There has been a marked increase in the number of women graduating from medical schools. As a result, the number of female neurosurgeons has increased relatively in the 21st century. However, despite this numerical increase, the number of female neurosurgeons is still disproportionately low, as supported by other studies conducted in the literature.[1, 4]
In the 15th century, Serefeddin Sabuncuoğlu (1385–1470) was the author of the first illustrated Turkish surgical textbook in the Turkish literature. His book Cerrahiyyetu'l-Haniyye (Imperial Surgery) contains the first illustrations depicting female surgeons. The miniatures he painted featured female surgeons known as Tabibe. The first evidence that Turkish women were also involved in neurosurgery even at that time are the drawings shown in miniatures applied to the treatment of a dead fetus with fetal hydrocephalus and macrocephaly (Figure 1).
Turkey’s first female neurosurgeon, Dr. Aysima Altınok (1929–), received her expertise in 1959 (Figure 2). She was born in Erzincan in 1929. Aysima Altinok, the first female neurosurgeon in Turkey, took up her post at Bakırköy Mental and Nervous Diseases Hospital and continued her position as clinical chief. She holds an honorary membership in the foundation of the Turkish Neurosurgical Society since 1996 and the Association of Brain and Neurosurgery since December 1, 2005. She left her official post in 1992 after more than 38 years.
The second female neurosurgeon in Turkey was Dr. Yıldız Yalcınlar.
Other pioneering women neurosurgeons followed, including Nilgün Alp who is the third female neurosurgeon she received the title of a neurosurgeon at Bakırköy mental and Nervous Diseases Hospital, and Dilek Könü-Leblebicioğlu, Hamiyet Camuşçu, and Nurperi Gazioğlu.
Nurperi Gazioğlu is the first female professor of neurosurgery in Turkey. She became an associate professor in 2000 and a professor in 2008 at Cerrahpaşa Faculty of Medicine. She was chosen as the first woman neurosurgeon president of the Central Nervous System Surgery Society in Turkey in 2013.Back in 1984, she was presented the Balkan Medical Union Award. She was named “Leading Woman Scientist” by the Turkish Association of University Women. She worked Istanbul University’s Cerrahpaşa Faculty of Medicine until 2017. Since 2017, Gazioğlu has chaired the Department of Neurosurgery at Demiroglu Bilim University in Istanbul.
Although the Turkish Neurosurgical Society has had 22 neurosurgery presidents over 36 years, in 2021, for the first in the history of the Society, Emel Avci, a female, has been elected as the president of the society. She was born in Malatya, in 1987. Her first professional position in Turkish Neurosurgical Society was as a member of the committee of young neurosurgeons in 2000. In 2008, Dr. Avcı studied as a research fellowship in Skullbase and Neuroanatomy Laboratory in Department of Neurosurgery at University of Wisconsin–Madison. She worked mainly in the areas of neuroanatomy and the skullbase. She was the head of the Neuroanatomy Group of Turkish Neurosurgical Society between 2016-2017. She is now the first female president of the Turkish Neurosurgical Society.
One of our authors, Prof. Dr. Pınar Akdemir Ozışık, a pediatric neurosurgeon, was the first woman to serve on the Board of Directors of the Turkish Neurosurgical Society. She is the first female neurosurgeon who became dean for the first time in 2021.
Female neurosurgeons in Turkey, with 10 professors, 16 associate professors, 5 assistant professors, and 63 specialists are a very strong and growing formation every day.
The world’s first female neurosurgeon was the British doctor Diana Beck (1943). Unfortunately, the situation around the world is very similar. For example, in the United States in 2016, women neurosurgeons comprised only 16.3% of total neurosurgery residents (232/1417) and 6.1% of board-certified neurosurgeons (259/4178).
In 2009 in Brazil, only 97 of the 1,758 members of the the Brazilian Society of Neurosurgery were women (5.5%). When we examined the literature, we found that 4% of neurosurgery specialists in the United Kingdom and only 2.3% of neurosurgeons in Canada were women.[6, 9]
When we looked at the field of neurosurgery in Germany, we found that only two universities had female neurosurgeons in executive positions, despite the fact that in 2017, 24% (496/2097) of certified neurosurgeons were female. Germany is the country with the highest number of female neurosurgeons in the world. In fact, even this is an indicator of how few women participate in neurosurgery.
In their study, Ganju et al reported that between 2000 and 2020 within the leadership of five neurosurgical organizations (Congress of Neurological Surgeons, American Association of Neurological Surgeons, Society of Neurological Surgeons, American Board of Neurological Surgery, Council of State Neurosurgical Societies), only 5 (11.1%) of a total of 45 doctors were female.
According to the data obtained in our study, the number of female neurosurgeons still lags behind the desired number in neurosurgery, with a rate of 5.5% (94/1699). However, especially recently, the number of female doctors in neurosurgery has started to increase. This can be explained by the fact that the female doctors in the platform support each other and that the new doctors look to them as an example.
The number of female neurosurgeons pursuing academic careers or holding executive positions is almost nonexistent worldwide. This situation is referred to as the “glass ceiling,” a metaphor used to indicate (Figure 3).The number of female neurosurgeons can be increased through organization and assistance. The joint work of mentor female neurosurgeons and young female neurosurgeons will help to ensure endurance and continuity within the profession. Looking at the literature, it is possible to see results that support the preference of the female-to-female work ratio. Among the journals articles examined by Aslan et al, it was found that 518 of 3247 (16.0%) female neurosurgeons were the first named author and 352 of 3247 (10.8%) female neurosurgeons were the senior author; accordingly, young doctors in particular preferred to work with female neurosurgeons as mentors. They indicated that the reason for this was that female neurosurgeons sympathized with their struggles and could relate to their difficulties. As a result of their research on a large data set of 68,737 published articles in 16 journals, Taha et al also reported an increase in the number of first and senior-level authors in female neurosurgery over the past years. They also concluded that articles with a female senior author were more likely to have a female first author as well. Especially with the increased awareness in recent years, initiatives such as the Women’s Association of Neurosurgery mentoring program will provide a significant contribution to the advancement of young women neurosurgeons in their academic careers.
The number of female neurosurgeons continues to increase each year in Turkey, as well as worldwide. However, despite this increase, it is not yet at sufficient levels.
In Turkey, the doors opened in 1959 with Aysima Altınok, and the field continues to grow every day with an increasing number for female neurosurgeons.