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Ng PR, Yearley AG, Eatz TA, Ajmera S, West T, Razak SS, Lazaro T, Urakov T, Jones PS, Coumans JV, Stapleton CJ, Shankar G, Chen HI, Komotar RJ, Patel AJ, Nahed BV. Neurological Surgery Residency Programs in the United States: A National Cross-Sectional Survey. Neurosurgery 2024; 94:529-537. [PMID: 37795983 DOI: 10.1227/neu.0000000000002703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/04/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education has approved 117 neurological surgery residency programs which develop and educate neurosurgical trainees. We present the current landscape of neurosurgical training in the United States by examining multiple aspects of neurological surgery residencies in the 2022-2023 academic year and investigate the impact of program structure on resident academic productivity. METHODS Demographic data were collected from publicly available websites and reports from the National Resident Match Program. A 34-question survey was circulated by e-mail to program directors to assess multiple features of neurological surgery residency programs, including curricular structure, fellowship availability, recent program changes, graduation requirements, and resources supporting career development. Mean resident productivity by program was collected from the literature. RESULTS Across all 117 programs, there was a median of 2.0 (range 1.0-4.0) resident positions per year and 1.0 (range 0.0-2.0) research/elective years. Programs offered a median of 1.0 (range 0.0-7.0) Committee on Advanced Subspecialty Training-accredited fellowships, with endovascular fellowships being most frequently offered (53.8%). The survey response rate was 75/117 (64.1%). Of survey respondents, the median number of clinical sites was 3.0 (range 1.0-6.0). Almost half of programs surveyed (46.7%) reported funding mechanisms for residents, including R25, T32, and other in-house grants. Residents received a median academic stipend of $1000 (range $0-$10 000) per year. Nearly all programs (93.3%) supported wellness activities for residents, which most frequently occurred quarterly (46.7%). Annual academic stipend size was the only significant predictor of resident academic productivity (R 2 = 0.17, P = .002). CONCLUSION Neurological surgery residency programs successfully train the next generation of neurosurgeons focusing on education, clinical training, case numbers, and milestones. These programs offer trainees the chance to tailor their career trajectories within residency, creating a rewarding and personalized experience that aligns with their career aspirations.
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Affiliation(s)
- Patrick R Ng
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Alexander G Yearley
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Tiffany A Eatz
- Department of Neurological Surgery, University of Miami, Miami , Florida , USA
| | - Sonia Ajmera
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia , Pennsylvania , USA
| | - Timothy West
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Shahaan S Razak
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Tyler Lazaro
- Department of Neurological Surgery, Baylor College of Medicine, Houston , Texas , USA
| | - Timur Urakov
- Department of Neurological Surgery, University of Miami, Miami , Florida , USA
| | - Pamela S Jones
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Jean-Valery Coumans
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Christopher J Stapleton
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - Ganesh Shankar
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
| | - H Isaac Chen
- Department of Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia , Pennsylvania , USA
| | - Ricardo J Komotar
- Department of Neurological Surgery, University of Miami, Miami , Florida , USA
| | - Akash J Patel
- Department of Neurological Surgery, Baylor College of Medicine, Houston , Texas , USA
| | - Brian V Nahed
- Harvard Medical School, Boston , Massachusetts , USA
- Department of Neurological Surgery, Massachusetts General Hospital, Boston , Massachusetts , USA
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Hulou MM, Park MT, Essibayi MA, McLouth CJ, Benner D, Samaan CA, Madriñán-Navia HJ, Howshar JT, Graffeo CS, Lawton MT. Academically Inclined: Predictors of Early Career Trajectory and Avenues for Early Intervention Among Neurosurgery Trainees. Neurosurgery 2023; 92:854-861. [PMID: 36729517 DOI: 10.1227/neu.0000000000002285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/30/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The relationship of academic activities before and during neurosurgery residency with fellowship or career outcomes has not been studied completely. OBJECTIVE To assess possible predictors of fellowship and career outcomes among neurosurgery residents. METHODS US neurosurgery graduates (2018-2020) were assessed retrospectively for peer-reviewed citations of preresidency vs intraresidency publications, author order, and article type. Additional parameters included medical school, residency program, degree (MD vs DO; PhD), postgraduate fellowship, and academic employment. RESULTS Of 547 neurosurgeons, 334 (61.1%) entered fellowships. Fellowship training was significantly associated with medical school rank and first-author publications. Individuals from medical schools ranked 1 to 50 were 1.6 times more likely to become postgraduate fellows than individuals from medical schools ranked 51 to 92 (odds ratio [OR], 1.63 [95% CI 1.04-2.56]; P = .03). Residents with ≥2 first-author publications were almost twice as likely to complete a fellowship as individuals with <2 first-author publications (OR, 1.91 [95% CI 1.21-3.03]; P = .006). Among 522 graduates with employment data available, academic employment obtained by 257 (49.2%) was significantly associated with fellowship training and all publication-specific variables. Fellowship-trained graduates were twice as likely to pursue academic careers (OR, 1.99 [95% CI 1.34-2.96]; P < .001) as were individuals with ≥3 first-author publications ( P < .001), ≥2 laboratory publications ( P = .04), or ≥9 clinical publications ( P < .001). CONCLUSION Research productivity, medical school rank, and fellowships are independently associated with academic career outcomes of neurosurgeons. Academically inclined residents may benefit from early access to mentorship, sponsorship, and publishing opportunities.
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Affiliation(s)
- M Maher Hulou
- Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA
| | - Marian T Park
- Creighton University School of Medicine, Phoenix, Arizona, USA
| | - Muhammed Amir Essibayi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | | | - Dimitri Benner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | | | - Humberto Jose Madriñán-Navia
- Center for Research and Training in Neurosurgery, Department of Neurosurgery, Hospital Universitario de la Samaritana, Bogota, Colombia
| | - Jacob T Howshar
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Christopher S Graffeo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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