs 2 vs 2, P <.0001). Residents with children were more likely than those without children to rank maternity leave policies as more important (3 vs 2, P <.0001). CONCLUSION As a whole, women urology residents prioritized non-gender-related factors. However, gender-specific factors were rated highly by married residents and those with children or planning to have children. Urology training programs may use these results to highlight desirable characteristics to aid recruitment of female residents.
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Affiliation(s)
| | | | - Amy Zheng
- Penn State College of Medicine, Hershey, PA
| | | | | | | | - Madison Goss
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Sarah McNutt
- Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - Jay D Raman
- Department of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
| | - Amy S Burns
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA.
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Saeed F, Ilic T, Haq M, Sarmath G, Syrmos N, Alalade AF, Hernández-Durán S. Representation of minorities in European neurosurgical leadership. BRAIN & SPINE 2023; 3:101788. [PMID: 38021028 PMCID: PMC10668052 DOI: 10.1016/j.bas.2023.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/25/2023] [Indexed: 12/01/2023]
Abstract
Introduction Ethnic diversity has significantly increased within European countries since World War II for several reasons. However, there continues to be a contrasting lag in leadership positions within healthcare circles, and neurosurgery is no exception. Under-representation of minorities is a contributory factor to recurring problems of healthcare inequality. Research question The European Association of Neurosurgical Societies (EANS) Diversity Committee (DC) set out to examine trends in underrepresented minority (URM) representation in leadership positions across Europe. Material and methods Data on the race and ethnicity of departmental heads across the units in the European nations was collated. We defined the term 'ethnic minority' in line with the criteria set by the European Commission against Racism and Intolerance (ECRI). The percentage of URM among the European neurosurgical units was analysed against the demographics of the respective countries to assess whether there was a corresponding association. Results The percentage of URM representation was low across most European countries. Countries with the highest immigration rates e.g. Great Britain and Germany had the highest rates of representation within the neurosurgical leadership in comparison to other countries. The Balkan states had zero rates of URM representation within the neurosurgical leadership. Discussion and conclusion Our findings demonstrate that URM representation in neurosurgical leadership across European countries is significantly low. Selection policies, training curricula and recruitment processes aimed at improving health inequality are necessary. Further studies are needed to elucidate the factors contributing to the low participation of URM in neurosurgical leadership.
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Affiliation(s)
- Fozia Saeed
- Department of Neurosurgery, Leeds General Infirmary, Leeds, LS1 3EX, United Kingdom
| | - Tijana Ilic
- National Department of Neurosurgery, Center Hospitalier de Luxembourg, Luxembourg
| | - Makinah Haq
- King's College London, Strand Campus, Strand, London, WC2R 2LS, United Kingdom
| | - Gargi Sarmath
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Nikolaos Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Andrew F. Alalade
- Department of Neurosurgery, Royal Preston Hospital, Preston, PR2 9HT, United Kingdom
| | | | - for the European Association of Neurosurgical Societies (EANS) Diversity Committee
- Department of Neurosurgery, Leeds General Infirmary, Leeds, LS1 3EX, United Kingdom
- National Department of Neurosurgery, Center Hospitalier de Luxembourg, Luxembourg
- King's College London, Strand Campus, Strand, London, WC2R 2LS, United Kingdom
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, United Kingdom
- Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Department of Neurosurgery, Royal Preston Hospital, Preston, PR2 9HT, United Kingdom
- Department of Neurosurgery, Gottingen University Hospital, Gottingen, Germany
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Castillo-Huerta NM, Campos-Gamarra RN, Gamarra Valverde NN, Torres-García ON. Letter to the Editor: Women Doctors' Preferences Toward Neurosurgery Residency in Latin America- A Peruvian Perspective. World Neurosurg 2023; 173:289-290. [PMID: 37189312 DOI: 10.1016/j.wneu.2023.02.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 05/17/2023]
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Feghali J, Antar A, Wicks EE, Sattari SA, Li S, Witham TF, Brem H, Huang J. Recruitment of women in neurosurgery: a 7-year quantitative analysis. J Neurosurg 2023; 138:251-260. [PMID: 35901758 DOI: 10.3171/2022.4.jns22410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The authors aimed to characterize which US medical schools have the most female neurosurgery residents and to identify potential associations between medical school characteristics and successful recruitment of women pursuing a neurosurgery career. METHODS The authors evaluated a total of 1572 residents in US neurosurgery programs accredited by the Accreditation Council for Graduate Medical Education as of February 2021, representing match cohorts from 2014 to 2020. The authors extracted US medical school characteristics and ranked schools based on the percentages of women graduates entering neurosurgery. They additionally studied yearly trends of the percentage of women constituting incoming neurosurgery resident cohorts as well as associations between female recruitment percentage and medical school characteristics using univariable and stepwise multivariable linear regression (including significant univariable factors). RESULTS The cohort consisted of 1255 male and 317 (20%) female residents. Yearly trends indicated a significant drop in incoming female residents in 2016, followed by significant increases in 2017 and 2019. On multivariable analysis, the following factors were associated with a higher average percentage of female graduates entering neurosurgery: total affiliated neurosurgery clinical faculty (β = 0.006, 95% CI 0.001-0.011, p = 0.01), allopathic versus osteopathic schools (β = 0.231, 95% CI 0.053-0.409, p = 0.01), and top 10 U.S. News & World Report ranking (β = 0.380, 95% CI 0.129-0.589, p < 0.01). When the number of female clinical faculty was added to the model, the variable was not statistically significant. Multivariable bibliometric analyses indicated a higher mean preresidency H-index for men, with an even greater gender difference identified in the 2021 H-index. CONCLUSIONS This study characterizes which medical schools are most successful at recruiting female students who constituted the total neurosurgery resident workforce of the 2020-2021 academic year. The overall number of clinical neurosurgery faculty rather than faculty gender was independently associated with female recruitment. Gender differences in research productivity persisted with control for confounders and increased between preresidency and 2021 time points. Such understanding of factors that influence the recruitment of women can help improve female representation in neurosurgery residency training moving forward.
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Affiliation(s)
- James Feghali
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Albert Antar
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Elizabeth E Wicks
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Shahab Aldin Sattari
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Sean Li
- 2Pratt School of Engineering, Duke University, Durham, North Carolina
| | - Timothy F Witham
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Henry Brem
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Judy Huang
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
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Ryan CA, Sciscent BY, Bhanja D, Tucker J, Daggubati LC. Female Neurosurgery Residency Program Directors in the United States: A Cross-sectional Descriptive Analysis. World Neurosurg 2023; 169:52-56. [PMID: 36448829 DOI: 10.1016/j.wneu.2022.10.091] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The residency program director (PD) position is a valued leadership appointment in academic medicine. PDs are responsible for the success of their program and its residents. The objective of this study is to provide a cross-sectional analysis of baseline demographics and academic backgrounds of current neurosurgery program directors. METHODS Data was compiled on neurosurgery PDs and their residency programs, as of the end of May 2021, using publicly available resources including Doximity, FREIDA, and Healthgrades. The Mann-Whitney and Fisher exact tests were used for statistical analysis. RESULTS Of 113 PDs identified, 91.15% are male (P < 0.01). The majority of PDs (88.5%) received their medical degrees from U.S. medical schools. The average age of current PDs is 54 years, and the average age at appointment was 48 years. Compared to their male counterparts, female PDs are more likely to be younger at appointment (41 vs. 48 years; P = 0.001) and while holding the same position (45 vs. 55 years; P = 0.001). As a result, female PDs experience less time to appointment after residency (8.6 years vs. 14.7 years, P = 0.013). There are no significant differences regarding the gender of the PD and university affiliation, current appointment, completion of a fellowship, and resident gender ratios. CONCLUSIONS The position of neurosurgery residency PD is dominated by fellowship-trained men in their late 40s to 50s. The gender ratio of neurosurgery residents is consistent with the underrepresentation of women in this position. With increasing female representation in neurosurgery, more women may assume this leadership position and begin to hasten the gender balance.
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Affiliation(s)
- Casey A Ryan
- Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA
| | - Bao Y Sciscent
- Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA
| | - Debarati Bhanja
- Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA
| | - Jacqueline Tucker
- Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA
| | - Lekhaj C Daggubati
- Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA.
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Alghamdi KT, Alamoudi AA, Bomonther MA, Alasmari HA, Nejaim KH, Samman AM, Alzahrani MT, Algahtani AY. Factors affecting the choice of becoming a neurosurgeon in the western region of Saudi Arabia. Surg Neurol Int 2022; 13:424. [PMID: 36324952 PMCID: PMC9610601 DOI: 10.25259/sni_226_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background: The preference of medical specialty for students can start even before enrollment into medical school, or as late as following their graduation. During their senior years, students often get a prospective on the working environment and the difficulties faced in the field. This, along with other factors, can strongly alter their career choice. This study aims to explore the degree of interest in neurosurgical specialty among medical students and the factors influencing their choice of becoming a neurosurgeon in the western region of Saudi Arabia. Methods: This is a cross-sectional study which was done across three universities of the western region of Saudi Arabia including King Saud bin Abdulaziz University for Health Sciences, Umm Al Qura University, and King Abdulaziz University. Results: A sample of 1023 students from the second medical year up to the internship was conducted, and out of them, 585 (57.2%) were males and 438 (42.8%) were females. Three hundred and fifty-nine (35.1%) of the students were interested in neurosurgery, while 664 (64.9%) were not. The data show that females have more interest (40.8% of females) compared to males (35.1% of males). Furthermore, there was a general trend toward a decrease in the interest in neurosurgery with time. The impact on patients “rewarding feeling” was the most reported attraction to the specialty, followed by income. Stress was the most reported deterring factor among students. Neurosurgery is one of the most challenging specialties, yet it is still considered one of the most competitive ones. Conclusion: Many factors have been found to influence medical students’ choices to apply for neurosurgical training as we described. Interestingly, we noted higher interest among female students, and among college freshmen compared to their counterparts. Further studies should be conducted on a larger scale to analyze these findings.
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Affiliation(s)
- Khalid Talal Alghamdi
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah, Saudi Arabia
| | - Ahmad Abdullah Alamoudi
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah, Saudi Arabia
| | | | - Haitham Ali Alasmari
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah, Saudi Arabia
| | - Kenan Hatem Nejaim
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah, Saudi Arabia
| | - Afnan Mahfouz Samman
- Department of Surgery, Section of Neurosurgery, King Abdulaziz Medical City National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Moajeb Turki Alzahrani
- Department of Surgery, Section of Neurosurgery, King Abdulaziz Medical City National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Abdulhadi Y. Algahtani
- Department of Surgery, Section of Neurosurgery, King Abdulaziz Medical City National Guard Health Affairs, Jeddah, Saudi Arabia
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11
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Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them: A Systematic Scoping Review. Ann Surg 2022; 276:246-255. [PMID: 35797642 DOI: 10.1097/sla.0000000000005510] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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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Wang A, Shlobin NA, DiCesare JAT, Holly LT, Liau LM. Diversity in Neurosurgical Recruitment and Training in the United States: A Systematic Review. World Neurosurg 2022; 162:111-117.e1. [PMID: 35339710 DOI: 10.1016/j.wneu.2022.03.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The benefits of diversity are particularly salient in neurosurgical training because of treatment of varied patient populations and the importance of close collaboration between trainees and attending neurosurgeons of different backgrounds. However, there is a paucity of literature that comprehensively examines diversity in neurosurgical recruitment and training. The aim of this study is to systematically review the scope of diversity in neurosurgical recruitment and training. METHODS PudMed, Embase, and Scopus were searched since inception to October 31, 2021. Inclusion consisted of 1) on neurosurgery training; 2) sample was medical student, resident, fellows or attending; 3) discussed diversity variable(s). This study followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Of 1578 articles, 15 studies were included. Studies largely reported gender (n = 14) underrepresentation in neurosurgery compared with racial/ethnic diversity (n = 2) and socioeconomic status (n = 1). From studies focusing on residency match (n = 4), women medical students placed greater emphasis on mentorship, earlier clinical exposure, and program camaraderie and reputation as most important. From studies (n = 4) reporting retention and attrition, although women residents and attendings representation has increased, black, indigenous and people of color groups continue to represent <15% of studies on neurosurgical training. Studies (n = 4) discussing research suggested that women residents were more likely to have lower h-indices with fewer research grants. Studies (n = 4) describing workforce employment further showed that women and racial/ethnic minority groups were less likely to hold high academic and leadership positions. In studies (n = 4) on work-life balance, 18.5% women attendings found less career fulfillment and 20.4% would not choose to pursue neurosurgery again because of lack of protected personal time. CONCLUSIONS This systematic review shows the scope of studies of diversity within neurosurgery and provides impetus for efforts to expand our understanding of diversity within the field.
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Affiliation(s)
- Andrew Wang
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA; College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, Los Angeles, California, USA.
| | - Nathan A Shlobin
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jasmine A T DiCesare
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Langston T Holly
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Linda M Liau
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Bauman MMJ, Wang K, Bhandarkar AR, Scheitler KM, Clarke MJ. A step toward equal representation? A cross-sectional analysis of the gender composition of neurosurgical editorial boards from 2000 to 2020. J Neurosurg 2021:1-8. [PMID: 34678785 DOI: 10.3171/2021.6.jns21474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE At present, females constitute less than 10% of neurosurgeons in the US, despite representing approximately half of all medical students. Multiple barriers have been described for females entering the neurosurgical field, particularly academic neurosurgery. Understanding the environment that female neurosurgeons face and any potential barriers preventing career advancement is needed to recruit, promote, and retain females in neurosurgery. METHODS The gender composition of editorial boards for 5 high-impact neurosurgery journals was analyzed from 2000 to 2020. The names of editorial board members were obtained directly from the journal administration, physical copies of the published journal, or publicly available data through each journal's website. The gender, degrees, academic titles, H-index, and country were determined for each individual and statistical tests were performed to identify significant differences. RESULTS Of the 466 identified individuals that served on at least one editorial board between 2000 and 2020, there were 36 females (7.7%) and 430 males (92.3%). There were no significant differences between males and females serving on multiple editorial boards. Most females possessed an additional graduate degree (58.3%), while only one-third of males (33.5%) obtained such a degree (p = 0.002). In addition, males had significantly higher average H-indices than females (p = 0.002). These trends were also observed when analyzing only US-based editorial board members. Although females were more likely overall to be identified as associate professors, males were more likely to be appointed as full professors (p = 0.001); this trend did not remain true in the US-based cohort. When analyzing the editorial boards for individual journals, all 5 journals experienced an increase of female representation since 2000 or since their inception after 2000. The highest proportion of females for a single journal was 27.3% in 2020. All other journals ranged from 11.0% to 13.5% in 2020. CONCLUSIONS When entering the field of neurosurgery, females continue to face significant social and academic barriers. While the proportion of females on editorial boards for neurosurgery journals in 2020 is consistent with the proportion of practicing female neurosurgeons, there is a statistically significantly higher likelihood that females possess additional graduate degrees and lower H-indices compared to their male counterparts. The authors encourage neurosurgical journals to continue expanding female representation on editorial boards.
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Affiliation(s)
- Megan M J Bauman
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Kimberly Wang
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Archis R Bhandarkar
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | | | - Michelle J Clarke
- 1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and
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Maqsood H, Naveed S, Younus S, Khan MT, Khosa F. Gender and Racial Trends Among Vascular Neurology Fellowship Programs: By Design or By Default. Cureus 2021; 13:e17740. [PMID: 34659953 PMCID: PMC8491989 DOI: 10.7759/cureus.17740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 01/20/2023] Open
Abstract
Introduction Benefits of increasing diversity in teams include the addition of different perspectives leading to increased innovation and creativity, faster problem solving, improved workforce morale, and reduced burnout leading to improved patient outcomes. This article reviewed the trend of gender and racial disparity in vascular neurology fellowship programs. Methods We retrospectively analyzed the data extracted from the Accreditation Council for Graduate Medical Education (ACGME)'s annual Data Resource Books from 2007 to 2019. ACGME cataloged gender as men and women and race/ethnicity was categorized as White/Non-Hispanic, Asian or Pacific Island, Hispanic, Black/Non-Hispanic, Native American/Alaskan, others, and unknown. Counts, proportions, relative, and absolute percentage changes were calculated to highlight trends in resident appointments over time and across the specialty of vascular neurology. Results The representation of females increased steadily; with a relative increase of 11.78% from the year 2007 to 2019. Race/ethnicity was reported starting from the year 2011. When averaged across the nine-year study period, 35% of the study sample was White (Non-Hispanic), followed by Asian/Pacific Islanders at 25%. The representation of Hispanics was 4.8%, Black/African Americans were 3%, Native Americans/ Alaskans were 0.23% and Others were 13% of the total study population. For 17.7% of the fellows, racial data were not known and was categorized as Unknown racial distribution. Conclusion Our study concludes that gender and racial disparity persists within the fellowship programs of vascular neurology. Effective strategies at individual, administrative, and national levels are needed to engage women and under-represented minorities in vascular neurology as a career choice.
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Affiliation(s)
- Hamza Maqsood
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Sadiq Naveed
- Psychiatry, Hartford Hospital - Institute of Living, CT, USA
| | - Shifa Younus
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | | | - Faisal Khosa
- Radiology, Vancouver General Hospital, Vancouver, CAN
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15
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Maqsood H, Younus S, Naveed S, Chaudhary AMD, Khan MT, Khosa F. Sticky Floor, Broken Ladder, and Glass Ceiling: Gender and Racial Trends Among Neurosurgery Residents. Cureus 2021; 13:e18229. [PMID: 34703711 PMCID: PMC8541839 DOI: 10.7759/cureus.18229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction Diversity and equity in academic medicine are critically important in improving healthcare standards and patient-related outcomes. Gender and racial disparities are some major challenges faced by the health system. This article reviews the gender and racial trends among residents of neurosurgery in the United States (US). Methods We retrospectively analyzed the data extracted from the Accreditation Council for Graduate Medical Education (ACGME)'s annual Data Resource Books from 2007 to 2019. ACGME cataloged gender as men and women and race/ethnicity was categorized as White/non-Hispanic, Asian or Pacific Island, Hispanic, Black/non-Hispanic, Native American/Alaskan, others, and unknown. Counts, proportions, relative, and absolute percentage changes were calculated to highlight trends in resident appointments over time and across the specialty of neurosurgery. Results The number of female residents increased steadily from 10.6% in 2007 to 19.3% in 2019; with an absolute increase of 8.74%, a relative increase of 63.9%, and a simultaneous decrease in male residents. When averaged across the nine-year study period, 51% of the study sample was White (non-Hispanic), followed by Asian/Pacific Islanders at 15.2%. The representation of Hispanics was 4.3%, Black/African Americans were 4.5%, Native Americans/Alaskans were 0.2%, and others were 8% of the total study population. Conclusion Our study concludes that gender and racial disparity persist within the neurosurgery residency training programs in the US. Concrete efforts at all academic levels are needed to provide greater support for the females and for the careers of underrepresented minority (URM) trainees to ensure their increased representation in neurosurgery.
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Affiliation(s)
- Hamza Maqsood
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Shifa Younus
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Sadiq Naveed
- Psychiatry, Hartford Hospital - Institute of Living, CT, USA
| | | | | | - Faisal Khosa
- Radiology, Vancouver General Hospital, Vancouver, CAN
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Gabriel PJ, Alexander J, Kārkliņa A. Diversity in Neurosurgery: Trends in Gender and Racial/Ethnic Representation Among Applicants and Residents from U.S. Neurological Surgery Residency Programs. World Neurosurg 2021; 150:e305-e315. [PMID: 33684577 DOI: 10.1016/j.wneu.2021.02.127] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/27/2021] [Accepted: 02/28/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess trends in gender, racial, and ethnic diversity of applicant pools and subsequent resident cohorts in neurosurgical residency programs in the United States. METHODS Applicant and residency data from 2009 to 2018 were analyzed from the Electronic Residency Application Service, Journal of the American Medical Association, and National Resident Matching Program to evaluate trends in diversity. RESULTS There was no statistically significant difference between applicant sex from 2009 to 2013 compared with 2014 to 2018 (P > 0.05). From 2009 to 2018, the percentage of female residents saw a statistically significant increase from 12.9% to 17.5% but remained less reflective of women's representativeness in the United States (50.8%). The percentage of Black and Hispanic applicants decreased across the observed period (4% and 1%, respectively). While Black people represented 5.2% of the resident pool in 2009, this decreased to 4.95% by 2018. Hispanic residents saw a <2% net increase (5.5% to 7.2%) in resident representation but still fell behind when compared with census statistics. The application pool did not see a significant change in the percentage of White and Asian applicants; however, the percentage of residents did decrease slightly over the observed decade. CONCLUSIONS Current efforts to improve racial and ethnic diversity have not been sufficient in generating parity in the recruitment and retention of racially underrepresented groups in neurosurgery. Although the presence of women in applicant and resident pools has increased, not much is known about the impact on women who also identify within racially underrepresented groups. More proactive measures for recruitment and retention are needed to reach equity in the future neurosurgical workforce.
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Affiliation(s)
| | | | - Anastasia Kārkliņa
- Department of Gender, Sexuality, and Feminist Studies, Duke University, Durham, North Carolina, USA; Department of African and African-American Studies, Duke University, Durham, North Carolina, USA
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Thum JA, Chang D, Tata N, Liau LM. Neurosurgeons in 2020: the impact of gender on neurosurgical training, family planning, and workplace culture. Neurosurg Focus 2021; 50:E11. [PMID: 33789233 DOI: 10.3171/2020.12.focus20965] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/16/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In 2008, a Women in Neurosurgery Committee white paper called for increased women applicants and decreased women's attrition in neurosurgery. However, contributing factors (work-life balance, lack of female leadership, workplace gender inequality) have not been well characterized; therefore, specific actions cannot be implemented to improve these professional hurdles. This study provides an update on the experiences of neurosurgeons in 2020 with these historical challenges. METHODS An anonymous online survey was sent to all Accreditation Council for Graduate Medical Education (ACGME)-accredited US neurosurgical programs, examining demographics and experiences with mentorship, family life, fertility, and workplace conduct. RESULTS A total of 115 respondents (64 men, 51 women; age range 25-67 years) had trained at 49 different US residencies. Mentorship rates were very high among men and women in medical school and residency. However, women were significantly more likely than men to have a female mentor in residency. During residency, 33% of women versus 44% of men had children, and significantly fewer women interested in having a child were able to do so in residency, compared to men. Significantly more women than men had a child only during a nonclinical year (56.3% vs 19.0%, respectively). Thirty-nine percent of women and 25% of men reported difficulty conceiving. The major difficulty for men was stress, whereas women reported the physical challenges of pregnancy itself (workplace teratogens, morning sickness, etc.). Failed birth rates peaked during residency (0.33) versus those before (0.00) and after residency (0.25).Women (80%) experience microaggressions in the workplace significantly more than men (36%; p < 0.001). Ninety-five percent of macro-/microaggressions toward female neurosurgeons were about their gender, compared to 9% of those toward men (p < 0.001). The most common overall perpetrators were senior male residents and attendings, followed by male patients (against women) and female nurses or midlevel providers (against men). CONCLUSIONS Accurate depictions of neurosurgery experiences and open discussions of the potential impacts of gender may allow for 1) decreased attrition due to more accurate expectations and 2) improved characterization of gender differences in neurosurgery so the profession can work to address gender inequality.
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Affiliation(s)
- Jasmine A Thum
- 1Department of Neurosurgery, University of California, Los Angeles
| | - Diana Chang
- 2Department of Neurosurgery, UCSF School of Medicine, University of California, San Francisco, California; and
| | - Nalini Tata
- 3Department of Neurosurgery, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Linda M Liau
- 1Department of Neurosurgery, University of California, Los Angeles
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Nieblas-Bedolla E, Williams JR, Christophers B, Kweon CY, Williams EJ, Jimenez N. Trends in Race/Ethnicity Among Applicants and Matriculants to US Surgical Specialties, 2010-2018. JAMA Netw Open 2020; 3:e2023509. [PMID: 33136131 PMCID: PMC7607442 DOI: 10.1001/jamanetworkopen.2020.23509] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Surgical programs across the US continue to promote and invest in initiatives aimed at improving racial/ethnic diversity, but whether this translates to changes in the percentage of applicants or matriculants from racial/ethnic minority groups remains unclear. OBJECTIVE To examine trends in the percentage of applicants and matriculants to US surgical specialties who identified as part of a racial/ethnic group underrepresented in medicine from the 2010-2011 to 2018-2019 academic years. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study examined trends in self-reported racial/ethnic identity among applicants and matriculants to US residency programs to evaluate demographic changes among surgical programs from 2010 to 2018. Data were obtained from the Association of American Medical Colleges. RESULTS The study population consisted of a total of 737 034 applicants and 265 365 matriculants to US residency programs, including 134 158 applicants and 41 347 matriculants to surgical programs. A total of 21 369 applicants (15.9%) and 5704 matriculants (13.8%) to surgical specialties identified as underrepresented in medicine. There was no statistically significant difference in the percentage of applicants underrepresented in medicine based on race/ethnicity for all surgical specialties combined in 2010 vs 2018 (15.3% [95% CI, 14.7%-15.9%] vs 17.5% [95% CI, 16.9%-18.1%]; P = .63). Thoracic surgery was the only surgical specialty in which there was a statistically significant change in the percentage of applicants (8.1% [95% CI, 4.9%-13.2%] vs 14.6% [95% CI, 10.2%-20.4%]; P = .02) or matriculants (0% [95% CI, 0%-19.4%] vs 10.0% [95% CI, 4.0%-23.1%]; P = .01) underrepresented in medicine based on race/ethnicity. Obstetrics and gynecology had the highest mean percentage of applicants (20.2%; 95% CI, 19.4%-20.8%) and matriculants (19.0%; 95% CI, 18.2%-19.8%) underrepresented in medicine among surgical specialties. Thoracic surgery had the lowest mean percentage of applicants (12.5%; 95% CI, 9.46%-15.4%) and otolaryngology the lowest mean percentage of matriculants (8.5%; 95% CI, 7.2%-9.9%) underrepresented in medicine. CONCLUSIONS AND RELEVANCE In this cross-sectional study, overall US surgical programs had no change in the percentage of applicants or matriculants who self-identified as underrepresented in medicine based on race/ethnicity, but the proportion remained higher than in nonsurgical specialties. Reevaluation of current strategies aimed at increasing racial/ethnic representation appear to be necessary to help close the existing gap in medicine and recruit a more racially/ethnically diverse surgical workforce.
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Affiliation(s)
| | - John R. Williams
- Department of Neurological Surgery, University of Washington, Seattle
| | - Briana Christophers
- Weill Cornell Medicine–Rockefeller–Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York
| | - Christopher Y. Kweon
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle
| | | | - Nathalia Jimenez
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle
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