Special Publication of the Brazilian Society of Neurosurgery - SBN

Edição 01 • Setembro de 2018

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Women in the neurosurgery market: challenges and achievements


Female neurosurgeon and member of the BSN Commission of Female Neurosurgeons.


Oncological female neurosurgeon and member of the BSN Commission of Female Neurosurgeons.

A story of perseverance, courage and competence. Thus, we can summarize the trajectory of women who have defied prejudice and left their mark on medicine. Although they had waited a long time – in Brazil, for example, only in 1879 women were allowed to enroll in undergraduate programs – they gained recognition and were precursors of the movement towards gender equality.

In recent years, women are increasingly present in the medical field, but there is still a long way to go. Proof of this is that, since 2009, the number of women entering medicine in Brazil is higher than that of men, but the female presence is much lower in the area of ​​surgery – more than 90% of professionals are men, according to research by the USP Medical School (FMUSP). The female neurosurgeon, who has been taking care of children for over 15 years, Nelci Zanon Collange, M.D., estimates that there is an unconscious but real prejudice. “In surgery it’s a bit more obvious. When an unknown female surgeon arrives at a new surgical center, the attendants ask which team she belongs to or who is the team leader. On the other hand, a male instrumentator, for example, is usually mistaken as a physician”. However, she points out that barriers sometimes start already in recruitment and selection processes. “I know cases in which a female candidate achieved maximum score in the written test and had a good resume but went pretty bad in the interview. Other recruiters were more direct and said that ‘women are not welcome here’. There are also other, more misogynist behaviors for women colleagues to give up, but fortunately, these stories belong to the past”, says Dr. Nelci. The oncology neurosurgeon Tatiana Vilasboas remembers the difficulties she faced at the beginning of her career. “My professor, the head of the service, during my interview to be admitted at residency, openly expressed his opinion that neurosurgery is a very exhausting field, especially for women.” She reinforces that she has doubts about the space conquered when talking about leadership. “There are a number of extremely competent women who run the leadership positions, but a small number are in the top management positions. Few of them are presidents of neurosurgical societies around the world and health managers”. She also highlights the need to break stereotypes and encourage meritocracy. “Men are still the majority in this universe, so we need everyone’s support for presidents, directors and managers are elected despite of fellowship and class support”, says Dr. Tatiana. Data from the Brazilian Institute of Geography and Statistics [Instituto Brasileiro de Geografia e Estatística] (IBGE) corroborate this point of view – female participation decreases as the hierarchical level increases. Women account for 37% of management positions. At the top, in the executive committees of large companies, they are only 10% in Brazil. In addition, a report by the World Economic Forum states that gender equality will only be possible by 2095 and that the disparity, when it comes to economic participation and opportunities for women, is around 60%. Brazil ranks 124th among 142 countries in the ranking of equal pay. The female public earns, in average, 73.7% of the salary received by men, according to the PNAD’s latest survey [National Household Sample Survey]. Although many women still earn less than men, by exercising the same functions, a large space has already been conquered, in Nelci Zanon Collange, M.D. point of view. “The reality today is very different from the past and only time will be responsible for softening the edges and make individual qualities overlap referrals and meritocracy arrives at the collective issue, regardless of the gender issue”, she says.

Maternity and Neurosurgery

Another challenge for women is motherhood, which is accompanied by cases of discrimination and prejudice when it comes to career. A study made by MindMiners points out that nearly half of all women in Brazil have already been turned down for a job simply because they are mothers or wish to have children. Among the scenarios observed by them are discouragement when scheduling medical appointments during work hours (28%), task overload (26%), and unpleasant comments related to pregnancy (20%). Eight percent even enjoyed less maternity leave for fear of losing their job on the way back. On the other hand, some companies are already indicating changes, building programs dedicated to the professionals that are also mother. And examples of successful women who combine motherhood and career multiply. For health care professional mothers, it is no different. Although the strenuous routine demands an even greater effort, they show that it is possible to succeed in the profession without neglecting the children. In the second year of residence, the neurosurgeon Tatiana Vilasboas was pregnant of her first child. The unplanned pregnancy meant that she had to put extra effort into pursuing her goals. “I do not advise anyone to plan for a pregnancy during their residency. It is very exhausting, but it is not impossible. With much dedication and effort, it can be successfully tackled”. She says that the fear of one of her bosses and her colleagues was that she could not handle the workload and slow down but, being pregnant did not reduce her contribution at all. “I fulfilled all my shifts including the vacation coverage of my fellow residency students. I was able to work until the last day of my pregnancy. I was away for 4 months after my son was born. I chose to continue the residence and for 4 years, my husband and I live in different cities. He and I, with the help of several people, took care of my baby”, she recalls.

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