WINS: A Changing Landscape in Neurosurgery
The percentage of women in medicine has increased dramatically, with women comprising the majority of medical school applicants for the first time in 2003.1 Since that time, women have represented approximately 50 percent of medical students, with equal achievements in GPA, MCAT, and USMLE scores.2 We have seen an increase in women entering all specialties, but with significant variability. The percentage of women in neurosurgery has increased, though slowly when compared with other subspecialties, with just under 8 percent of all neurosurgery residents in 1989, compared to 10 percent in 20083, and now 16.3 percent in the 2016 match (personal communication ABNS). The number of female neurosurgeons in the workforce has remained even more static, with only 5.9 percent of board-certified neurosurgeons being women in 20063 and 6.1 percent in 2016 (personal communication, ABNS).
Stacey Quintero-Wolfe, MD, WINS meeting, 2016 CNS Annual Meeting
Recognition of these disparities does seem to be making a difference. There are currently 91 women in academic neurosurgery (unpublished data), up from 25 in 20083. Two female interim department chairs have been named in the past year, after years of only a single female chair of neurosurgery. Additionally, there are currently three female vice-chairs and seven female program directors. This increase in female mentorship is critical for the overall training environment as we work to attract top medical students, 50 percent of whom are women.
Increasing diversity is important in the training and retention of residents, and in the work environment. From 2000-2009, the overall resident attrition rate was 6.7 percent, with a noticeable difference between women and men (17 percent versus 5.3 percent, respectively)4. Leadership must now include an understanding of different learning styles and individual motivations. Addressing differences between generations, cultures, and gender can significantly improve education. Mentorship and promotion are key elements of fostering future generations into faculty and leadership roles.
1 U.S. Medical School Applicants and Students 1982- 1983 to 2011-2012.; 2012. Available at: https://www. aamc.org/download/153708/data/.
2 Cuddy MM, Swanson DB, Clauser BE: A multilevel analysis of examinee gender and USMLE step 1 performance. Acad Med 83:S58–62, 2008.
3 Benzil DL, Abosch A, Germano I, et al. The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery. J Neurosurg. 2008;109(3):378-86.
4 Renfrow JJ, Rodriguez A, Liu A, et al. Positive trends in neurosurgery enrollment and attrition: analysis of the 2000-2009 female neurosurgery resident cohort. J Neurosurg. 2016;124(3):834-9.