• Muhammad Shakir, Ahmed Altaf, Hammad Atif Irshad, Eisha Abid Ali, Aly Hamza Khowaja, Akmal Shahzad, Amna Adil, Haseeb Mehmood Qadri, Zainab Faisal, and Syed Ather Enam.
• Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. Electronic address: muhammad.shakir@alumni.aku.edu.
• World Neurosurg. 2024 Mar 1; 183: 5135-13.

BackgroundDespite 15,000 annual medical graduates, few choose neurosurgery, especially women. The scarcity of female neurosurgeons is a global concern, particularly in resource-limited settings such as Pakistan. This study focuses on gender-based differences in medical student perceptions of neurosurgery in Pakistan.MethodsA nationwide cross-sectional study was conducted from March 6 to April 20, 2023, using a Web-based survey. Data collectors were recruited through an ambassadorship program, distributed evenly across all provinces. A questionnaire was used after a pilot study. Data analysis was performed using SPSS version 26 and STATA 15.ResultsA total of 2353 medical students participated in the study, of which 63.4% were female and 36.5% were male. Around 40.3% of women strongly agreed to the existence of potential gender bias in neurosurgery, in contrast to their corresponding male students, at 17.3%. Some of the highlighted deterring factors in pursuing neurosurgery as a career according to women include longer training duration (44.6%), poor work-life balance (41%), limited residency slots (50.6%), and limited exposure to neurosurgery (45.1%). Other factors included the high-intensity nature of training (33.6%), perceived gender bias (31.4%), competitive work environment (29.1%), complex surgical skills (38.6%), required level of medical knowledge (29.6%), and financial burden (33.9%).ConclusionsOur study shows that female students are more likely to believe in the existence of potential gender bias in the field compared with their counterpart male participants, which highlights the graveness of the situation in view of the evident paucity of female neurosurgeons in the country.Copyright © 2023 Elsevier Inc. All rights reserved.

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