Healthcare services have been working towards gender equality in every specified field of medicine, with almost equal distribution between men and women among medical graduates, yet more needs to be done because most surgical sub specialities are still lacking adequate female representation and this is most notably present within neurosurgery. But how big is this gender divide and what is being done about it?  
 

Factors including representation, a lack of mentoring, and discrimination have been among the issues cited by female neurosurgeons as contributing to gender disparity in the field. This is according to a study published in the Journal of Neurosurgery by Tina Lulla (Rutgers New Jersey Medical School, Newark, USA) et al, who conducted a systematic literature review of studies pertaining to women in neurosurgery. 
 
In the report, Lulla points to a recent study which estimated “the total number of neurosurgeons globally, including trainees, was reported to be 49,940.” Historically, neurosurgery has been a male-dominated field, and many medical fields have made strides toward gender equity. However, surgical fields continue to have higher percentages of men than women. In 2017, 50.7% of students entering medical school in the United States were women, but according to the physician speciality report produced by the Association of American Medical Colleges (AAMC), only 8.4% of neurosurgeons in the United States were women in the same year. The same report demonstrated that there are consistently low numbers of women in neurosurgery training programs and cited a lack of female role models for mentoring. This is one of the major factors as to why there are less women working in neurosurgery.  
 
The same can be said for the UK and the statistics are very similar to their US counterparts. In 2018, the General Medical Council reported that 56% of all medical students were female. However, the number of women pursuing a surgical career still lags behind. Based on data from the Royal College of Surgeons, the proportion of female consultant surgeons was only 3% in 1991 and 13.2% in 2020. 
 
The Journal of Neurosurgery recently conducted an extensive survey of current perceptions and challenges in gender disparity in UK neurosurgery. Of the 286 respondents, 44.5% feel that there is no gender disparity in neurosurgery. This represents the opinions of 52.2% of men and 29.2% of women. In total, 56.2% of female and 19.8% of male respondents believe their male colleagues are treated better in the workplace. Only 9.3% of the respondents feel that women are treated better than men in neurosurgery. Clearly from these statistics alone, more needs to be done to decrease the gender disparity in UK neurosurgery.  

 
There are many factors as to why this gender disparity exists in neurosurgery. In the same study published in The Journal of Neurosurgery, the paper identified eight factors that have contributed towards gender disparity in the field. These included: conference representation, the proverbial glass ceiling, lifestyle, mentoring, discrimination, interest, salary and physical burden. According to the authors, the most frequently cited factor was mentorship, with 22 (56.4%) of studies finding it impactful. They also note that mentorship was mentioned as a factor even from the earliest study, in 2004, and was mentioned across multiple continents. 
 
The second most cited factor—mentioned across 19 (48.7%) studies—was lifestyle, such as work, family goals, and personal goals. Similar to mentorship, this factor was mentioned consistently and across multiple continents which, according to researchers, indicated this is not a culture-specific concern. Authors cite a number of studies, including one from Japan, in which women had reported leaving their neurosurgery careers due to difficulty balancing their career and motherhood, and a study which reported that both male and female residents were leaving surgery due to lifestyle reasons. The authors comment that “In conjunction with our analysis, this data suggests that work-life balance is of increasing importance to incoming surgical trainees regardless of gender.” 
 
Based on these studies and the two main factors that contribute towards gender disparity in Neurosurgery, better mentoring of medical trainees to see the benefits in a career in neurosurgery could massively bridge the gap in the number of women entering the field. Likewise, a good work-life balance would encourage women to stay in the field for longer and with Covid-19 now changing perceptions on the way we work in all fields of work life, not just medical, there could be radical changes in the coming years to address gender disparity.  

At Neuro Convention, we're determined to be as inclusive as possible and strive to include more female representation in our conference programme. Interested in speaking? Get in touch via marketing@neuroconvention.com