title: Positive trends in neurosurgery enrollment and attrition: analysis of the 2000-2009 female neurosurgery resident cohort.
abstract: OBJECTIVE
  Women compose a minority of neurosurgery residents, averaging just over 10% of matched applicants per year during this decade. A recent review by Lynch et al. raises the concern that women may be at a higher risk than men for attrition, based on analysis of a cohort matched between 1990 and 1999. This manuscript aims to characterize the trends in enrollment, attrition, and postattrition careers for women who matched in neurosurgery between 2000 and 2009.
  
  
  METHODS
  Databases from the American Association of Neurological Surgeons (AANS) and the American Board of Neurological Surgery (ABNS) were analyzed for all residents who matched into neurosurgery during the years 2000-2009. Residents were sorted by female gender, matched against graduation records, and if graduation was not reported from neurosurgery residency programs, an Internet search was used to determine the residents' alternative path. The primary outcome was to determine the number of women residents who did not complete neurosurgery training programs during 2000-2009. Secondary outcomes included the total number of women who matched into neurosurgery per year, year in training in which attrition occurred, and alternative career paths that these women chose to pursue.
  
  
  RESULTS
  Women comprised 240 of 1992 (12%) matched neurosurgery residents during 2000-2009. Among female residents there was a 17% attrition rate, compared with a 5.3% male attrition rate, with an overall attrition rate of 6.7%. The majority who left the field did so within the first 3 years of neurosurgical training and stayed in medicine--pursuing anesthesia, neurology, and radiology.
  
  
  CONCLUSIONS
  Although the percentage of women entering neurosurgical residency has continued to increase, this number is still disproportionate to the overall number of women in medicine. The female attrition rate in neurosurgery in the 2000-2009 cohort is comparable to that of the other surgical specialties, but for neurosurgery, there is disparity between the male and female attrition rates. Women who left the field tended to stay within medicine and usually pursued a neuroscience-related career. Given the need for talented women to pursue neurosurgery and the increasing numbers of women matching annually, the recruitment and retention of women in neurosurgery should be benchmarked and assessed.
authors.affiliation: Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina;
authors.forename: Jaclyn J
authors.initials: JJ
authors.lastname: Renfrow
authors.affiliation: Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina;
authors.forename: Analiz
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina;
authors.forename: Ann
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Albany Medical College, Albany;
authors.forename: Julie G
authors.initials: JG
authors.lastname: Pilitsis
authors.affiliation: Department of Neurosurgery, New York University School of Medicine, New York;
authors.forename: Uzma
authors.initials: U
authors.lastname: Samadani
authors.affiliation: Department of Neurosurgery, Northwestern Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Aruna
authors.initials: A
authors.lastname: Ganju
authors.affiliation: Department of Neurosurgery, Mount Sinai School of Medicine, New York;
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Germano
authors.affiliation: Department of Neurosurgery, Columbia University, New York, New York; and.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Benzil
authors.affiliation: Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina;
authors.forename: Stacey Quintero
authors.initials: SQ
authors.lastname: Wolfe
mesh_terms: D002321:Career Choice; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009493:Neurosurgery / Q000193:education*; D010560:Personnel Selection; D010822:Physicians, Women; D012737:Sex Factors; D014481:United States
keywords: AANS = American Association of Neurological Surgeons; PGY = postgraduate year; WINS = Women in Neurosurgery; neurosurgery; residency; resident attrition; resident retention; women in neurosurgery