S. Shukla2,3, C.M. Pace4, H. Paraquett1,3 1MEDICAL SCIENCES FACULTY – UNIVERSITY OF BUENOS AIRES, ARGENTINA, BUENOS AIRES, Argentina 2Qingdao University, Department Of Surgery, Qingdao, SHANDONG, China 3Gender Equity Initiative in Global Surgery, Boston, MA, USA 4Federal University of Rio de Janeiro, Rio De Janeiro, Brazil
Introduction:
Studies have shown female surgeons were correlated with superior clinical and surgical outcomes and more proficient patient-centered communication. Notwithstanding significant advancements in gender equity in the US and Brazil, the representation of women in the competitive surgical subspecialties has remained static, with overwhelmingly limited roles of women in leadership positions contributing to a prevalent glass ceiling effect, which may be a reflection of cultural values such as women primarily in charge of childcare and housework that constrain the progression of female neurosurgeons(FN). In our study, we analyzed the representation of FN in the USA and Brazil, within neurosurgery residency and fellowships.
Methods:
This retrospective cross-sectional study utilized the FREIDA database to examine the distribution of women neurosurgery trainees across US residency and fellowships programs and the 2023 Brazilian Medical Demography. We also evaluated twelve articles from PubMed, Embase, and the National Health Library databases with the use of covidence and endnote. The study scrutinized the recent portrayal of women in Brazilian neurosurgery, with a particular focus on subspecialty distribution.
Results:
We accounted for a total of 402 neurosurgery trainees, 240 in the US and 162 in Brazil from the previous academic year. Male neurosurgeons(MN) outnumbered FN in neurosurgery & fellowships both in the US and Brazil. Shockingly in the USA, only, 27% of FN completed fellowships post-residency. Among these, pediatric neurosurgery was the most popular choice (33%) followed by oncology (15%). In comparison, significantly more MN (94.4%) completed spine fellowships than FN (5.6%). Skull base, vascular, functional, peripheral nerve, and endovascular fellowships remain male-dominant in the US. In Latin America, only 8.71% of neurosurgeons are women, mirroring Brazil's proportion at 9.4%. However, within various subspecialties such as vascular, spinal, functional, and oncology, males predominantly dominate, whereas women tend to occupy more prominent roles in pediatric neurosurgery, while in Brazil, FN held neuropediatrics positions possibly reflecting cultural norms of women being in charge of children
Conclusion:
Despite gradual advancements in the gender equity landscape, gender disparity remains prevalent within the competitive surgical subspecialties in the US and Brazil. This similarity in the outcomes in the US and Brazil opens new discussions and doors to understanding why there is a pattern in women's representation in neurosurgical fellowships. This analysis emphasizes the necessity for innovative approaches to address these imbalances, aiming ultimately to promote greater accessibility and societal inclusiveness within the realm of neurosurgery.