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

BACKGROUND Women have historically been underrepresented in academic medicine, particularly in surgical subspecialties. This study investigates potential associations between gender and promoting practices in academic neurosurgery. METHODS 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 (AANS) 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. RESULTS 1629 faculty members were examined. 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. CONCLUSIONS While significantly more men hold leadership positions in United States 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 our 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.