• Taketoshi Maehara, Kazuko Kamiya, Takamitsu Fujimaki, Akira Matsumura, Kazuhiro Hongo, Satoshi Kuroda, Mitsunori Matsumae, Hideo Takeshima, Nobuo Sugo, Naoyuki Nakao, Nobuhito Saito, Fusao Ikawa, Noriko Tamura, Kaori Sakurada, Shoko Shimokawa, Hajime Arai, Kaoru Tamura, Kazutaka Sumita, Shoko Hara, Yoko Kato, and Gender Equality Committee of the Japan Neurosurgical Society.
• Department of Neurosurgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan. Electronic address: maehara.nsrg@tmd.ac.jp.
• World Neurosurg. 2020 Jan 1; 133: 331-342.

ObjectiveTo analyze why women quit full-time employment as neurosurgeons and to discuss the conditions required for their reinstatement.MethodsWe asked 94 core hospitals providing training programs in the board certification system adopted by the Japan Neurosurgical Society to indicate the total number and present status of women in their department and to send our anonymous questionnaire to women who had formerly worked as full-time neurosurgeons. The questionnaire consisted of closed and open questions on their reasons for quitting as full-time neurosurgeons.ResultsAmong 427 women evaluated, 72 (17%) had quit full-time employment as neurosurgeons. Twenty-one women who had quit 3-21 years after starting their neurosurgery careers responded to the questionnaire, including 17 board-certified neurosurgeons, 11 individuals with master's degrees, and 16 mothers. Their main reasons for quitting full-time work were difficulty in balancing their neurosurgical career and motherhood (52%) and the physical burden (38%). At the time of quitting, only 2 units (5%) had a career counseling system for women. Two thirds of participants might resume full-time work as neurosurgeons in the future. Their support system during pregnancy and the child-raising period, and understanding of male bosses and colleagues were identified as the key themes.ConclusionsThe Japan Neurosurgical Society could facilitate supportive environments for women in neurosurgery by enhancing adequate childcare services, changing the work style of full-time neurosurgeons to incorporate diverse working styles, shorter working hours, understanding of their bosses and colleagues, and a career counseling system.Copyright © 2019 Elsevier Inc. All rights reserved.

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