162 Recruiting Women Into Neurosurgery: A Quantitative Analysis of Feeder Medical School Characteristics

Abstract

INTRODUCTION: Despite a recent increase in the number of women pursuing neurosurgery residency, medical school characteristics associated with the successful recruitment of female medical students into the field remain poorly studied. METHODS: A total of 1572 current residents in U.S. Accreditation-Council-for-Graduate-Medical-Education-accredited neurosurgery programs, representing match cohorts from 2014 to 2020, were evaluated. U.S. medical school characteristics such as class size and number of total and female clinical neurosurgery faculty were recorded. Medical schools were ranked based on the percentage of female graduates entering neurosurgery, and yearly trends of the percentage of females constituting incoming neurosurgery resident cohorts were studied. Associations between percent female recruitment and medical school characteristics were then evaluated using univariable and stepwise multivariable linear regression (including significant univariable factors). RESULTS: The cohort consisted of 1255 male and 317 (20%) female residents. Yearly trends indicated a significant drop in incoming female residents in 2016 followed by significant increases in 2017 and 2019. The following factors were associated with a higher average percentage of female graduates entering neurosurgery on multivariable analysis: total affiliated neurosurgery clinical faculty (β = 0.006, 95% CI [0.001-0.011], p = 0.013), allopathic vs. osteopathic schools (β = 0.231, 95% CI [0.053-0.409], p = 0.011), and top-10 U.S. News ranking (β = 0.380, 95% CI [0.129-0.589], p = 0.002). Upon adding the number of female clinical faculty to the model, the variable was not statistically significant. Multivariable bibliometric analyses indicated a higher mean pre-residency H-index for males with an even greater gender difference identified in current H-index. CONCLUSION: This study characterizes which medical schools have recruited the most female students who are currently in neurosurgery residency. The overall number of clinical neurosurgery faculty rather than faculty gender was independently associated with female recruitment. Gender differences in research productivity persisted while controlling for confounders and increased between pre-residency and current time-points.