Hello, my name is Catherine Kearns and I'm one of the neurosurgery residents at the University of Virginia Health System. This talk is discussing gender equity of promoting practices in academic neurosurgery in the United States. None of the authors have any affiliations or interests to disclose regarding this matter. Just a little bit of background. Women are steadily increasing in number within the field of medicine and in fact, men and women are matriculating into medical school at comparable rates and women now actually make up approximately 45% of the current national resident cohort. However, only approximately 12% of academic neurosurgeons are women and this number is less than the 15% typically required to even be considered an official minority group. Even greater still is the difference in percentage of women holding higher academic ranks such as associate professor, full professor, or chair positions in surgical subspecialties compared to men. Our group has previously examined the gender pay discrepancy in academic neurosurgery and in our research found several characteristics that may be contributing to the present gender inequity. Characteristics often cited in contributing to academic advancement are years out of training, subspecialty fellowship training, production of scientific research and literature, word of mouth support by highly placed individuals, and additional advanced degree related to the field of practice. The current study investigated potential associations between gender and promoting practices evaluating these current factors associated with professorship and chair or directorship among academic neurosurgeons in training institutions across the United States. This was a cross-sectional study of publicly available faculty data from academic neurosurgical training programs listed in the AANS neurosurgical residency training program directory. Programs were included for analysis if sufficient data including time out of residency, professorship status, and specialty were available from individual program websites or specific provider informational pages. Faculties from foreign institutions and fellowship only programs were excluded from the analysis. The extracted data included faculty demographics, training information, academic rank, chair or director position, and Scopus H index. All 1,606 faculty members were examined, 167 of those were female and 1,439 were male. When comparing characteristics of male versus female academic neurosurgeons, women were found to be more likely to have completed training more recently, to have received fellowship training, to have trained in pediatrics, and to hold the title of assistant professor compared to men. Men, however, were more likely to be full professors, to hold chair or directorship positions, and to have a higher Scopus H index. We next conducted a multivariable analysis to identify predictors of academic rank in Model 1 and chair or directorship in Model 2. Years out from residency training was a significant positive predictor of full professorship, but not for chair or directorship. Chair or directorship was a significant positive predictor of full professorship, and H index was a significant positive predictor of both full professorship and chair or directorship. However, gender was not found to be a significant predictor of either full professorship or chair or directorship. Of course, there are some limitations to this study. We assumed accurate representation of the full faculty list and up-to-date individual faculty member attributes on publicly accessible program websites. A potential source of error for this study would be any inaccuracy in program reporting, such as unreporting staffing changes, or errors in training information. Additionally, while all clinical faculty listed on a program website that met inclusion criteria were included for analysis, it is possible that not every listed faculty member actively participated in resident education. Unfortunately, women only comprised approximately 10% of the total data set, which negatively affected the power of our statistical analysis. However, this number closely represents the current distribution of women in academic neurosurgery and also contributes to the generalizability of this study. Also, while some programs did not meet inclusion criteria, faculty lists from 115 of the 132 American AANS residency programs were analyzed, which comprised approximately 87%. This suggests that these conclusions are generalizable to the majority of United States academic neurosurgical programs. So in conclusion, while significantly more men currently hold higher neurosurgical leadership positions in academic institutions in the United States, and they were more likely to have characteristics often cited as contributing to promotion, gender was not a significant predictor of either full professorship or chair or directorship. This suggests a lack of identifiable gender discrimination in promoting practices at academic neurosurgical institutions within the United States. These results may serve as encouragement to female neurosurgeons who are looking to advance their careers in academic neurosurgery, though of course, significant work still needs to be done to reach gender equity. These are our references. Thank you.

gender equity

promoting practices

academic neurosurgery

United States

women in neurosurgery