Spine surgery has a glaring gender disparity, and there are notable gaps between orthopedic spine surgeons and neurosurgeons, says Rachel Bratescu, MD, of Washington, D.C.-based George Washington University Hospital.
Dr. Bratescu worked with Roger Härtl, MD, on a study published Aug. 21 in The Spine Journal measuring female spine surgeon representation in academic hospitals.
"The results honestly were pretty sobering," Dr. Bratescu said. "We found that out of almost 1,000 adult spine surgeons at 73 academic hospitals, the breakdown of total orthopedic versus neurosurgical spine surgeons is roughly equal. However, among orthopedic spine surgeons, only 4% are female, and among spinal neurosurgeons, 9% are female."
Those findings lead to questions on why the numbers are so low, especially for orthopedics compared to neurosurgery, Dr. Bratescu said. And there are questions on how academic hospitals can both tap into the pool of female spine surgeons and grow their numbers.
Dr. Bratescu said that hiring the best and most qualified surgeons should be top priority and not to focus on quotas. The one solution centers should focus on is mentorship.
"In our paper, we highlight a number of plausible solutions, but the one that I personally think will have the highest impact is an increased focus on mentorship," she said. "During residency, I was involved in a study looking at why women pick certain orthopedic specialties, and we found that strong mentorship is the largest extrinsic modifiable factor that affected choice of subspecialty."
Mentorship was found to play a key role in why female physicians chose one subspecialty of orthopedics compared to others.
"This tells us that residents and medical students are influenced in a positive way by having a mentor in their field of interest," Dr. Bratescu said. "The best way to make an impact is to institute initiatives that increase the exposure of both female medical students and residents to the field of spine surgery. Our hope is that every spine surgeon that reads our paper is equally shocked by the results and seeks out opportunities to be a mentor."
At George Washington University, Dr. Bratescu works closely with residents as part of her role on the faculty and plans to work with orthopedic-specific programs as well.
"There's a women in surgery section of the Ruth Jackson Orthopedic Society at GW, which I'm hoping to get more involved in as the year progresses and they have more events," she said. "That's a great source to be a mentor to residents and to medical students and to encourage not just other people in my department of orthopedic surgery, but in other subspecialties throughout the hospital."
And in her own network, mentorship has played a positive role for every female spine surgeon Dr. Bratescu knows.
"Every single female spine surgeon that I personally know has either acted as a mentor to me or is involved in mentoring opportunities," she said. "Just from the people that I know, they're all involved because they would say the same thing — that mentorship is so incredibly important."