Women in Nigerian Neurosurgery: A Cross-Sectional Survey.

BACKGROUND: Although women have made remarkable strides in several medical specialties in Sub-Saharan Africa, their presence and contribution to the development of neurosurgery remain limited. We sought to study the gender differences within Nigerian neurosurgery, identify challenges resulting from these differences, and recommend how African female neurosurgeons can maximize their effects in neurosurgery. METHODS: A structured online survey captured data on neurosurgical infrastructural capacity, workforce, and training from neurosurgical consultants and residents in neurosurgical centers in Nigeria. All the collected data were coded and analyzed. RESULTS: Altogether, 82 neurosurgical consultants and 67 neurosurgical residents from 50 primary medical institutions in Nigeria completed the online survey. Only 8 of the respondents (5.4%) were women, comprising 3 consultants, 2 senior residents, and 3 junior residents. Although 40.2% of the respondents did not believe that being female affected the decision of whether to specialize in neurosurgery, 46.3% believed that being female was a disadvantage. Most did not believe that being female affected admission (57.8%), completion of a neurosurgery residency (58.5%), or life working as a neurosurgeon after graduation (63.4%). The most common challenges women face while navigating through neurosurgery training and practice are erosion of family and social life, lack of female mentors, and lack of a work-life balance. CONCLUSIONS: There is a deficit of both female consultants and trainees among Nigerian neurosurgeons. Identifying female medical students with a strong interest in neurosurgery and providing early mentorship might increase the number of female neurosurgeons.

Chronic subdural haematoma: a case series of uncommon presentations of a common disease.

Chronic subdural haematoma is a common neurological condition especially among the elderly population. Its presentation can be unspecific but often attributed to pressure, cortical irritation, and/or vascular compromise. In the patients' cohort presented below, we have a series of cases where clinical history and examination did not result in an initial clinical diagnosis or suspicion of chronic subdural haematoma, with the diagnosis made only after brain imaging. We reviewed the literature regarding the aetiopathogenesis and clinical features of our patient cohort, which included a young woman with isolated right ptosis and pupillary dilatation, an elderly man with paraplegia, another elderly man with isolated right foot drop, and a young military man with no history of trauma. Our series re-emphasizes the sometimes non-specific and varied clinical presentation of chronic subdural haematoma. We reiterate the need for early brain imaging in patients who present with neurological disorder.

Gender Perspective in the Workplace: The Experience of Women Medical Doctors.

Background: Women are a considerable part of the population and contribute to every facet of life with significant participation in all professions, however, despite such advancements by women, there is still a gender bias in all walks of life including the medical field. This study aimed to evaluate the opportunities, challenges, and job satisfaction of women doctors in the workplace. Methodology: This was a descriptive, cross-sectional study conducted among 165 women medical doctors living in Rivers State, Nigeria. Data was collected using a structured, self-administered questionnaire and results have been reported as frequencies and percentages for categorical variables. Results: Of the 165 women recruited, 62(37.6%) were working as resident doctors, 43(26.1%) were medical officers and 42(25.5%) consultants. Only 85(51.5%) women reported global satisfaction in their workplace while 69(41.8%) admitted to career satisfaction. Most of the respondents agree that their career has limited the time available to spend with their family (74.5%) and their friends (78.2%) outside their working environment. The greatest challenges perceived at work include poor work-life balance in 123(74.5%) and lack of career advancement opportunities in 46(27.9%) respondents. While 112 women doctors (67.9%) had experienced insubordination from a junior male colleague in the workplace, 75(45.5%) had experienced some form of physical violence in the workplace (from staff or patients). One hundred and twenty women (72.7%) had experienced some sort of sexual harassment from both their male colleagues and male patients in the workplace, with 11(6.7%) reporting frequent sexual harassment from their male colleagues. Conclusion: Gender disparities and bias do exist in the medical field and should be discouraged at every level. When there is a positive organizational culture and supportive environment at work, women medical professionals can offer excellent medical care and break both clinical and academic glass ceilings.

Developing a Guideline for Neurotrauma in Nigeria.

BACKGROUND: The Nigerian Academy of Neurological Surgeons in 2019 resolved to standardize the practice of neurosurgery in Nigeria. It set up committees to standardize the various aspects of neurosurgery, such as neurotrauma, pediatrics, functional, vascular, skull base, brain tumor, and spine. The Committee on Neurotrauma convened and resolved to study most of the available protocols and guidelines in use in different parts of the world. OBJECTIVE: To formulate a standard protocol for the practice of neurotrauma care within the Nigerian locality. METHODS: The Committee split its membership into 3 subcommittees to cover the various aspects of the Neurotrauma Guidelines, such as neurotrauma curriculum, standard neurotrauma management protocols, and neurotrauma registry. Each subcommittee was to research on available models and formulate a draft for Nigerian neurotrauma. RESULTS: All the 3 subcommittees had their reports ready on schedule. Each concurred that neurotrauma is a major public health challenge in Nigeria. They produced 3 different drafts on the 3 thematic areas of the project. The subcommittees are: 1. Subcommittee on Fellowship, Training and Research Curriculum; 2. Subcommittee on Standard Protocols and Management Guidelines; and 3. Subcommittee of the Nigerian Neurotrauma Registry. CONCLUSION: The committee concluded that a formal protocol for neurotrauma care is long overdue in Nigeria for the standardization of all aspects of neurotrauma. It then recommended the adoption of these guidelines by all institutions offering services in Nigeria using the management protocols, opening a registry, and mounting researches on the various aspects of neurotrauma.