V102 No 2 BULLETIN American College of Surgeons
a program, and if I did, patients wouldn’t come see
me. There comes a time, however, when you realize
your parents no longer know what is best for you.
The world they grew up in is not your world, and
you must have the courage to hope your world will
Finding a community
It is estimated that there are only 5,000 neurosurgeons
for a patient population of 60,000, and that they comprise only 1. 7 percent of all practicing physicians.
Of these neurosurgeons, 7 percent are women. In
addition, more than 40 percent of all practicing neurosurgeons are age 55 or older. 2 These statistics suggest
that there is a need to attract students with both the
technical and cognitive skill to handle a demanding
profession. 2 The pool of interested students is small,
and neurosurgery may not appear attractive to medical students, who are the lifeblood of this profession.
As a result, a number of surgical specialties, including
neurosurgery, have created programs that provide
early exposure and mentoring for medical students.
One Canadian study found that early exposure to
a neurosurgery program increased interest in neurosurgery. 3 The main drawbacks that students may
associate with neurosurgery include lack of time to
devote to outside interests, residency competition,
and busy workload. On the other end of the spectrum, neurosurgery offers great opportunities to have
a meaningful impact on patients and the promise of
intellectual stimulation for the practitioner. 3
The sense of community is very important in
ensuring the success of women and minorities in
health care professions. A community of supportive
peers ensures that you don’t have to fight all the time
to prove you belong when you are already exhausted
trying to learn the specialty. It has been my expe-
rience that women residents in general surgery do
better when more women are present in their training
program. I was lucky that, when choosing my resi-
dency at the University of Michigan, I was exposed
to a practicing woman neurosurgeon. She made the
dream seem possible.
When I went on to Yale University, New Haven,
C T, for my internship, I met another successful woman
neurosurgeon. But in the end, her career was a cautionary tale of the cost to the individual who takes on a
pioneering role. Years later, at a Women in Neurosurgery Annual Meeting, a colleague said that she had met
this distinguished neurosurgeon from Yale but that
she was so bitter it was unpleasant to speak with her.
I tried to explain to my colleague what had happened.
The Yale surgeon had been a nurse who wanted to be
a neurosurgeon. She was offered a position at Yale but
was forced to wait a year or so to see “if she was really
interested.” Finally, she was allowed to finish her residency and stayed on as faculty for many years. Despite
the fact that she was a full professor in neurosurgery
and a past-president of the American Association of
Neurological Surgeons section on Neurological Surgery, the OR staff asked her to share a locker rather
than give her one of her own. It was the last straw and
she left. Later as other people interviewed for her job,
we learned that she was grossly underpaid, and it took
multiples of her old salary to attract a replacement.
She moved to Dallas, TX, where she was again isolated, then on to the University of Michigan where
something that is, in my experience, unprecedented
occurred. When the chairman sent her credentials
to the tenure committee asking for an associate professorship, they sent them back, asking if it wouldn’t
make sense to make her a full professor. He said no.
Just before her retirement, she was finally made a
full professor, which irritated more than pleased her
because it was an exit gesture. So when this woman,
who persevered through all this, is blamed for her temperament, I suggest that she was the victim, and when
we encounter people who have experienced tremendous struggles, we should recognize that any bitterness
is the cost of that struggle.
The role of a diverse neurosurgical community
cannot be overstated in attracting the best students
to our specialty. I did not appreciate how important
Dr. Canady preparing