Diversity & Equality in European Neurosurgery–Opportunities for Growth

Diversity & Equality in European Neurosurgery–Opportunities for Growth

Doortje Engel1, Dorothee Mielke2, Yu-Mi Ryang3, Silvia Hernández-Durán2 – on behalf of the European Association of Neurosurgical Societies (EANS) Diversity in Neurosurgery Task Force

1 Department of Neurosurgery, Royal North Shore Hospital, Reserve Road, St. Leonards, 2065, NSW, Australia
2 Department of Neurological Surgery, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
3 Department of Neurosurgery, Helios Klinikum Berlin-Buch, 50 Schwanebecker Chaussee, 13125 Berlin Germany

In the past months, the world has experienced the challenges of the COVID-19 pandemic and its resulting far-reaching socioeconomic repercussions. These difficult times have exposed great disparities in wealth distribution across the globe, highlighting inequalities in all spheres of society, as the daily struggle for lives and livelihoods continues (1). While apparently grim, the Covid-19 pandemic has also created great opportunity for global solidarity and cooperation, underlining the importance of diversity and interdisciplinarity for effective problem-solving.

Diversity of ethnicity, religion, sexual orientation, gender, socioeconomic status and backgrounds within organizations and societies has been shown to be beneficial; it can drive innovation and creativity while reducing bias. Neurosurgery is no exception: neurosurgical patients are found all over the world, with different cultures, expectations, interests, genders, skin colors, restrictions and challenges. Neurosurgery is thus in constant global exchange. As neurosurgeons, it is our job to understand the diversity of our patients to provide the best possible care. But to be able to do so, we must understand this diversity within our field, and the barriers holding individuals back in our challenging yet most rewarding profession.

Europe has historically been a melting pot of peoples; a crossroads of ethnicities, cultures, languages, and religions. Western Europe is also the highest performing region in terms of gender equality according to the World Economic Forum. When it comes to gender, appropriate development and utilization of female talent – which constitutes half of the world’s workforce pool – is key to the advancement of societies at large, and neurosurgery specifically. According to Eurostat, 49% of currently practicing physicians in Europe are female (2); however, only 12% of the 12,985 neurosurgeons that constituted the workforce in the member countries of the EANS in 2016 were women (3). This percentage becomes even smaller when considering leadership positions: Wolfert et al (4) showed that only 6% of the European national neurosurgical societies’ boards of directors were women. While no studies have yet systematically analyzed other aspects of diversity within European neurosurgery, its leadership lacks people of color and local minorities, rendering the representation of individuals of diversity backgrounds scarce.

The EANS, leading neurosurgical education since the 1970s, is committed to progress, which is why it created the “Diversity in Neurosurgery Task Force” (DTF) in September 2019. The goal of the DTF is to identify barriers holding individuals back; and to help tackle them systematically, whether pertaining to gender, ethnicity, religion, socioeconomic background, or sexual orientation.

In order to do so, the DTF has launched several projects:
- An online and social media platform to increase the visibility of diverse leaders in European neurosurgery, to provide trainees with the opportunity to network with highachieving individuals, and to inspire them on their personal journeys.
- An annual scholarship for two candidates from diversity backgrounds to attend the “Young Physician Leaders” course at the German business school ESMT Berlin (starting in 2021), to equip them with the necessary tools to propel their careers.
- The DTF is working on a ‘white paper’ on parenthood and neurosurgery to showcase how institutions can improve policies to allow neurosurgeons with families to thrive.
- Providing assistance in cultural exchange to illustrate diversity in the world and in Europe, while being a magnifier for the recognition of obstacles in diversity and also a supporter of problem-solvers.

While much remains to be done to make the European neurosurgical workplace more diverse, we are optimistic that the steps we have been taking will act as a foundation and contribute to the diversification of the neurosurgical workforce in Europe and across the world, and of the neurosurgical leadership in particular. Within a month of its official launching, the DTF has had applications to join from all continents, highlighting the interconnectivity of the neurosurgical community and its desire to advance diversity. We are confident that, by increasing diversity in our neurosurgical ranks, we will equip our profession with the tools to face modern challenges and quickly adapt to an ever-evolving global society.

Contact: www.eans.org/page/Diversity_Task_Force. Twitter @EANS_diversity

DTF Members:

  • Silvia Hernández Durán, Universitätsmedizin Göttingen, Germany, Leader
  • Dorothee Mielke, Universitätsmedizin Göttingen, Germany, Co-Leader
  • Ellie Edlmann, University of Cambridge, England
  • Doortje Engel, Royal North Shore Hospital, Australia
  • Danica Grujicic, Klinicki centar Srbije, Serbia
  • Anke Hoellig, RWTH Aachen, Germany
  • Thomas Kapapa, Universitätsklinikum Ulm, Germany
  • Katrin Rabiei, NU sjukvarden, Sweden
  • Yu-Mi Ryang, Helios Klinikum Berlin-Buch, Germany
  • Idoya Zazpe, Complejo Hospitalario de Navarra, Spain


  1. Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socioeconomic implications of the coronavirus pandemic (COVID-19): A review. International Journal of Surgery [Internet]. 2020;78(April):185–93. Available from: https://doi.org/10.1016/j.ijsu.2020.04.018
  2. Eurostat. Healthcare personnel statistics [Internet]. 2019 [cited 2020 Jul 15]. Available from: https://ec.europa.eu/eurostat/statisticsexplained/ index.php/Healthcare_personnel_statistics_-_physicians
  3. Steklacova A, Bradac O, de Lacy P, Benes V. E-WIN Project 2016: Evaluating the Current Gender Situation in Neurosurgery Across Europe—An Interactive, Multiple- Level Survey. World Neurosurgery [Internet]. 2017;104:48–60. Available from: http://dx.doi.org/10.1016/j.wneu.2017.04.094
  4. Wolfert C, Rohde V, Mielke D, Hernández-Durán S. Female Neurosurgeons in Europe— On a Prevailing Glass Ceiling. World Neurosurgery. 2019;129.
February 2024