BACKGROUND: Despite advancements in gender equality within neurosurgery, the field continues to encounter challenges related to the under-representation of women and reports of gender-based disparities. This study examines the impact of these disparities on the experiences, professional development, and well-being of female neurosurgery residents in Germany, identifying specific challenges within the neurosurgical community.

METHODS: An anonymous, questionnaire-based survey was conducted among female neurosurgery residents from various German training hospitals nationwide, using a quantitative approach. Data were collected from June 2021 to January 2023.

RESULTS: A total of 63 female neurosurgery residents participated, representing about 19% of all female neurosurgery residents in Germany. Seventy percent reported experiencing incidents of discrimination during training, with 39% encountering "sometimes" emotional abuse, 20% physical abuse, and 17% "rarely" experiencing sexual harassment. Eighty-six percent did not report these incidents, primarily due to doubts about reporting effectiveness (24%) and the belief that reporting would not lead to change (24%). Discrimination significantly impacted job satisfaction (56%) and career progression (71%). Additionally, 60% reported frequent frustration, 52% experienced occasional depression, and burnout was common.

CONCLUSIONS: The survey highlights gender disparities affecting female neurosurgery residents in Germany, negatively influencing job satisfaction and career advancement. Tackling gender discrimination and harassment requires a multifaceted approach, and further studies are warranted to assess these methods. The neurosurgical community must ensure a supportive environment by adopting no-tolerance policies against discrimination for all residents, paving the way for a future where professional excellence and patient care are free from gender inequalities.