The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education

Sujit Gnanakumar; Bilal Abou El Ela Bourquin; Faith C Robertson; Davi J Fontoura Solla; Claire Karekezi; Kerry Vaughan; Roxanna M Garcia; Fahd Derkaoui Hassani; Alexander Alamri; Julius Höhne; Nesrine Mentri; Martin Stienen; Tsegazeab Laeke; Luis Rafael Moscote-Salazar; Ahmed Nasser Al-Ahmari; Hosam Al-Jehani; Federico Nicolosi; Nicolás Samprón; P David Adelson; Franco Servadei; Ignatius N Esene; Amro Al-Habib; Angelos G Kolias; World Federation of Neurosurgical Societies Young Neurosurgeons Committee

doi:10.1016/j.wnsx.2020.100083

The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education

World Neurosurg X. 2020 May 19:8:100083. doi: 10.1016/j.wnsx.2020.100083. eCollection 2020 Oct.

Authors

Sujit Gnanakumar^{1

2}, Bilal Abou El Ela Bourquin^{1

2}, Faith C Robertson³, Davi J Fontoura Solla⁴, Claire Karekezi⁵, Kerry Vaughan⁶, Roxanna M Garcia⁷, Fahd Derkaoui Hassani⁸, Alexander Alamri⁹, Julius Höhne¹⁰, Nesrine Mentri¹¹, Martin Stienen¹², Tsegazeab Laeke¹³, Luis Rafael Moscote-Salazar¹⁴, Ahmed Nasser Al-Ahmari¹⁵, Hosam Al-Jehani^{16

17}, Federico Nicolosi¹⁸, Nicolás Samprón¹⁹, P David Adelson²⁰, Franco Servadei¹⁸, Ignatius N Esene²¹, Amro Al-Habib²², Angelos G Kolias^{2

23}; World Federation of Neurosurgical Societies Young Neurosurgeons Committee

Affiliations

¹ School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
² National Institute for Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.
³ Department. of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁴ Department of Neurosurgery, University of São Paulo, Brazil.
⁵ Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda.
⁶ Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁷ Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA.
⁸ Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco.
⁹ Department of Neurosurgery, The Royal London Hospital, London, United Kingdom.
¹⁰ Department of Neurosurgery, University Medical Center Regensburg, Regensburg, Germany.
¹¹ Department of Neurosurgery, Bejaia University Hospital, Bejaia, Algeria.
¹² Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Switzerland.
¹³ Department of Surgery, Neurosurgery Unit, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
¹⁴ Department of Neurosurgery, University of Cartagena, Cartagena de Indias, Colombia.
¹⁵ Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
¹⁶ Department of Neurosurgery, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia.
¹⁷ Neuroscience Center, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
¹⁸ Department of Neurosurgery, Humanitas University and Research Hospital, Rozzano, Milan, Italy.
¹⁹ Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain.
²⁰ Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona, USA.
²¹ Neurosurgery Division, Department of Surgery, University of Bamenda, Bamenda, Cameroon.
²² Division of Neurosurgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
²³ Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge and Addenbrooke's Hospital, Cambridge, United Kingdom.

Abstract

Background: Providing a comprehensive and effective neurosurgical service requires adequate numbers of well-trained, resourced, and motivated neurosurgeons. The survey aims to better understand 1) the demographics of young neurosurgeons worldwide; 2) the challenges in training and resources that they face; 3) perceived barriers; and 4) needs for development.

Methods: This was a cross-sectional study in which a widely disseminated online survey (April 2018-November 2019) was used to procure a nonprobabilistic sample from current neurosurgical trainees and those within 10 years of training. Data were grouped by World Bank income classifications and analyzed using χ² tests because of its categorical nature.

Results: There were 1294 respondents, with 953 completed responses included in the analysis. Of respondents, 45.2% were from high-income countries (HICs), 23.2% from upper-middle-income countries, 26.8% lower-middle-income countries, and 4.1% from low-income countries. Most respondents (79.8%) were male, a figure more pronounced in lower-income groups. Neuro-oncology was the most popular in HICs and spinal surgery in all other groups. Although access to computed tomography scanning was near universal (98.64%), magnetic resonance imaging access decreased to 66.67% in low-income countries, compared with 98.61% in HICs. Similar patterns were noted with access to operating microscopes, image guidance systems, and high-speed drills. Of respondents, 71.4% had dedicated time for neurosurgical education.

Conclusions: These data confirm and quantify disparities in the equipment and training opportunities among young neurosurgeons practicing in different income groups. We hope that this study will act as a guide to further understand these differences and target resources to remedy them.

Keywords: CT, Computed tomography; Demographics; Education; Global health; Global neurosurgery; HICs, High-income countries; ICU, Intensive care unit; LICs, Low-income countries; LMICs, Low-middle-income countries; MRI, Magnetic resonance imaging; Neurosurgery; Resources; Training; UMICs, Upper-middle-income countries; aSAH, aneurysmal subarachnoid hemorrhage.

Grants and funding

D43 TW010543/TW/FIC NIH HHS/United States