Hello, my name is Rosemary Bamer Hanson. I am a second year medical student at Rutgers New Jersey Medical School and I'm here today to present on gender and fellowship completion among academic neurosurgeons in the United States. Thank you to all of my co-authors for their help with this project. We have no disclosures. In the United States, more women graduate from medical school than men, yet only 17% of neurosurgery residents are female. The number of women pursuing neurosurgery training has increased, however. In the field of general surgery, we do know that women are less likely to pursue fellowship training than their male counterparts. In neurosurgery, we know that women are disproportionately concentrated in the field of pediatrics, a phenomenon which also occurs in urology, orthopedics, general surgery, and ENT. Our objective is to determine gender differences in neurosurgical fellowship distribution. We performed a quantitative cross-sectional analysis of fellowship training information of practicing academic neurosurgeons in the United States. This information was obtained from publicly available websites. Ultimately, we were able to find it for 85% of 1,600 neurosurgeons assessed. Fellowships were grouped into 10 categories. We used IBM SPSS statistics software to determine tests of association, and p-values of less than or equal to 0.05 were considered statistically significant. Sample demographics are shown here in Table 1. Ultimately, nearly 90% of all neurosurgeons in the sample were male, 10% were female. The majority, 61%, completed one fellowship, while 24% completed no fellowship training, and 14% completed multiple fellowships. The most popular subspecialties for fellowship training in this sample were spine at 27%, followed by vascular, pediatrics, and functional or stereotactic. When stratifying by gender, the male neurosurgeon's pie chart was very similar to the aggregate, where spine, vascular, and functional and stereotactic were the most popular subspecialties for fellowship completion. For female neurosurgeons, pediatrics, followed by neuro-oncology and functional and stereotactic were the most popular subspecialties for fellowship completion. Importantly, these pie charts demonstrate this is an analysis of those who received one fellowship for training. Multiple and no fellowship training completion rates are also reported. We compared rates of male and female neurosurgeons entering specific subspecialty training. For the field of spine, male neurosurgeons had higher percentage of fellowship completion relative to female neurosurgeons. In pediatrics, neuro-oncology, and critical care trauma, we saw higher percentages of female neurosurgeons entering the field. Male neurosurgeons had higher rates of no fellowship completion, whereas female neurosurgeons had higher rates of fellowship completion. In every field and subspecialty in neurosurgery, we see a significantly higher percentages of male neurosurgeons relative to female neurosurgeons. However, figure three demonstrates that there are within-field differences. In spine, for example, there are very few female neurosurgeons comprising the percentage of spine-trained fellowship neurosurgeons. However, when looking at pediatrics, there are significantly higher percentages of female neurosurgeons in the field. We know from previous studies that fellowship completion in neurosurgery is associated with higher mean age indices and future careers in academia. In this study, we demonstrated that women have higher rates of fellowship completion, and they are more likely than men to enter fields of pediatrics, neuro-oncology, critical care trauma, while the men were more likely to enter the field of spine. We did not see significant gender differences proportionally in the fields of functional stereotactic, vascular, skull base, and other fellowship training. Gender differences are ultimately evident in neurosurgical fellowship completion. A key limitation to this study is that we performed a broad cross-sectional analysis. This means that some of the neurosurgeons included in this study received their fellowship training upwards of 40 years ago, when expectations regarding fellowship training in neurosurgery were meaningfully different. We recommend future analyses stratify similar data by year of training completion to better detect trends in gender and fellowship training. For this study, we also made crude gender assessments of individual neurosurgeons' genders. We did so by looking at neurosurgeon name and picture. This understandably may not be accurate for every neurosurgeon. We performed tests of association, not multivariate analyses, and we assessed fellowship completion, not necessarily current subspecialty of practice for every individual academic neurosurgeon. For future work, we will be determining factors that contribute to gender based differences seen in neurosurgical fellowship choice. Special thanks to all of my mentors in the field. Any questions can be directed to me. My name is Rosemary Bamer-Hanson at rtb98 at njms.rutgers.edu. Here are references and thank you AANS for this opportunity to present.

gender differences

fellowship completion

academic neurosurgeons

United States

neurosurgery