Author: Aruna Ganju, MD
A seminal event occurred in the history of Women in Neurosurgery (WINS) this past year. With the approval of its parent neurosurgical organizations, the Congress of Neurological Surgeons and the American Association of Neurological Surgeons, WINS became the Joint Section on Women in Neurosurgery. The petition for WINS section status was ratified by the executive committees of both organizations, paving the way for a new era for WINS.
The Section on WINS debuted its inaugural session at the CNS Annual Meeting in Boston last October. This was a landmark moment for the organization; it gave the section an equal seat at the table with the other subspecialties within neurosurgery.
Was this necessary?
Women in neurological surgery are still the minority; the gender parity seen in entering medical school classes is still not seen in our field. Since 2001, approximately 47 percent of students entering medical schools nationally are female. However, over the course of those four years, women elect to pursue careers in specialties such as OB/GYN, pediatrics, and primary care. Neurological surgery, orthopedic surgery, and thoracic surgery share the distinction of having the least number of female trainees in residency programs. In each of these specialties, less than 20 percent of trainees are female. A number of studies have examined the variables that influence medical students’ career choice. These suggest that the decision to enter the surgical subspecialties is heavily influenced by early exposure to surgeons in medical school. Furthermore, there is a strong association between female medical students’ pursuing a surgical career and having a higher proportion of women as surgical faculty members.1
Neurosurgical leaders, recognizing the gender disparity in our field, organized a committee to investigate; the resulting white paper2 discussed strategies to attract the best and brightest females into neurosurgery.
Nevertheless, challenges still exist: a follow-up paper by Samadani et al.3 examined attrition rates of residents entering neurosurgical training programs during the years of 1990 to 1999. Females demonstrated a higher attrition rate than that of their male counterparts both during and after completion of neurosurgical training. In this study, 63 percent of the female cohort studied achieved board certification in comparison to 81.3 percent of men who achieved board certification.
The future may be more promising as reported in an upcoming paper by Wolfe et al.4 The authors found that in the 1990s, women comprised 10.7 percent of all residents enter-ing neurosurgical training programs; by the following decade, this number had increased to 12 percent. Although this represents a modest increase, there is suggestion of an upward trend; by 2013, females accounted for 15.5 percent of all residents entering neurosurgical training.
While progress has been made since the landmark paper of 2008, the journey is far from over. At present, there remains only one female chairperson of a neurosurgical department. On the other hand, there are now 10 female directors of neurosurgical residency training programs. WINS members discuss the ongoing journey, both in neurosurgical forums,5 as well as in the general medical community.6 As they point out, in another 50 years, both the workforce and its needs will have changed dramatically; they predict that the neurosurgical workforce will be comprised of 50 percent women.
The Section on WINS strives to provide a gender-neutral program for all neurosurgeons at all stages of their careers. At the most recent AANS meeting in Washington, DC, the first scientific session addressed the full gamut of a neurosurgical career, beginning with advice for medical students and residents up to the young faculty member. In the latter portion of the session, updates for the various neurosurgical subspecialties were given. Neurosurgeons Marjorie Wang, Sepideh Amin-Hanjani, and Patricia Raksin updated the audience with the latest developments in the areas of spine, vascular, and trauma.
WINS events at the recent meeting included a reception on May 5, 2015, featur-ing Dr. Ruth Kerr Jakoby. In addition to being the first female ABNS diplomate, she had a second career as an attorney later in life. For her many accomplishments, she was also recognized at the plenary session on May 6.
The WINS breakfast on May 6 featured the 2015 Louise Eisenhardt lecturer, Dr. Sally Satel, a practicing psychiatrist and lecturer at Yale University School of Medicine and member of the think tank American Enterprise Institute. She is a recognized expert in mental health policy as well as political trends in medicine. Her addresses included “How political correctness is corrupting medicine” and “Fifty shades of grey matter.” In the latter, Dr. Satel discussed the use of neuroscience in the legal system, highlighting the spurious link between structural neuroscience and behavior.
The Section on WINS is putting together a program for the 2015 CNS Annual Meeting, entitled “Innovation in Neurosurgery,” featuring speakers within the field who have been innovators and visionaries. Hope to see you in New Orleans!
THE SECTION ON WINS STRIVES TO PROVIDE A GENDER-NEUTRAL PROGRAM FOR ALL NEUROSURGEONS AT ALL STAGES OF THEIR CAREERS.... WINS IS PUTTING TOGETHER A PROGRAM FOR THE 2015 CNS ANNUAL MEETING, ENTITLED “INNOVATION IN NEUROSURGERY,” FEATURING SPEAKERS WITHIN THE FIELD WHO HAVE BEEN INNOVATORS AND VISIONARIES.
- Neumayer L, Kaiser S, Anderson K, et al.Perceptions of women medical students and their influence on career choice. Am J Surgery. 2002;183(2):146–150.
- Benzil DL, Abosch A, Germano I, et al. The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery. WINS White Paper Committee: J of Neurosurgery. 2008;109(3):378-386.
- Lynch G, Nieto K, Reyes M, et al. Attrition rates in neurosurgery residency: analysis of 1361 consecutive residents matched from 1990 to 1999. J of Neurosurgery. 2015;122(2):240-249.
- Renfrow JJ, Rodriguez A, Liu A, et al. Positive trends in neurosurgery enrollment and attrition: analysis of the 2000-2009 female neurosurgery resident cohort. Accepted for publication in the Journal of Neurosurgery, March 2015.
- Ben-Haim S, Pilitsis J. Women in neurosurgery: past, present, and future. Congress Quarterly. 2015;16(2):21-22.
- Thomson P. The long haul toward parity. The New Physician. Jan-Feb 2015; 13-15.