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Herstory of the Korean Women Neurosurgical Society since 2008

The Korean Women Neurosurgical Society (KWNS) was founded in 2008. To commemorate its 10th anniversary, herein we review its history and the status of Korean Neurosurgical Society (KNS)-certified women neurosurgeons. Based on the academic and social activity of the KWNS, we can expect to promote professional work as members of the KNS, facilitate interaction among neurosurgeons, and sustain professional careers.


INTRODUCTION
According to 2017 statistics on doctors in South Korea, 121572 doctors were registered with the Ministry of Health and Welfare, 25.4% of whom were women. According to the Korean Medical Association, in 2017, 101618 doctors reported to doctors' associations, with a gender ratio of 77689 male physicians (76.1%) to 23929 female physicians (23.9%). According to 2018 statistics on Korean neurosurgeons, 3169 neurosurgeons were registered (2.6% of all Korean doctors), and among these, 53 were women neurosurgeons (0.04% out of all Korean doctors).
In the history of women specialized in neurosurgery, the first woman neurosurgeon in the world was Diana Beck, M.D. ) of the United Kingdom 1) . During her 31-year ca-reer, she was the only woman neurosurgeon in Western Europe and the United States. Her original research, case reports, and seminal paper were related to the surgical treatment of intracerebral hemorrhage. In 1961, Dr. Ruth Kerr Jakoby was appointed the first woman diplomat of the American Board of Neurological Surgery 5) . In addition to her neurosurgical career, she developed an interest in medical-legal issues as a lawyer. Dr. Thanjavur Santhanakrishna Kanaka, who completed her degree (MCh) in neurosurgery in 1968, is widely recognized as Asia's first female neurosurgeon. Her remarkable research contributed to the field of stereotactic surgery. In Japan, Dr. Yoko Kato was promoted as a full professor and became the first female professor of neurosurgery in 1984 3) . She founded the Women's Neurosurgical Association of Japan in 1990 and the Asian Women's Neurosurgical Association in https://doi.org/10.3340/jkns.2019.0043 1996. She suggested that women's abilities should be developed further with the help of day care centers, reemployment, worksharing, team medicine, and neurosurgeons' societies and politics, and that this effort would also broaden the minds of male neurosurgeons. Dr. Hyo-Sook Chung became the first woman neurosurgeon in the history of South Korea in 1983, and became the first president of the Korean Women Neurosurgical Society (KWNS). Dr. Moon-Sun Park became the first full professor of neurosurgery in 2011. She majored in cerebrovascular neurosurgery and led the KWNS as its second president.
In the history of women's neurosurgery associations, Dr.
Deborah Benzil was a driving force behind the 1989 founding of Women in Neurosurgery (WINS) and became the first president of WINS in 1990 5) . WINS encourages the involvement of its members in neurosurgery organizations and serves as a resource for the American Association of Neurological Surgeons, Congress of Neurological Surgeons, and other neurosurgical and medical organizations at the local, state, and national levels 4,6) . Dr. Karin Muraszko, a pediatric neurosurgeon at the University of Michigan, became the first woman to be appointed chair of a residency training program approved by the Residency Review Committee in 2004. The KWNS was founded in 2008 and to commemorate its 10th anniversary, herein we review its history and the status of Korean Neurosurgical Society (KNS)-certified women neurosurgeons. Based on the academic and social activity of the KWNS, we can expect to promote professional work as members of the KNS, facilitate interaction among neurosurgeons, and sustain professional careers.

THE KOREAN WOMEN NEUROSURGICAL SOCI-ETY
The KWNS was founded on April 18, 2008 as a subgroup of the KNS 2) . A special session on the KWNS was held during the KNS spring meeting and an inauguration ceremony was conducted ( Fig. 1A). From 2008 to 2012, the first president of the KWNS was Dr. Hyo-Sook Chung, who was the first woman neurosurgeon in South Korea and worked in Hyehwa Neurosurgery Clinic ( Fig. 2A). Dr. Moon-Sun Park, a professor of Daejeon Eulji Medical Center, Eulji University, became the second president in November 2012 (Fig. 2B).
Among the 3169 neurosurgeons in South Korea in Decem-ber 2018, 53 (1.7%) were women neurosurgeons in the KWNS. These KWNS members were trained in 26 hospitals. Among the 335 residents in 2018, 21 (6.3%) were women residents.    (1) H a n y a n g U n iv e r s it y M e d ic a l C e n t e r K o r e a U n iv e r s it y H o s p it a l G a c h o n U n iv e r s it y G il M e d ic a l C e n t e r K e im y u n g U n iv e r s it y D o n g s a n M e d ic a l C e n t e r S e v e r a n c e H o s p it a l S o o n c h u n h y a n g U n iv e r s it y H o s p it a l G y e o n g s a n g N a t io n a l U n iv e r s it y H o s p it a l K y u n g h e e U n iv e r s it y H o s p it a l C h u n g n a m N a t io n a l U n iv e r s it y H o s p it a l C h u n g b u k N a t io n a l U n iv e r s it y H o s p it a l C h o n n a m N a t io n a l U n iv e r s it y H o s p it a l C h o n b u k N a t io n a l U n iv e r s it y H o s p it a l D a n k o o k U n iv e r s it y H o s p it a l H a ll y m U n iv e r s it y M e d ic a l C e n t e r S a m s u n g M e d ic a l C e n t e r N a t io n a l C a n c e r C e n t e r D a e je o n E u lj i M e d ic a l C e n t e r K a n g w o n N a t io n a l U n iv e r s it y H o s p it a l K y u n g p o o k N a t io n a l U n iv e r s it y H o s p it a l Y e u n g n a m U n iv e r s it y M e d ic a l C e n t e r The KWNS engages in academic and social activities. We publish newsletters that report news of individual members and KWNS activities. Regarding regular social activities, a ceremony is conducted for new KNS-certified women neurosurgeons and a dinner is held during the KNS annual autumn meeting. Regarding regular academic activities, a luncheon seminar for the KNS annual autumn meeting has been held since 2014 (Table 1). The president, Dr. Moon-Sun Park, moderated all seminars, and we focus on the promotion of professional growth for individual members, enhancement of member interaction, and maintenance of sustainable careers. To commemorate the 10th anniversary of the KWNS, we held a celebration party during the KNS annual meeting (Fig. 1B).

THE STATUS OF KOREAN NEUROSURGICAL SO-CIETY-CERTIFIED WOMEN NEUROSURGEONS
In December 2018, the total number of KNS-certified women neurosurgeons was 53, leading the organization of a women's meeting, which has gradually been increasing in attendance (Fig. 3) There were 26 training hospitals for women neurosurgeons in South Korea ( Table 2). The first training hospital for KNScertified women neurosurgeons was Hanyang University Medical Center in 1983. Subsequently training hospitals were as follows : Kyunghee University Hospital in 1988, Chungnam National University Hospital in 1993, Korea University Hospital in 1993, Ewha Womans University Hospital in 1998, Chun-   (Fig. 4). Generally, there were one or two women neurosurgeons in each training hospital.
Regarding the subspecialties of KNS-certified women neurosurgeons after the completion of residency programs, 18 trained in cerebrovascular surgery (34.6%), eight in stereotactic and functional neurosurgery (15.4%), six in spinal neurosurgery (11.5%), six in general neurosurgery (11.5%), five in pediatric neurosurgery (9.6%), five in brain tumor surgery (9.6%), three in neurocritical care (5.8%), and one in trauma (1.9%) ( Table 3, Fig. 5). In December 2018, most women neurosurgeons worked in academic institutes (n=32, 61.5%). Twelve neurosurgeons (23.1%) were salaried doctors, two worked in private clinics, one worked in the pharmaceutical industry, and one worked as a hospitalist. Of those working in academia, nine were in neurosurgery fellowships, two were research fellows, two were full-time instructors, 10 were assistant professors, four were associate professors, and five were professors (Fig. 6).

FUTURE CONSIDERATIONS
Women neurosurgeons were isolated individuals rather than a minority group. The individual's barriers for active professional development may neither be obvious nor even acknowledged, but exist. However, as described thus far, we have achieved modest quantitative growth in the past decade. It is the next decade in which we will occupy a distinct area of the KNS and the South Korean medical community.
At this point, it is our duty to clearly define the role of our meeting in the new generation and to act responsibly in the new era. As a result of our deep discussions, we have decided on the missions and goals of the KWNS. First, the mission is to educate, inspire, and encourage female neurosurgeons in South Korea to understand their professional and personal goals and solve the inherent problems therein. Our goals are as follows : 1) to maintain professionalism and develop competency. 2) To create an environment that recognizes and supports individual values and individual diversity. And 3) to promote communication among members and to contribute to the development of the KNS.
To achieve these missions and goals, we will always try to help each member overcome obstacles and grow, and to contribute to the well-being and growth of our society, the KNS, the medical community, and the nation.

CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.