As the Chair of Neurosurgery at the University of Nebraska, Aviva Abosch, MD, PhD, FAANS, has cracked the glass ceiling several times throughout her career as a female neurosurgeon. In achieving such remarkable accomplishments, she recognizes the importance of providing a ladder to help more women and underrepresented minorities reach the same heights.
“I was the third female chair ever to hold that position in the history of US neurosurgery. Then six months later, Dr. Shelly Timmons became the fourth. So that’s encouraging,” Dr. Abosch stated. “Dr. Timmons, who was the first female neurosurgeon to be President of the AANS in its 75-year history, has been a tremendous trailblazer.” Considering that approximately 9% of practicing neurosurgeons are women1, these achievements highlight the ongoing need to achieve greater gender diversity in neurosurgery.
Often, Dr. Abosch is the only woman present in neurosurgery spaces and has a deep, personal understanding of how meaningful it would be to have more women and people of color in the field, especially for patients within these groups. She contends that seeing other women in neurosurgery has had an overwhelming impact on her professionally.
“It’s incredibly powerful,” she said when recalling the hiring of a female neurosurgery fellow (Dr. Gail Rosseau) while she was in medical school. “Having someone cast in your own image eliminates much of the anxiety about whether or not you can succeed in the profession.”
Indeed, there is a long way to go when it comes to diversity, equity and inclusion in neurosurgery, and Dr. Abosch believes the most urgent steps need to happen before students reach medical school. This is evident as the percent of underrepresented minorities applying to neurosurgery residency lags when compared to census statistics2.
“The problem lies at the beginning of the pipeline. You have to start engaging students in STEM (science, technology, engineering, medicine) early, so that medical school becomes an option before the battle is lost. Then, if you can increase exposure to neuroscience, neurosurgery becomes an option.”
On the journey to change the face of neurosurgery, Dr. Abosch remains inspired by her colleagues, including Chief of Pediatric Neurosurgery at the University of Nebraska, Dr. Arnett Klugh, who is African-American.
“Dr. Klugh has been committed to engaging a diverse workforce since his time in the US Marine Corps. He is changing the face of pediatric neurosurgery in Omaha and the surrounding regions and is very effective at getting high school students involved in STEM programs.”
To promote ethnic, racial, gender and socioeconomic inclusion, Dr. Abosch and colleagues have set up a diversity task force within the AANS. The task force addresses how to engage high school students in neurosurgery in order to expand the pipeline of diverse applicants feeding into residency training programs, but also how to retain and promote neurosurgeons who come from diverse backgrounds at all levels of professional development.
Dr. Abosch’s advice for institutions who seek to promote diversity is to reach out to their communities when seeking a solution or developing STEM programs intended to reach underrepresented groups. It’s important that institutions seek help, outside and inside their organizations. Certainly, within her own institution, there has been the development of several programs on campus that deal specifically with STEM education in underserved Omaha neighborhoods.
“That’s a great way to start. You can encourage participation and engagement locally, regionally and on a national level through the AANS, CNS, and joint sections,” Dr. Abosch states.
The key to diversity, equity and inclusion outreach is to do it authentically and meaningfully. “There has to be somebody to respond to the questions. There has to be somebody willing to mentor,” Dr. Abosch states. “I think the more people involved in this kind of effort, the more likely it is that the number of women and underrepresented minorities in medical school reflects their representation in the populations we serve. So that’s how you can start. It’s awesome.”
References
- Donaldson K, Callahan KE, Gelinne A, Everett W, Ames SE, Air EL, Durham SR. Gender diversity in United States neurosurgery training programs. J Neurosurg. 2021 Jan 29:1-6. doi: 10.3171/2020.7.JNS192647. Epub ahead of print. PMID: 33513578.
- Gabriel PJ, Alexander J, Kārkliņa A. Diversity in Neurosurgery: Trends in Gender and Racial/Ethnic Representation Among Applicants and Residents from U.S. Neurological Surgery Residency Programs. World Neurosurg. 2021 Jun;150:e305-e315. doi: 10.1016/j.wneu.2021.02.127. Epub 2021 Mar 5. PMID: 33684577.
