The role of women in Western society has changed dramatically in the past several decades. Despite this, many gender inequality still exist for professionals in the health care sector. In neurosurgery, a disproportionately small percentage of the workforce in the United States and Canada is female. These figures are lower than most reported in other medical specialties. A review critically examines factors that may be influencing women's ability to advance in demanding subspecialties such as neurosurgery.

The literature on women in medicine, and surgery, in particular, were reviewed to identify different issues facing women currently in practice in neurosurgery. In addition, the concerns of prospective trainees were examined.

There remain many challenges for women entering neurosurgery, including unique lifestyle concerns, limited mentorship, outdated career programs, and deep-seated societal beliefs. Discrimination and harassment are also contributing factors.

If neurosurgery is to continues to progress as a subspecialty, the issue of gender inequality needs to be scrutinized more closely. Innovative programs must be developed to meet the needs of current female faculty members and to ensure attracting the brightest individuals of both genders into a career in neurosurgery ¹⁾.