Abstract Aim To explore gender distribution of invited lecturers and panel speakers at major international neurosurgical conferences and investigate this as a potential contributor to lack of female representation in neurosurgery, known as a significant workforce problem, worldwide. Method We retrospectively analysed annual meetings organised by 4 major neurosurgical organisations between January 2016 and December 2021. Male and female faculty were academically stratified according to mean publications, citations, and H-index. A manel was defined as a session with 2 or more speakers, all of whom are men. Sex was determined by specific speaker title in conference program, online autobiography, or Gender Balance Assessment Tool (GBAT). Results Of the 21 conferences hosted by 4 major international neurosurgical societies/organisations analysed there were 5883 speakers, of which 10.93% (n = 643) were female. Of 885 panel sessions, 534 (60.34%) were manels. There were statistically significant changes between online and in-person conferences (45.45% (n = 60) manels online vs 62.95% (n = 474) manels in-person; p<0.05). Male invited lecturers had significantly higher mean H-index than female invited lecturers (male = 34.88, female = 18.95; p<0.05). There was a significant reduction in the proportion of manels over time (67.35% in 2016 vs 39.83% in 2021; p<0.05). Conclusions Despite encouraging findings that manels are becoming less prevalent in major neurosurgical meetings, they continue to comprise the majority, while female representation remains poor. This study hopes to highlight the need for greater gender diversity and female representation in neurosurgery.
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