Bandyopadhyay, BA (Hons)1
Moudgil-Joshi, BMedSci (Hons)2
Jane Norton, BSc (Hons)3
Makinah Haq MBBS (Candidate)4
Division, University of Oxford, Oxford, OX3 9DU
2The University of
Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ
3St George’s, University of London, Cranmer Terrace, London, SW17 0RE
4GKT School of Medical Education, King’s College London, London, WC2R 2LS
Ottawa 2010 consensus declared that surgical specialties should produce a
workforce broadly representative of the population they serve without
compromising on the quality of the workforce1. Since then, the proportion of female NHS doctors has
grown year on year. However, despite a narrowing of the gender gap, surgery
continues to be predominantly male2. This is most
evident in neurosurgery, trauma and orthopaedic surgery (T&O), and cardio-thoracic
surgery, where only around 18% of the surgeons are female. Notably, the
proportion of women in the latter two disciplines has increased in line with
the majority of other medical specialities. This trend was not seen in
neurosurgery2.Whilst there are significant barriers to
the advancement of women in surgical careers3, the increasing use of
social media for professional purposes4 could aid and benefit women
passionate about neurosurgery to address some of the challenges that they face.
attempts to attract women into surgery have been confounded by insufficient
understanding of how best to approach this5. Research in this area
typically involves using quantitative methods to investigate barriers women
have faced in surgery. These methods have resulted in a list of contributory
factors to women not entering or choosing to leave neurosurgery, such as
insufficient role models, inflexible work environments, gender discrimination
and harassment, sleep deprivation, and family responsibilities6,7.
Whilst these methods have been excellent at describing the challenges faced by
women in surgery, it has not been able to explain how to counter these
challenges. Additionally, quantitative studies are not able to investigate
phenomena that are not described in their fixed-choice surveys. Qualitative
studies do not need to suffer from these limitations8. The richness
of language paired with the researchers’ openness to paradoxical findings can
answer problems in previously unthought of ways9. In addition,
qualitative research is less likely to lead to assumptions as it does not rely
on the use of measurement instruments that may be tacitly biased10.
study will be qualitative in nature. It will focus on individuals’
expectations which are highly subjective and based on personal priorities11.
Women interested in neurosurgery or currently practicing neurosurgery will be
interviewed. The questions will be focussed around why they want to do
neurosurgery/ are doing neurosurgery, perceived barriers, and the role social
media can play. We will take a participatory qualitative approach12,
where research subjects will be actively involved in the research process and
the co-creation of understandings and potential solutions. All interviews will
be recorded and reduced via manifest level coding to identify themes.
We aim to assess how social media could be used to incentivise women to
apply to and remain within neurosurgery.
Qualitative approach will be employed to obtain the necessary data.
Participants will be sent information about this project and asked for their
consent to proceed. Interviews will only be conducted if participants have
provided informed consent, including permission to record and transcribe the
conversations. Collected data will be 1. recorded during the interviews, 2.
Transcribed, 3. Analysed, 4. Labelled and coded, 5. Codes will be reduced to
themes. Following the generation of themes, participants will be invited
to check their own extracts related to each theme and delete portions if
Inclusion and Exclusion Criteria
Inclusion: Women who are practicing neurosurgeons or want to become
Exclusion: Cannot speak English or Unable to attend interview
Data is collected through one on one interviews in person or by
telephone. These interviews will be semi structured with a few pre-determined
question prompts to guide the interviewee if need be. Leading questions will be
avoided. Depending on emerging themes, these questions will be changed and
altered. The semi structured interviews suit the study well and will follow the
advice of Whiting in 200813.
The study will result in the following data sources:
of the above
These data sources will be stored in accordance to Good clinical
practise and the Data Protection Act 1998
This study is not funded.
Transcribing and coding will be done manually. Data will be reduced via
manifest level coding to identify themes. Sub-group analysis depending on the
stage of training of the women may be done.
The survey findings will be disseminated in national and international
conferences, and peer-reviewed publications.
- Prideaux D, Roberts
C, Eva K, et al. Assessment
for selection for the health care professions and specialty training: Consensus
statement and recommendations from the Ottawa 2010 Conference. Medical
Teacher. 2011;33:215-223. Available
Digital. Narrowing of NHS gender divide but men still the majority in senior
roles. Available from
[Accessed 25th February 2020].
- Abosch A, Rutka JT. Women in neurosurgery: inequality redux.
J Neurosurg. 2018 Aug 1;129(2):277–81.
- Guraya SY. The usage of social networking sites by medical
students for educational purposes: A meta–analysis and systematic review. Vol.
8, North American Journal of Medical Sciences. North American Journal of
Medical Sciences; 2016. p. 268–78.
U, Meyer FJ. Awareness and impact of WINS on female surgical trainees. Ann R
Coll Surg Engl. 2011; 93: 1E-5E.
J. Women in neurological surgery. J Neurosurg (4 Suppl Pediatrics). 2006; 104:227-232
SJ, Gilmer-Hill H, Rutka JT. The neurosurgical workforce in North America: a
critical review of gender issues. Neurosurgery. 2006; 59: 749 – 758.
G. It’s NOT rocket science: rethinking our metaphors for research in health
professions education. Med Ed. 2010; 44: 31-39.
K. The art and science of clinical knowledge: evidence beyond measures and
numbers. Lancet. 2001; 358: 397-400.
NK, Lincoln YS. The SAGE handbook of qualitative research. 5th edn.
SAGE publishing, Thousand Oaks; 2017 p. 151-194.
- Hammarberg K, Kirkman M, de Lacey S. Qualitative
research methods: when to use them and how to judge them. Human
Reproduction, Volume 31, Issue 3, March 2016, Pages 498–501,
P. Doing participatory research: a feminist approach. Centre for International
Education, Amherst, MA1987:305.
- Whiting LS. Semi-structured interviews: Guidance for novice researchers.
Nursing standard. 2008; 22(23), pp.35-40