Where are the women in spine surgery? A demographic study of the range of gender disparity in academic spine hospitals in the United States

There is a paucity of women in the field of academic spine surgery. In 2022, 20% of orthopedic surgery residents and 24% of neurosurgery residents were women, the lowest and third lowest of all medical specialties respectively. There exists a significant discrepancy in the number of women employed as adult spine surgeons at academic hospitals. This papers quantifies the number of female attending spine surgeons at academic hospitals and identify institutions that based on faculty diversity are demonstrating inequity. Demographic data was collected utilizing the 2023 to 2024 NASS Fellowship Directory in combination with publicly available information on faculty profiles from January 1, 2024 to January 30, 2024. Data collected included gender and training institutions (medical school, residency, and fellowship). Adult spine fellowship-trained orthopedic surgeons and neurosurgeons who perform adult spine surgery were included. There are 943 neurosurgical and orthopedic adult spine surgeons employed at 73 academic hospitals. The breakdown of orthopedic spine surgeons versus neurosurgeons is roughly equivalent, at 453 and 490, respectively. Among orthopedic spine surgeons, 19 out of 453 (4%) are female. Among neurosurgeons, 44 out of 490 (9%) are female. The number of female academic spine surgeons who are neurosurgeons is more than double that of orthopedic surgeons. Twelve out of the 19 (63%) female orthopedic spine surgeons, and 16 out of the 44 (36%) female neurosurgeons are employed at the program where they trained. Out of 45 larger academic spine hospitals with >10 faculty members, there were 15 without any female faculty. There is 1 academic hospital with ≥ 20 spine faculty, and zero women. The number of women pursuing academic spine careers continues to lag behind present day demographics of training programs. These continued trends should prompt both individuals and institutions to support progress in gender disparity research.