Female Neurosurgeons Research Articles

Becoming a Neurosurgeon: A Perspective of the Ghanaian Female Neurosurgeon

AbstractChoosing a career path is not straightforward for most people, more so for the neurosurgeon. The decision-making process is influenced by knowledge of the options available, interest, and the pros and cons of the specific career path. Other factors that contribute are: previous education, family influence, exposure to mentors, and socioeconomic and cultural factors.This article is a perspective on becoming a neurosurgeon in Ghana, describing a path of determination, innovation, commitment, frustration, and the joy of making a difference—a career in Neurosurgery!

A step toward equal representation? A cross-sectional analysis of the gender composition of neurosurgical editorial boards from 2000 to 2020.

At present, females constitute less than 10% of neurosurgeons in the US, despite representing approximately half of all medical students. Multiple barriers have been described for females entering the neurosurgical field, particularly academic neurosurgery. Understanding the environment that female neurosurgeons face and any potential barriers preventing career advancement is needed to recruit, promote, and retain females in neurosurgery. The gender composition of editorial boards for 5 high-impact neurosurgery journals was analyzed from 2000 to 2020. The names of editorial board members were obtained directly from the journal administration, physical copies of the published journal, or publicly available data through each journal's website. The gender, degrees, academic titles, H-index, and country were determined for each individual and statistical tests were performed to identify significant differences. Of the 466 identified individuals that served on at least one editorial board between 2000 and 2020, there were 36 females (7.7%) and 430 males (92.3%). There were no significant differences between males and females serving on multiple editorial boards. Most females possessed an additional graduate degree (58.3%), while only one-third of males (33.5%) obtained such a degree (p = 0.002). In addition, males had significantly higher average H-indices than females (p = 0.002). These trends were also observed when analyzing only US-based editorial board members. Although females were more likely overall to be identified as associate professors, males were more likely to be appointed as full professors (p = 0.001); this trend did not remain true in the US-based cohort. When analyzing the editorial boards for individual journals, all 5 journals experienced an increase of female representation since 2000 or since their inception after 2000. The highest proportion of females for a single journal was 27.3% in 2020. All other journals ranged from 11.0% to 13.5% in 2020. When entering the field of neurosurgery, females continue to face significant social and academic barriers. While the proportion of females on editorial boards for neurosurgery journals in 2020 is consistent with the proportion of practicing female neurosurgeons, there is a statistically significantly higher likelihood that females possess additional graduate degrees and lower H-indices compared to their male counterparts. The authors encourage neurosurgical journals to continue expanding female representation on editorial boards.

Women in neurosurgery: review of the literature combined with a gender-based analysis of the development over the past 20 years in Austria.

The number of female neurosurgeons has grown over the last decades, however, a gender gap still exists in most western countries. The reasons for this gender gap remain mostly unclear. The aim of the present study was to analyze the development of the numbers of female neurosurgeons in Austria over the last 20 years in comparison to other surgical disciplines. Additionally, a literature review was performed summarizing articles reporting on women in neurosurgery. Data including male and female residents as well as board certified surgeons over the last 20 years retrieved from the Austrian Medical Association were collected. An additional PubMed query was performed focusing on literature reporting on working conditions, work-life-balance as well as data of female leading positions. In 2021, 5237 surgeons were registered at the Austrian Medical Association including 258 (5%) neurosurgeons. In total, 1081 of 5237 (21%) surgeons and 61 of 253 (24%) of all Austrian neurosurgeons were female. In comparison to the percentage of women in all surgical disciplines, the number of female neurosurgeons is represented slightly above the average of 21%. According to data representing the trend of the last 20 years, the percentage of female neurosurgeons in Austria has doubled over the last 20 years. Comparably, this trend can be observed in all surgical disciplines. The percentage of female neurosurgeons in Austria are constantly increasing over the last 20 years, however a gender gap still exists. Consequently, studies are warranted to analyse the causes to improve the reported gender gap in Neurosurgery.

Lessons from the life of Asia's first female neurosurgeon for modern neurosurgical trainees and educators worldwide.

Surgical specialties, and particularly neurosurgery, have historically had and continue to have poor representation of female trainees. This is especially true of South Asia, considering the added social and cultural expectations for women in this region. Yet it was in India, with its difficult history of gender relations, that Asia's first fully qualified female neurosurgeon, Dr. T. S. Kanaka (1932-2018), took root, flourished, and thereafter played an integral role in helping develop stereotactic and functional neurosurgery in the country. While a few biographical accounts of her exist, highlighted here are the lessons from her illustrious life for neurosurgical trainees and educators worldwide, along with the instances that exemplify those lessons, drawn from several hitherto unutilized primary sources. These lessons are consistent with the factors identified in previous systematic reviews to be contributing to gender disparities in neurosurgery. Many of the virtues that ensured her success are attributes that continue to be critical for a neurosurgical career. Additionally, the circumstances that helped Kanaka succeed have been recounted as considerations for those working to promote diversity and inclusion. Finally, her life choices and sacrifices are described, which are underexplored but relevant concerns for women in neurosurgery.

Gender disparity in German neurosurgery.

Despite the rising number of women in higher education and leadership positions, the proportional rise of female neurosurgeons still lags behind these fields. This study evaluates the gender distribution in German neurosurgical departments across all career levels, and is aimed at heightening the awareness of gender disparity and the need for improving gender equality and its related opportunities. Data on gender distribution across all professional levels in German neurosurgical departments were obtained from departmental websites as well as by email and telephone request. Results were additionally analyzed in reference to hospital ownership type of the neurosurgical departments. A total of 140 German neurosurgical departments employing 2324 neurosurgeons were evaluated. The analysis revealed a clear preponderance of men in leadership positions. Only 9 (6.3%) of 143 department heads were women, and there were only 1 (2.4%), 17 (14.5%), and 4 (12.5%) women among 42 vice-directors, 117 chief senior physicians, and 32 managing senior physicians, respectively. Senior physicians not holding a leadership position were female in 23.1%, whereas board-certified neurosurgeons not holding a senior physician position and residents were female in 33.6% and 35.0%, respectively. Of note, the highest proportion of female department heads (15.6%) was found in private hospitals. The number of women in leadership positions in German neurosurgical departments is dramatically low, and with increasing leadership status gender disparity increases. Mentorship, recruitment, the perception of benefits offered by diversity and programs facilitating gender equality, job sharing, parental leave policies, and onsite childcare programs are needed to turn German neurosurgical departments into modern medical departments reflecting the gender profile of the general patient population.

107 Composition and Gender Distribution of Editorial Boards for Top Neurosurgical Journals

INTRODUCTION: Women are underrepresented in academic medicine, most notably in surgical subspecialties. Despite increasing numbers of female neurosurgery residents, female neurosurgeons are not obtaining competitive national positions at comparable rates. Serving as a journal editor is one measure of academic success. METHODS: This is a cross-sectional study of editorial boards for the top 10 English-language neurosurgical journals (Journal of Neurosurgery, Neurosurgery, JNS: Spine, World Neurosurgery, Neurosurgical Focus, JNS: Pediatrics, Acta Neurochirurgica, Surgical Neurology International, Neurosurgical Review, and Neurosurgical Clinics). Board members were identified from journal websites. Data was obtained from journal websites, program faculty lists, or physician online profiles. Editors with medical degrees (MD or equivalent) were included. Gender differences were compared using Student’s t-test and chi-squared analysis. RESULTS: 722 board members were examined (female n=65; male n=650; unidentified n=7). Overall, women had fewer years in practice (p=0.002) while men were more likely to have additional degrees (p=0.009) and to have higher h-indices (p<0.0001). Within the editorial boards of Neurosurgery and Acta Neurochirurgica, men were more likely to have been in practice longer (p=0.014;p=0.023), and to have higher h-indices (p=0.003;p=0.025). Male editors for JNS: Spine and World Neurosurgery were more likely to have higher h-indices (p=0.007;p=0.018). CONCLUSION: Women constitute ∼8% of the editorial boards for top neurosurgical journals. While this is comparable to the amount of practicing female academic neurosurgeons, much needs to be done to achieve gender parity in competitive, high-ranking positions. The differences in years in practice and h-index suggest that this discrepancy may improve with time as more women enter practice and produce scientific literature. Efforts to recruit and retain women in neurosurgery should be pursued to rectify this discrepancy.

826 Gender Equality in Neurosurgery and Strategic Goals Towards a More Balanced Workforce

INTRODUCTION: The Women in Neurosurgery (WINS) published a white paper in 2008 setting a goal for women to comprise 20% of neurosurgery residents by 2012 and 20% of practicing neurosurgeons by 2020. There has been notable progress toward these benchmarks, but we ultimately fell short of their achievement. METHODS: A literature review was performed PubMed, Google Scholar, and published data from Accreditation Council for Graduate Medical Education (ACGME) and other society websites. to perform a thorough progress assessment. The combined expertise and experience of the authors was used to create new specific recommendations. RESULTS: There was an exponential increase in the number of female neurosurgical trainees in the past several decades, the percentage of female neurosurgery residents increased from 12.7% to 19.3%and the percentage of ABNS certified female neurosurgeons increased from 5% to 12% between 2010 and 2020. The total female authorship in Neurosurgery and Journal of Neurosurgery increased from 12 to 16.5% between 2003 and 2018, however there was no increase in senior authorship. Women were more likely to be published as first author with a female senior author than with a male senior author (30.4% v 14.1%). Systemic barriers identified include wage inequity of 10-25%, rampant sexual harassment, and barriers regarding parental leave policies. CONCLUSIONS: We propose the following updated recommendations. Neurosurgical departments and societies should make targeted effort to retain women in academic neurosurgery in order to foster mentorship opportunities. There must be explicit policies regarding sexual harassment, compensation equity, and parental leave. Finally, we propose new benchmarks of women comprising 30% of residents by 2030, and 30% of practicing neurosurgeons by 2040.

351 Dear Program Director: Evaluating Implicit Bias in Neurosurgery Residency Letters of Recommendation

INTRODUCTION: Despite comprising half of medical students, women represent 25% of neurosurgery applicants, 17% of residents and 12% of practicing neurosurgeons. This trend suggests “leaks” in the career pipeline for female neurosurgeons. The NRMP Program Director Survey has shown that neurosurgery programs identify Step 1 score and letters of recommendation (LORs) as the most important factors in selecting applicants to interview. Other specialties have evaluated implicit biases in LORs, but no such study exists in neurosurgery. METHODS: Retrospective analysis of LORs for neurosurgery applicants interviewed between 2014-2020. LORs were evaluated using the Linguistic Inquiry & Word Count (LIWC) software and a Reader Scoring System. The LIWC dictionary and a custom dictionary containing additional categories (e.g. grindstone) and terms (e.g. hardworking) were used. Analyses were done using SAS. RESULTS: 218 applications were reviewed (81.1% male, n=177), for a total of 827 letters. LIWC analysis showed significant differences in word count (331 females vs. 296 males, p = 0.017), ability words (6.61 females vs. 5.51 males, p = 0.018), and agentic words (6.31 females vs. 5.53 males, p = 0.020). Female letters showed a higher average number of grindstone, communal and commitment words. The Reader Scoring System showed similarities between candidates, but revealed a trend that in female letters writers mention personal attributes and “career” versus “residency” potential. CONCLUSION: This is the first study to evaluate for implicit gender bias within neurosurgery LORs. LORs are key in the selection process and therefore represent one area to target when it comes to increasing female representation in neurosurgery. Our study showed that female applicant’s letters were longer, had more ability and agentic terms, and trended towards more grindstone, communal and commitment words.

Women in neurosurgery: perspectives from a developing country; Turkey.

Although at least half of medical students are women, neurosurgery is not often preferred by women, and the proportion of female neurosurgeons who can participate in the academic platform is very low. In this study, we aimed to show the role of female neurosurgeons in the Turkish Neurosurgical Society and to describe the number and the location of female neurosurgeons in Turkey. We examined the age, academic rank, years of work in the profession, membership rate in society subgroups, h-index parameters, and relationships of certificated female neurosurgeons registered in the Turkish Neurosurgical Society. We examined gender rate differences between society subgroups using chi-square tests. A P value < 0.05 was considered statistically significant. According to the year-end 2020 data of the Turkish Neurosurgery Society, 94 (5.5%) of the 1699 neurosurgery specialists registered in Turkey are women. There are currently 94 board-certified female neurosurgeons between the ages of 31 and 92years; 10 are full professors (10.6%), 16 are associate professors (17%), 5 are assistant professors (5.3%), and 63 are neurosurgery specialist physicians (67%). Female neurosurgeons are present among six of the subfields categorized by the Turkish Neurosurgical Society: 7 in pediatric neurosurgery (11.47%); 8 in spinal and peripheral nerve surgery (2.4%); 3 in neurovascular surgery (2.02%); 7 in functional neurosurgery (5.8%); 11 in neuroanatomy (9.2%); and 23 in neurooncology (6.9%). The number of female neurosurgeons in Turkey continues to grow each year. To increase the proportion of women in this field, it is important to support female neurosurgeons and enable them to take on more tasks.

Challenges in Neurosurgery During the COVID-19 Pandemic: The Experience of Kazakhstan

BackgroundThe practice of neurosurgery has been profoundly affected by the coronavirus disease 2019 (COVID-19) pandemic in Kazakhstan. Many elective surgeries were postponed or canceled, which resulted in difficulties in hospitalization. In the present study, we aimed to describe the effects of COVID-19 on neurosurgical practice and to determine whether a discrepancy was present in the effects between metropolises and regional cities in Kazakhstan.MethodsWe performed an electronic internet-based survey among Kazakhstan’s neurosurgeons using the virtual snowball sampling method. The invitation link to complete the questionnaire was sent to neurosurgeons through personal and corporate electronic mail and social networks. The data were analyzed using Excel and Stata.ResultsA total of 43 neurosurgeons completed the survey. The distribution of regional and urban respondents was almost equal. The male neurosurgeons outnumbered the female neurosurgeons (93.02% vs. 6.98%). A decrease in consultations (65.34% ± 28.24%) and surgeries (56.55% ± 26.34%) had been observed by all neurosurgeons, regardless of city type. However, the proportion of neurosurgeons who had attended online educational courses during the pandemic was significantly higher (P = 0.001) for the surgeons from major cities (68.18%) compared with the surgeons from smaller cities (19.05%). The regional neurosurgeons tended to perform urgent surgeries on COVID-19–positive patients 3 times more often than had the metropolitan neurosurgeons (P < 0.001).ConclusionsThe true effect of the pandemic remains unknown for Kazakhstan. A discrepancy between the metropolitan and regional cities was found in the present study. Efforts are required and relevant guidelines must be developed to ensure that the neurosurgical treatment of various conditions continues to be available during health emergencies and that the disparities are addressed.

Letter to the Editor Regarding “Bibliometric Analysis of Publications from 2011–2020 in 6 Major Neurosurgical Journals (Part 1): Geographic, Demographic, and Article Type Trends”

Women have historically been underrepresented in academic medicine, particularly in surgical subspecialties. This study investigated potential associations between gender and promoting practices in academic neurosurgery.Faculty data, including time from residency, professorship, specialty, and h-index, were obtained from websites of the institutions listed in the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Demographics, training, and appointments were compared between male and female neurosurgeons. Predictors of professorship, chair, directorship, and division leadership were identified using multivariable models.The study examined 1629 faculty members. Women were more likely to be assistant professors (P < 0.0001), while men were more likely to be full professors (P < 0.0001), hold chair positions (P = 0.007), lead subspecialty divisions (P = 0.008), and have a higher Scopus h-index (P < 0.0001). In a multivariable analysis, years from training (P < 0.001), fellowship (P = 0.009), h-index (P < 0.001), and chair/program director/division leadership position (P < 0.001) were significant positive predictors of full professorship. Holding additional advanced degrees (P = 0.010), leading a subspecialty division (P = 0.005), and having a higher h-index (P = 0.002) positively predicted chair position. However, when accounting for all other factors, gender was not a significant predictor of full professorship, division leadership, chair, or program directorship.While significantly more men hold leadership positions in U.S. academic institutions, after controlling for contributing variables, there did not appear to be an association between gender and full professorship, division leadership, chair, or program directorship in academic neurosurgery. While the field still has significant work to do to achieve gender equity, these results may serve as encouragement to women who are looking to advance their careers in academic neurosurgery.

Women in pediatric neurosurgery

Pediatric neurosurgery is an ever-evolving field, and at the heart of it are talented and hardworking neurosurgeons who harness technology and research to enhance the standard of neurosurgical care for children. Recent studies have found that female neurosurgeons tend to choose a career focused on pediatric neurosurgery more than other subspecialties. However, the achievements and contributions of women in pediatric neurosurgery are not well known. To address this, an international working group of pediatric neurosurgeons was established from the World Federation of Neurosurgical Societies (WFNS) Women in Neurosurgery (WINS) group and Pediatric Neurosurgery Committee. The working group reviewed the current literature and collected information through personal communications with the global WINS network. Despite the increasing number of women entering neurosurgical training, the number of female pediatric neurosurgeons is still a mere handful worldwide. In this article, the authors summarize the current status of female pediatric neurosurgeons across the globe, highlighting their achievements as well as the gender bias and challenges that they face at every level of progression of their career. A better organized pediatric neurosurgery workforce, with more female representation and mentorship, would encourage future generations of diverse genders toward a career in this field.

Gender disparity in neurosurgery: A multinational survey on gender-related career satisfaction

IntroductionWomen continue to be underrepresented in the majority of surgical specialties, including neurosurgery. Research questionIn this multinational survey, we aimed to assess current gender disparities in neurosurgery focusing on job satisfaction and inequity/discrimination at work. Material and methodsFemale and male members of the European Association of Neurosurgical Societies were asked to complete an electronic survey (Google Forms, Mountain View) containing demographic baseline data and questions on attitudes regarding gender disparity, personal experience with gender inequity and career satisfaction/work-life balance. Quantitative analyses were performed to analyse the responses, including summary and comparative statistics. ResultsWe received 168 responses from 40 different countries. Survey responders had a mean age of 40.8 ​± ​11.5 years; 29.8% were female. There were significant more male than female residents and attending surgeons per department. Eighty-eight percent of female and 38.1% of male responders experienced gender inequity or discrimination at work (adjusted OR 10.8, 95%CI 4.2–27.8, p<0.001). Female neurosurgeons were more likely to be discriminated by colleagues (aOR 4.32, 95%CI 2.1–9.1, p<0.001) and by patients/relatives (aOR 3.65, 95%CI 1.77–7.54, p<0.001). There was a trend towards lower job satisfaction (p=0.012), less satisfaction with career goals (p=0.035) and worse work-life balance (p=0.0021) in female surgeons. Discussion and conclusionThis survey underlines that a significant proportion of neurosurgeons – in particular females – continue to experience gender inequity & discrimination at work, which may translate into lower work-related satisfaction. A better understanding of the gender-related aspects of job satisfaction is an important step to improving gender equity in our profession.

Gender differences in work-life balance of European neurosurgeons

IntroductionNeurosurgery is one of the most demanding medical specialties. For neurosurgeons, balancing professional activity with personal life can be challenging. Research questionTo evaluate gender differences in contribution of neurosurgeons in the household and child-rearing, as well as their impact on personal life and career. Material and methodsAn anonymous, electronic, 59-item web-based survey was administered to National Neurosurgical Societies of Europe, and European Member Societies of the European Association of Neurosurgical Societies (June–October 2021). ResultsA total of 205 European neurosurgeons (87 females and 118 males, mean age 40.7) are included in our survey. In neurosurgery, females are significantly more likely to be alone (37.9%), while males are significantly more likely to have children (66.9%). In terms of household efforts, females spend more time than males on the same tasks. Most participants (71.2%) view gender issues as a disadvantage in career pursuing. Women feel less accepted (54.3%) and having fewer opportunities (58.6%), while men believe that pregnancy/child-rearing (65.8%) and having many roles (51.3%) are the main obstacles. Both genders (77.6%) favor more convenient working conditions for young parents.Discussion and Conclusion. In our study we found that, women neurosurgeons take more responsibilities at home, especially in the child-rearing years. Female neurosurgeons are more likely to live alone or stay childless more often compared to their male colleagues. Supportive facilities, flexible programs, universal life policies and presumably curbing of the social stereotypes are of importance to overcome gender inequities that women are still facing in neurosurgery.

Gender Equity of Promoting Practices in Academic Neurosurgery in the United States

Women have historically been underrepresented in academic medicine, particularly in surgical subspecialties. This study investigated potential associations between gender and promoting practices in academic neurosurgery. Faculty data, including time from residency, professorship, specialty, and h-index, were obtained from websites of the institutions listed in the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Demographics, training, and appointments were compared between male and female neurosurgeons. Predictors of professorship, chair, directorship, and division leadership were identified using multivariable models. The study examined 1629 faculty members. Women were more likely to be assistant professors (P < 0.0001), while men were more likely to be full professors (P < 0.0001), hold chair positions (P= 0.007), lead subspecialty divisions (P= 0.008), and have a higher Scopus h-index (P < 0.0001). In a multivariable analysis, years from training (P < 0.001), fellowship (P= 0.009), h-index (P < 0.001), and chair/program director/division leadership position (P < 0.001) were significant positive predictors of full professorship. Holding additional advanced degrees (P= 0.010), leading a subspecialty division (P= 0.005), and having a higher h-index (P= 0.002) positively predicted chair position. However, when accounting for all other factors, gender was not a significant predictor of full professorship, division leadership, chair, or program directorship. While significantly more men hold leadership positions in U.S. academic institutions, after controlling for contributing variables, there did not appear to be an association between gender and full professorship, division leadership, chair, or program directorship in academic neurosurgery. While the field still has significant work to do to achieve gender equity, these results may serve as encouragement to women who are looking to advance their careers in academic neurosurgery.

Women in neurosurgery in the United Kingdom: past, present and future.

Whilst a growing number of women in the United Kingdom (UK) are making a success of a career in medicine as a whole, a considerable gender imbalance persists in neurosurgery. The extent of this disparity and the factors that perpetuate it are difficult to assess. Furthermore, over the 70 years since the first female neurosurgeon in the UK commenced her postgraduate training, it is difficult to gauge the progress that has been made. In this article we present a snapshot of women who have played, and who are playing, a key role in UK neurosurgery, highlighting their diverse career paths. We also present the current training distribution and subspecialties of women in UK neurosurgery. We use these data to reflect upon the possible barriers to completion of neurosurgical training, obtaining a substantive consultant position, and reaching positions of academic and clinical leadership. We discuss potential interventions that may overcome these. Highlighting the role women play in UK neurosurgery's past, present and future should inspire more female neurosurgeons to become leaders in the coming years.

First Female Neurosurgeon in the United States: Dorothy Klenke Nash, MD.

Dr Dorothy Klenke Nash (1898-1976) became the first female neurosurgeon in the United States in 1928 and maintained her status as the country's only female neurosurgeon until 1960. She graduated with her medical degree from the Columbia College of Physicians and Surgeons in 1927 and then trained at the Neurologic Institute of New York under Dr Byron Stookey. During her training, she contributed to the advancement of neurosurgical practice through academic research. In 1931, she married Charles B. Nash, and together they had 2 children, George (1932) and Dorothy Patricia (1937). Dr Nash became a senior surgeon at St. Margaret's Hospital in Pittsburgh in 1942. Shortly thereafter, she joined the inaugural University of Pittsburgh Department of Neurosurgery led by Dr Stuart N. Rowe and became an instructor of neurosurgery at the University of Pittsburgh School of Medicine. In acknowledgment of her advocacy for public access to services for mental health and cerebral palsy, Dr Nash was recognized as a Distinguished Daughter of Pennsylvania (1953) and honored by Mercy Hospital (1957), Bryn Mawr College (1960), and Columbia University (1968). She retired from neurosurgical practice in 1965, at which time she devoted herself to her grandchildren and her Catholic faith. She died on March 5, 1976 at the age of 77. With unwavering tenacity, Dr Nash paved the way for all women in neurosurgery.

In Reply to the to Letter to the Editor Regarding “Academic Accomplishments of Female Neurosurgeons Currently in Practice in the United States”

In Reply to the to Letter to the Editor Regarding “Academic Accomplishments of Female Neurosurgeons Currently in Practice in the United States”

Letter to the Editor Regarding “Academic Accomplishments of Female Neurosurgeons Currently in Practice in the United States”

Skull base leiomyomas (LMs) and angioleiomyomas (ALMs) are rare, and the understanding of this disease is limited. We present a systematic literature review of skull base LM and ALM and report a case of internal auditory canal (IAC) ALM.A systematic review was conducted following the PRISMA guidelines. PubMed and Embase were systematically queried for skull base LM and ALM, and Rayyan QCRI was used for the review. After applying exclusion criteria, individual articles were evaluated for quality control, data collection, and analysis. The presentation, management, and outcome of a 37-year-old man with a right-sided IAC ALM are described.Of 68 unique entries, 27 studies were included. Thirty-four cases of skull base LM (n = 6) or ALM (n = 28) were identified. Average age at presentation was 45.1 ± 14.5 years, and 52.9% of patients were male. Tumor diameter was 2.75 ± 1.6 cm, with headaches being the most reported symptom. Commonly reported locations were the cavernous sinus and the external auditory canal. Only 3 cases of IAC ALM met the criteria for this review. All tumors were treated with surgery, and gross total resection was achieved in 27 patients. Radiation was given in 3 cases with subtotal resection.Skull base LM and ALM are rare. Given the need for pathology, surgery has been the standard treatment for symptomatic skull base LM and ALM. It is important to understand the available data about this disease and consider it in the differential of skull base lesions.

Gender diversity in United States neurosurgery training programs.

Neurosurgery continues to be one of the medical specialties with the lowest representation of females in both the resident and faculty workforce. Currently, there are limited available data on the gender distribution of faculty and residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs. This information is critical to accurately measure the results of any effort to improve both the recruitment and retention of women in neurosurgery. The objective of the current study was to define the current gender distribution of faculty and residents in ACGME-accredited neurosurgery training programs. Data publicly available through institutional and supplemental websites for neurosurgical faculty and residents at ACGME-accredited programs were analyzed for the 2017-2018 academic year. Data collected for faculty included gender, age, year of residency graduation, academic rank, h-index, American Board of Neurological Surgery certification status, and leadership positions. Resident data included gender and postgraduate year of training. Among the 109 ACGME-accredited neurosurgical residency programs included in this study, there were 1350 residents in training, of whom 18.2% were female and 81.8% were male. There are 1320 faculty, of whom 8.7% were female and 91.3% were male. Fifty-eight programs (53.2%) had both female faculty and residents, 35 programs (32.1%) had female residents and no female faculty, 4 programs (3.7%) had female faculty and no female residents, and 6 programs (5.5%) lacked both female residents and faculty. Six programs (5.5%) had incomplete data. Female faculty were younger, had lower h-indices, and were less likely to be board certified and attain positions of higher academic rank and leadership. This study serves to provide a current snapshot of gender diversity in ACGME-accredited neurosurgery training programs. While there are still fewer female neurosurgeons achieving positions of higher academic rank and serving in leadership positions than male neurosurgeons, the authors' findings suggest that this is likely due to the small number of women in the neurosurgical field who are the farthest away from residency graduation and serves to highlight the significant progress that has been made toward achieving greater gender diversity in the neurosurgical workforce.