Women in Neurosurgery (WINS) Paper Details Workfor

Newswise — A compelling paper, authored by Women in Neurosurgery (WINS) offers insight into the predominately male world of neurosurgery. In 2007, the American Association of Neurological Surgeons (AANS) recognized the need to take bold steps to recruit and retain more women in neurosurgery and requested that WINS author a white paper. The AANS believes that fairness and equality are fundamentally right and vital to the future success of this evolving specialty. The article is published in the September 2008 issue of Journal of Neurosurgery, and is available online beginning August 1 at http://thejns.org/doi/full/10.3171/JNS/2008/109/9/0378.

"The WINS paper not only outlines the realities and challenges for female neurosurgeons, but offers viable solutions targeted at resolving these inequities. The paper touches on the fact that that the number of neurosurgeons appears to be decreasing relative to a growing population and that there is an urgent need to attract more qualified candidates to address this potential shortage. Failure to attract the brightest and most talented in the applicant pool by exclusions of subtle and deniable discrimination is unacceptable. This is an issue that affects the specialty as a whole " and inevitably our patients " and we intend to work together to resolve it," stated James R. Bean, AANS president and author of the accompanying editorial, available at http://thejns.org/doi/full/10.3171/JNS/2008/109/9/0377.

"While some small strides have been made, female neurosurgeons comprise just an estimated 5.9 percent of the neurosurgical workforce," said Deborah Benzil, MD, lead author of the article. "The first female neurosurgeon received Board certification from the American Board of Neurological Surgery (ABNS) in 1960, and there are only 189 ABNS-certified female neurosurgeons in the United States today," remarked Dr. Benzil. Additional US-specific statistics cited in the article include:

"¢In 2005, women comprised more than 55 percent of students accepted to medical school, yet this has not translated to an increase in the number of women pursuing neurosurgery."¢While women comprise 30 percent of the general surgery resident population, only 10 percent of neurosurgical residents are women."¢As late as the 1990s, at least 30 percent of neurosurgical residency programs had never graduated a female resident."¢There are 25 full-time female academic neurosurgeons."¢The first and only female chair to date of a neurosurgery department was not appointed until 2005."¢Female neurosurgeons account for 6 percent of full-time faculty."¢Female neurosurgeons account for 4.6 percent in private practice.

According to the authors, women physicians today occupy many chair positions and hold prominent national and editorial positions. Yet advances for women in several surgical specialties " including orthopedics, thoracic surgery, and neurosurgery " have progressed at a much slower pace. Some of the obstacles to pursuing a career in neurosurgery cross gender boundaries, such as:

"¢Long working hours"¢Length of training"¢Risk of litigation"¢Limited exposure to neurosurgery in the medical school curriculum

The authors note that women may face the following additional obstacles:

"¢Gender inequity in regard to salaries, academic promotion, and achieving leadership positions."¢Inadequate mentoring and lack of role models for women who wish to become leaders locally, regionally, or nationally."¢The perception among medical students that female applicants have difficulty gaining acceptance into neurosurgical residency training programs and may face harassment once accepted.

To overcome the obstacles and issues identified in the paper, the authors propose implementing a broad strategic plan:

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.

"It is important to keep in mind that many of the changes recommended in this paper are likely to benefit all neurosurgeons, irrespective of gender, and will help ensure the future viability of our specialty. Given the challenges facing neurosurgery and academic medicine in general, WINS joins with all of organized neurosurgery in the desire to see neurosurgery continue to grow and prosper," concluded Dr. Benzil.

Co-authors include Aviva Abosch, MD, PhD, Isabelle Germano, MD, FACS, Holly Gilmer-Hill, MD, Nozipo Maraire, MD, Karin Muraszko, MD, Susan Pannullo, MD, Gail Rosseau, MD, Lauren Schwartz, MD, Roxanne Todor, MD, Jamie Ullman, MD, and Edie Zusman, MD.

Founded in 1944, the Journal of Neurosurgery, the official scientific journal of the AANS, has been recognized by neurosurgeons and related medical specialists worldwide for its authoritative and cutting-edge clinical articles, laboratory research papers, case reports, literature reviews, technical notes, book reviews, and more. Each successive editor-in-chief " from Louise Eisenhardt to the current editor, John A. Jane, Sr. " has played a key role in shaping a publication that stays on the cutting edge of a constantly advancing specialty. Each manuscript is reviewed by at least three editorial board members, in addition to the Editor and occasionally one or more expert reviewers.

Founded in 1989, the main goal of WINS is to promote a cooperative and supportive environment among women practicing neurosurgery, including those in training to become neurosurgeons. As the group has grown, it has become an international organization with members in Asia, Europe and Africa. For more information on WINS, visit http://www.neurosurgerywins.org/.

The authors report no conflict of interest.