Representation of Female Neurosurgeons across the United States

Introduction: Females are underrepresented in neurosurgery and their distribution is far from equitable across the U.S. Previous literature indicates that gender concordance in physician-patient pairings yields higher quality care. Patients in states with a low number of female neurosurgeons lack the autonomy to choose same-gender providers, potentially compromising clinical outcomes. The study therefore aims to identify trends in the number of female neurosurgeons in each state and identify state characteristics that affect such values.

Methods: The Physician Compare National Dataset was obtained from the Center for Medicare & Medicaid Services for 2017 and 2023. States were ranked by the number of female neurosurgeons. The percent growth in the number of female neurosurgeons was calculated for each state. Univariable and multivariable regressions were used to identify state characteristics that affect the current number of female neurosurgeons. Alpha was set to 0.05.

Results: The total number of female neurosurgeons was 369 in 2017 and 490 in 2023. The number of female neurosurgeons was higher in urban states while rural states saw a greater increase compared to the past. Univariable regression showed an association between the number of female neurosurgeons and the number of neurosurgery residency programs, neurosurgery hospitals ranked in U.S. News & World Report, paid parental leave law, number and percentage of female physicians, and diversity index score (p < 0.05). The diversity index score independently affected the number of female neurosurgeons (p < 0.05).

Conclusion : Individual state characteristics that affect the number of female neurosurgeons are multifaceted. Diversity in the state population is crucial for gender equality in neurosurgery. The physician shortage in rural states may be providing a unique opportunity for female neurosurgeons and further research is warranted. Understanding factors that improve the representation of female neurosurgeons at a state level can help improve gender inequality in the neurosurgery workforce.