====== Diversity ====== The Diversity in Neurosurgery [[Committee]] (DC) of the European Association of Neurosurgical Societies ([[EANS]]) recognizes the challenges individuals face in [[parenthood]] with neurosurgery and wishes to address them in a [[white paper]]. Vayssiere et al. will focus on the issues of [[family planning]] and [[neurosurgical practice]] during [[pregnancy]] in an itemized fashion based on an exhaustive [[literature]] search and will make [[recommendation]]s to address the matters raised. Potential solutions would be to further improve the work-family time ratio as well as improve working conditions in the [[hospital]]. While many obstacles have been quoted in the literature about [[parenthood]] in medicine, and [[neurosurgery]] specifically, initiatives can and should be undertaken to ensure not only retention of colleagues but also to increase [[productivity]] and [[job satisfaction]] of those seeking to combine neurosurgery and family life, regardless of their sexual identity and orientation ((Vayssiere P, Broekman M, Cavallo C, Engel D, Hadelsberg UP, Majernik GH, Hoellig A, Ilic T, Janz C, Jeltema HR, Mielke D, Rodríguez-Hernández A, Ryang YM, Fozia S, Syrmos N, Vanchaze K, Hernandez-Duran S. [[Parenthood]] and [[neurosurgery]] in [[Europe]] a [[white paper]] from the [[European Association of Neurosurgical Societies]]' [[Diversity]] in Neurosurgery Committee Part I - Family Planning and Practice during Pregnancy. Brain Spine. 2023 Nov 2;3:102690. doi: 10.1016/j.bas.2023.102690. PMID: 38021011; PMCID: PMC10668082.)) ---- Surgery lacks women and racial minorities that are underrepresented in medicine (UIM). A systematic review evaluates interventions used to promote diversity in surgery. The PubMed (MEDLINE), EMBASE, and Cochrane databases were searched for studies (1) describing interventions for increasing UIM and gender diversity, (2) within surgery, and (3) targeting any learner prior to residency. Nine surgical specialties were searched: general, neurosurgery, plastics, orthopedics, otolaryngology, urology, cardiothoracic, vascular, and ophthalmology. Of the 982 studies identified, 16 were included. Awards, clerkships, and workshops were each described by three studies; awards funded research or travel to national meetings, clerkships referred to a third- or fourth-year rotation that provided exposure to surgery, and workshops were hands-on skills sessions for learners. Two studies proposed a holistic review of residency applications, which involves emphasizing an individual's attributes and life experiences rather than strictly academics. Two studies detailed a longitudinal mentoring program comprised of mentorship throughout medical school plus opportunities for research, lectures, and workshops. One study described a combination of interventions and the remaining 2 presented interventions that were characterized as "other." Longitudinal mentoring programs significantly increased the likelihood of women and UIM applying to surgical residency, while holistic review significantly increased the numbers of women and UIM being interviewed and ranked by residency programs. One award increased the number of female residents matriculating into surgical residency. Clerkships significantly increased the number of women applying to surgical residency. The mere mention of diversity initiatives on a program's website was associated with more female surgical residents, but not UIM residents. Workshops led to a higher, but not statistically significant, proportion of women applying to surgery. Holistic review and longitudinal mentoring programs are the most effective interventions for increasing UIM and female representation among surgical trainees ((Hemal K, Reghunathan M, Newsom M, Davis G, Gosman A. [[Diversity]] and [[Inclusion]]: A [[Review]] of Effective Initiatives in [[Surgery]]. J Surg Educ. 2021 Apr 17:S1931-7204(21)00063-5. doi: 10.1016/j.jsurg.2021.03.010. Epub ahead of print. PMID: 33879396.)).