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Anand A, Ajayi AO, Ansari A, Mustapha MJ, Verma A, Adinoyi SA, Uthman U, Usman A, Mofatteh M, Khatib MN, Zahiruddin QS, Gaidhane S, Sharma RK, Rustagi S, Satapathy P, Ajibade AA, Oluwamayowa O, Obanife HO, Ahmad KI, Ogunleye OO. Academic Neurosurgery in Nigeria- Past, Present, and Future: A Review. World Neurosurg 2024; 189:108-117. [PMID: 38851629 DOI: 10.1016/j.wneu.2024.05.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
Nigeria's neurosurgical field faces profound challenges, including a critically low neurosurgeon-to-patient ratio and significant migration of medical professionals to developed countries. High costs, low socioeconomic status, and the urban-centric location of neurosurgical centers impede access to care. Key barriers to service delivery include lack of manpower, insufficient emergency care, limited imaging modalities, inadequate operative equipment, and ineffective political and administrative policies. Neurotrauma is the primary reason for neurosurgical intervention but is poorly managed due to delayed access and insufficient guidelines. The neurosurgical education system is strained by limited training capacity and the absence of subspecializations, restricting specialized care. Research output is low, hindered by limited infrastructure, lack of databases, insufficient funding, and minimal international collaboration. To address these issues, it is critical to enhance the imaging capabilities, ensure the availability of operative equipment, and establish effective policies for task sharing and communication at different levels of care. Other approaches include expanding training capacity, particularly in rural areas, implementing a uniform match system for residency, addressing gender disparities, and utilizing dual practice to ensure adequate compensation for neurosurgeons. Furthermore, stakeholders should develop subspecialization programs in areas such as neurovascular, neuro-oncology, pediatric neurosurgery, and minimally invasive neurosurgery to expand service scope. To transform the neurosurgical research landscape, efforts should be made to establish electronic medical databases, foster international collaborations to ensure funding, and make research mandatory for accreditation renewal to ensure continuous academic contribution.
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Affiliation(s)
- Ayush Anand
- B. P. Koirala Institute of Health Sciences, Dharan, Nepal; MediSurg Research, Darbhanga, India; Global Consortium of Medical Education and Research, Pune, India
| | | | - Ayesha Ansari
- Global Consortium of Medical Education and Research, Pune, India; Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), India
| | | | - Amogh Verma
- Rama Medical College Hospital and Research Centre, Hapur, India
| | | | | | - Abubakar Usman
- Ahmadu Bello University Teaching Hospital Zaria, Nigeria
| | - Mohammad Mofatteh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- Division of Evidence Synthesis, South Asia Infant Feeding Research Network (SAIFRN), Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
| | - Rakesh Kumar Sharma
- Graphic Era (Deemed to be University), Dehradun, India; Graphic Era Hill University, Dehradun, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Iraq
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O'Malley GR, Sarwar SA, Weisman HE, Wan E, Prem Kumar R, Patel NV. Assessing Diversity, Equity, and Inclusion in Patient-Facing Websites in Neurosurgical Departments in the United States. World Neurosurg 2024; 186:e366-e373. [PMID: 38556163 DOI: 10.1016/j.wneu.2024.03.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Patient-facing websites serve as essential platforms for disseminating information, engaging with patients, and increasing access to neurosurgical resources and services. Diversity, Equity, and Inclusion are at the forefront of issues facing the field of neurosurgery, especially concerning race and gender disparities in regards to providers in the field. METHODS Data were collected in regards to the race and gender of patients and providers displayed on the neurosurgery department's patient-facing website in addition to accommodations for disabilities, decreased ability to pay, and language. RESULTS Patients who were White were depicted more commonly than those of color (69% vs. 31%, P < 0.00001). White patients also were over-represented when compared with the average demographics of the communities in which the hospitals served (P = 0.03846). Neurosurgical providers who were White outnumbered those of color (70% vs. 30%, P < 0.00001). The racial depiction of providers was comparable with racial disparities currently observed in neurosurgery (P = 0.59612). Female neurosurgery providers were seen less than male providers on patient-facing websites (P < 0.00001) but were seen more commonly on patient-facing websites than the percentage of practicing neurosurgeons they currently comprise (28% vs. 8%, P < 0.00001). CONCLUSIONS The results of this study suggest that patient-facing websites of neurosurgical departments are an area of improvement in regards to Diversity, Equity, and Inclusion in the field of neurosurgery. Disparities are noted in regards to the racial depiction of patients and further call to attention racial and gender disparities in the field of neurosurgery.
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Affiliation(s)
- Geoffrey R O'Malley
- Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.
| | - Syed A Sarwar
- Department of Neurosurgery, HMH-Jersey Shore University Medical Center, Neptune, New Jersey, USA
| | - Hannah E Weisman
- Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Erica Wan
- Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Rohit Prem Kumar
- Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Nitesh V Patel
- Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA; Department of Neurosurgery, HMH-Jersey Shore University Medical Center, Neptune, New Jersey, USA
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Cazorla-Morales IJ, Chan AW, Mikhail MM, Fu A, Koutsouras GW, Heary RF, Mazzola CA. The Accreditation Council for Graduate Medical Education 20-Year Trends in Diversity, Equity, and Inclusion in the United States: How Does Neurological Surgery Compare? World Neurosurg 2024; 185:e969-e975. [PMID: 38458250 DOI: 10.1016/j.wneu.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Within the current medical workforce, diversity is limited among surgical specialties. However, diversity allows physicians to provide culturally competent care. This paper discusses the trends in racial, ethnic, and gender representation within different surgical subspecialties with an emphasis on neurosurgery over a 20-year time frame. METHODS A retrospective review of data collected by the Accreditation Council for Graduate Medical Education over the past twenty years, as reported in Journal of the American Medical Association, was conducted. Residents from 5 surgical specialties were evaluated based on gender, race, and ethnic identifications from 2002 to 2022. One-way analysis of variance was performed to compare the levels and retention rates of racial, ethnic, and gender diversity within these specialties. RESULTS Analysis of resident demographics of the 5 surgical specialties reveals an overall trend of increasing diversity over the study period. Over the past 20 years, neurosurgery had an overall increase in Asian (+5.1%), Hispanic (+3.0%), and female (+11.4%) residents, with a decrease in White residents by 2.1% and Black residents by 1.1%. Among the surgical specialties analyzed, otolaryngology had the greatest overall increase in minority residents. Notably, there has been an overall increase in female residents across all 5 surgical specialties, with the highest in otolaryngology (+20.3%) which was significantly more than neurosurgery (P < 0.001). CONCLUSIONS This chronological analysis spanning 20 years demonstrates that neurosurgery, like other specialties, has seen a growth in several racial and ethnic categories. Relative differences are notable in neurosurgery, including Black, Asian, Hispanic, and White ethnic categories, with growth in females, but at a significantly lesser pace than seen in otolaryngology and plastic surgery.
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Affiliation(s)
- Ilona J Cazorla-Morales
- Department of Neurological Surgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.
| | - Amber W Chan
- Department of Neurological Surgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Mirai M Mikhail
- Department of Neurological Surgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Allen Fu
- Department of Neurosurgery, New Jersey Pediatric Neuroscience Institute, Morristown, New Jersey, USA
| | - George W Koutsouras
- Department of Neurosurgery, SUNY Upstate University Hospital, Syracuse, New York, USA
| | - Robert F Heary
- Department of Neurological Surgery, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Catherine A Mazzola
- Department of Neurological Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA; Department of Neurosurgery, New Jersey Pediatric Neuroscience Institute, Morristown, New Jersey, USA
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Badejo OA, Oboh E, Abu-Bonsrah N, Petitt Z, Ekweogwu OC, Morgan E, Onyia CU, Ahmad MH, Ayodele OA, Usman B, Dawang Y, Orhorhoro OI, Oyemolade TA, Okere OE, Deng DD, Njeru PN, Otun A, Nischal SA, Opara O, Iroegbu-Emeruem LU, Fuller AT, Haglund MM, Chikani MC, Adeleye AO, Adeolu AA, Ukachukwu AEK. Women in Nigerian Neurosurgery: A Cross-Sectional Survey. World Neurosurg 2024; 185:e75-e85. [PMID: 38741331 DOI: 10.1016/j.wneu.2023.12.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 05/16/2024]
Abstract
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.
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Affiliation(s)
- Oluwakemi A Badejo
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Ena Oboh
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA
| | - Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zoey Petitt
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Ofodile C Ekweogwu
- Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Eghosa Morgan
- Department of Surgery, Babcock University Teaching Hospital, Ilishan Remo, Nigeria
| | | | - Misbahu H Ahmad
- Department of Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Olabamidele A Ayodele
- Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Babagana Usman
- Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
| | - Yusuf Dawang
- Department of Surgery, University of Abuja Teaching Hospital, Gwagwalada-Zuba, Nigeria
| | - Omuvie I Orhorhoro
- Department of Surgery, Delta State University Teaching Hospital, Oghara, Nigeria
| | | | | | - Di D Deng
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA
| | - Paula N Njeru
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Ayodamola Otun
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Shiva A Nischal
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Oluwamayowa Opara
- Department of Surgery, Imo State Specialist Hospital, Owerri, Nigeria
| | | | - Anthony T Fuller
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael M Haglund
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Mark C Chikani
- Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Amos O Adeleye
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Augustine A Adeolu
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Alvan-Emeka K Ukachukwu
- Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
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Wang A, Holly LT. Racial and Ethnic Diversity in Neurosurgery: Challenges, Progress, and Future Directions. Neurosurgery 2024; 94:643-647. [PMID: 38497806 DOI: 10.1227/neu.0000000000002738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 03/19/2024] Open
Affiliation(s)
- Andrew Wang
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Langston T Holly
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA
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Cénat JM, Broussard C, Jacob G, Kogan C, Corace K, Ukwu G, Onesi O, Furyk SE, Bekarkhanechi FM, Williams M, Chomienne MH, Grenier J, Labelle PR. Antiracist training programs for mental health professionals: A scoping review. Clin Psychol Rev 2024; 108:102373. [PMID: 38232574 DOI: 10.1016/j.cpr.2023.102373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/17/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
Racism has been shown to be directly deleterious to the mental health care received by minoritized peoples. In response, some mental health institutions have pledged to provide antiracist mental health care, which includes training mental health care professionals in this approach. This scoping review aimed to synthesize the existing published material on antiracist training programs among mental health care professionals. To identify studies, a comprehensive search strategy was developed and executed by a research librarian in October 2022 across seven databases (APA PsycInfo, Education Source, Embase, ERIC, MEDLINE, CINAHL, and Web of Science). Subject headings and keywords relating to antiracist training as well as to mental health professionals were used and combined. There were 7186 studies generated by the initial search and 377 by the update search, 30 were retained and included. Findings revealed four main antiracist competencies to develop in mental health professionals: importance of understanding the cultural, social, and historical context at the root of the mental health problems; developing awareness of individual biases, self-identity and privilege; recognizing oppressive and racism-sustaining behaviors in mental health care settings; and, employing antiracist competencies in therapy. Professionals who have taken trainings having the main components have developed skills on the interconnectedness between racialized groups' mental health and the cultural, religious, social, historical, economic, and political issues surrounding race, necessary for successful clinical practice and for providing anti-racist mental health care. This scoping review presents a summary of the essential antiracist competencies drawn from the literature which must be applied in a mental health care setting, to improve help seeking behaviors, and reduce distrust in mental health care professionals and settings.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Cathy Broussard
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Grace Jacob
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Cary Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Institute for Mental Health at The Royal, Ottawa, Ontario, Canada
| | - Kim Corace
- The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Institute for Mental Health at The Royal, Ottawa, Ontario, Canada
| | - Gloria Ukwu
- Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Olivia Onesi
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Monnica Williams
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Canada Research Chair on Mental Health Disparities, Ottawa, Ontario, Canada
| | - Marie-Hélène Chomienne
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on the Health Status of Black Immigrant Francophones, Ottawa, Ontario, Canada; Institut du Savoir Montfort, Ottawa, Ontario, Canada
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Pugazenthi S, Fabiano AS, Barpujari A, Vessell M, Reddy V, Adogwa O, Swartz KR. Sociodemographics Impact Competitiveness in the Neurosurgical Match: Survey Results. World Neurosurg 2024; 182:e308-e318. [PMID: 38008166 DOI: 10.1016/j.wneu.2023.11.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND The neurosurgical match involves selecting future neurosurgeons who will comprise the future national workforce, based on a competitive ranking process of applicants. We aimed to identify which sociodemographic and academic factors influence competitiveness and rank position in the match. METHODS A Council of State Neurosurgical Societies (CSNS) survey was distributed to current U.S. neurosurgical residents. The primary outcome measure was self-reported rank position of matched program. Variables included sociodemographic and academic metrics. Fisher exact, logistic regression, and t tests were performed. RESULTS Among the 72 respondents, median United States Medical Licensing Examination Step 1 score was 248, 34.7% were Alpha Omega Alpha inductees, 77.8% completed 1-3 sub-internship rotations, median number of publications was 5, and 13.9% had a Ph.D. Sociodemographic analysis demonstrated that 69.4% were male and 30.6% were female. Applicants with a home neurosurgery program or of female gender had statistically significantly higher odds of matching into a top 3 program on their rank list (odds ratio = 9 and odds ratio = 6, respectively). Female applicants exhibited similar mean, but less variance, compared with male respondents for United States Medical Licensing Examination Step 1 scores and number of publications. Respondents with a top 3 program match were more likely to agree that the home program supported their pursuance of neurosurgery. CONCLUSIONS Two sociodemographic factors were independently associated with high match rank: presence of home neurosurgery program and female gender. Female respondents reported consistently strong academic metrics (similar mean, but less variance, compared with male respondents).
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Affiliation(s)
- Sangami Pugazenthi
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alexander S Fabiano
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Awinita Barpujari
- Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Meena Vessell
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA; Department of Pediatric Neurosurgery, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Vamsi Reddy
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Owoicho Adogwa
- Department of Neurosurgery, Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Karin R Swartz
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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Wani FA, Alanazi KM, Alblwan AS. Factors Affecting the Choice of Neurosurgery as a Future Career: A Cross-Sectional Study. Cureus 2024; 16:e52836. [PMID: 38406169 PMCID: PMC10884721 DOI: 10.7759/cureus.52836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Selecting a specialty is a very important and stressful decision that students must make, as it will have a lasting impact on their professional lives. Medical students could gain insight into a variety of specialties during their clinical years, especially the work environment in different specialties. Numerous factors can influence this decision, such as work-life balance, lifestyle, and gender differences. The goal of our study is to demonstrate the different factors, both attractive and deterrent, that influence neurosurgery selection as a future specialty among students. Also, we will consider the exposure-related geographical distribution of the neurosurgery field regarding conferences and workshops, as well as the availability of university professors and their impact on the interest of students in the specialty. Methods A cross-sectional study spanning from June 2023 to September 2023 was conducted among students at medical colleges across the Kingdom of Saudi Arabia. All medical students from the second medical year up to the internship were invited to take part in the study. Non-medical students, first-year medical students, and incomplete questionnaires were excluded. Employing a stratified random sampling technique, we ensured diverse representation, eventually gathering data from 1141 participants. Results The study involved a diverse group of 1141 medical students and interns, with an average age of 21.7 years. Among them, 683 (59.9%) were female. Approximately half of the participants, 572 (50.1%), express an interest in pursuing a career in neurosurgery, and a significant portion of respondents find neurosurgery appealing due to its challenging nature (50.9%). On the other hand, stress emerged as the most significant deterrent factor (50.3%). Among educational levels, interns, 39 (28.3%), showed the least interest, while second-year students, 193 (64.8%), exhibited the highest interest (p < 0.001*). The analysis revealed statistically significant gender differences in factors. Specifically, a higher percentage of females found "interested in neuroscience" to be the most attractive factor compared to males (18.2% vs. 15.5%, p < 0.001*). Regarding deterring factors, a greater percentage of males found "risk" as the most deterring factor compared to females (19.2% vs. 17.1%, p = 0.001*). Conclusion We found no significant age variation in the most attractive factors; however, significant gender differences in attractive and deterrent factors were observed. The "risk" associated with neurosurgery was the most deterring factor for students across different cumulative grade point average (CGPA) ranges and for students from the eastern and central areas. Our findings suggest that most factors are consistently attractive or deterring across different educational and clinical levels, emphasizing the stability of these perceptions throughout medical education. We propose innovative educational initiatives with increased faculty participation to implement the curricula with early exposure of students to neurosurgery.
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Affiliation(s)
- Farooq A Wani
- Pathology and Laboratory Medicine, Jouf University, Sakaka, SAU
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Anand A, Ibrahim IA, Kathayat P, Ansari A, Aggarwal Y, Kaur Wahi R, Satapathy P, Rustagi S. Need to address the gender disparities in neurosurgery in India. Ann Med Surg (Lond) 2024; 86:20-22. [PMID: 38222733 PMCID: PMC10783270 DOI: 10.1097/ms9.0000000000001544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/17/2023] [Indexed: 01/16/2024] Open
Affiliation(s)
- Ayush Anand
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
- Global Consortium of Medical Education and Research, Pune
| | - Ismail A. Ibrahim
- Fenerbahçe Üniversitesi, Faculty of Health Sciences, Physiotherapy and Rehabilitation Pr, Istanbul, Turkey
- Global Consortium of Medical Education and Research, Pune
| | - Priyangi Kathayat
- Smt NHL Municipal Medical College, Ahmedabad, Gujarat
- Global Consortium of Medical Education and Research, Pune
| | - Ayesha Ansari
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha
- Global Consortium of Medical Education and Research, Pune
| | - Yash Aggarwal
- Global Consortium of Medical Education and Research, Pune
- Government Institute of Medical Sciences, Greater Noida
| | - Riddhpreet Kaur Wahi
- Global Consortium of Medical Education and Research, Pune
- Grant Government Medical College and Sir J.J Group of Hospitals, Mumbai, Maharashtra
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai
- School of Pharmacy, Graphic Era Hill University, Dehradun, Uttarakhand, India
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Carter A, Findlay MC, Earl ER, Khan M, Bauer S, Farsi K, Lucke-Wold B, Karsy M. Systematic Review of Research, Mentorship, and Career Resources for Medical Students Pursuing Neurosurgical Training. World Neurosurg 2023; 179:28-36. [PMID: 37544605 DOI: 10.1016/j.wneu.2023.07.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Medical students are important team members and future healthcare providers in neurosurgery or other medical fields. We performed a systematic review evaluating studies assessing medical student guidance, mentorship, and career development in neurosurgery. The study aimed to identify the best practices and acknowledge gaps requiring improvement. METHODS A systematic review of 586 research studies evaluating important aspects of medical student career development in neurosurgery was performed. The studies were analyzed for evidence supporting specific strategies to foster career development. RESULTS A total of 45 studies were identified and categorized into 8 categories: 1) medical student interest groups; 2) student fellowships and institutional programs; 3) research and observership funding; 4) medical student research and scholarship; 5) student-led interest groups; 6) student mentorship; 7) educational resources; and 8) diversity, equity, and inclusion for medical students. Studies supported the significant positive effects of career resources for medical students, which often resulted in higher publication quantities, increased interest in the field, and greater ease of matriculation into a neurosurgical residency. One central gap included limited formal opportunities at many institutions, including medical schools without neurosurgery programs. Additional gaps were an absent structure for many forms of mentorship and delayed engagement of medical students in neurosurgical training, which significantly affects career interests. The currently available resources for these aspects of career development are listed. CONCLUSIONS These studies highlight the current endeavors to encourage medical student careers. However, ample gaps and missed opportunities were also identified. Further work at both institutional and national levels is needed to improve the current environment.
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Affiliation(s)
- Ashley Carter
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Matthew C Findlay
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA; School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Emma Rose Earl
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA; School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Majid Khan
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Sawyer Bauer
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Koorosh Farsi
- Global Neurosciences Institute, Philadelphia, Pennsylvania, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Michael Karsy
- Global Neurosciences Institute, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
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Fava A, Gorgoglione N, De Angelis M, Esposito V, di Russo P. Key role of microsurgical dissections on cadaveric specimens in neurosurgical training: Setting up a new research anatomical laboratory and defining neuroanatomical milestones. Front Surg 2023; 10:1145881. [PMID: 36969758 PMCID: PMC10033783 DOI: 10.3389/fsurg.2023.1145881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/13/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionNeurosurgery is one of the most complex surgical disciplines where psychomotor skills and deep anatomical and neurological knowledge find their maximum expression. A long period of preparation is necessary to acquire a solid theoretical background and technical skills, improve manual dexterity and visuospatial ability, and try and refine surgical techniques. Moreover, both studying and surgical practice are necessary to deeply understand neuroanatomy, the relationships between structures, and the three-dimensional (3D) orientation that is the core of neurosurgeons' preparation. For all these reasons, a microsurgical neuroanatomy laboratory with human cadaveric specimens results in a unique and irreplaceable training tool that allows the reproduction of patients' positions, 3D anatomy, tissues' consistencies, and step-by-step surgical procedures almost identical to the real ones.MethodsWe describe our experience in setting up a new microsurgical neuroanatomy lab (IRCCS Neuromed, Pozzilli, Italy), focusing on the development of training activity programs and microsurgical milestones useful to train the next generation of surgeons. All the required materials and instruments were listed.ResultsSix competency levels were designed according to the year of residency, with training exercises and procedures defined for each competency level: (1) soft tissue dissections, bone drilling, and microsurgical suturing; (2) basic craniotomies and neurovascular anatomy; (3) white matter dissection; (4) skull base transcranial approaches; (5) endoscopic approaches; and (6) microanastomosis. A checklist with the milestones was provided.DiscussionMicrosurgical dissection of human cadaveric specimens is the optimal way to learn and train on neuroanatomy and neurosurgical procedures before performing them safely in the operating room. We provided a “neurosurgery booklet” with progressive milestones for neurosurgical residents. This step-by-step program may improve the quality of training and guarantee equal skill acquisition across countries. We believe that more efforts should be made to create new microsurgical laboratories, popularize the importance of body donation, and establish a network between universities and laboratories to introduce a compulsory operative training program.
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Affiliation(s)
- Arianna Fava
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy
- Department of Neuroscience, Sapienza University, Rome, Italy
- Correspondence: Arianna Fava
| | | | | | - Vincenzo Esposito
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy
- Department of Neuroscience, Sapienza University, Rome, Italy
| | - Paolo di Russo
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy
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