Artículo

Mapping the global neurosurgery workforce. Part 2: Trainee density

Resumen

OBJECTIVE A sustainable neurosurgery workforce depends on robust training pipelines, but the size and distribution of the global neurosurgery trainee workforce has not been described. The objective of this study was to identify the types of training programs that exist in the global neurosurgery workforce, the support that trainees receive, the diversity of trainee experiences, and the accreditation processes that exist to regulate training programs. METHODS This study was a subanalysis of a cross-sectional survey administered online in all 193 countries and 26 territories, independent states, and disputed regions as defined by the World Bank and United Nations. Participants were identified through neurosurgery society leadership, the personal contacts of the coauthors, and bibliometric and search engine searches. Population-weighted statistics were constructed and segregated by country income level and WHO regions. RESULTS Data were obtained for 187 countries (96.9%) and 25 additional territories, states, and disputed regions (96.2%). There were an estimated 1261 training programs and 10,546 trainees within the regions sampled, representing a global pooled density of 0.14 neurosurgery trainees per 100,000 people and a median national density of 0.06 trainees per 100,000 people. There was a higher density in high-income countries (HICs; 0.48 trainees per 100,000 people) compared with upper-middle-income countries (0.09 per 100,000), lower-middle-income countries (0.06 per 100,000), and low-income countries (LICs; 0.07 per 100,000). The WHO European (0.36 per 100,000) and Americas (0.27 per 100,000) regions had the highest trainee densities, while the Southeast Asia (0.04 per 100,000) and African (0.05 per 100,000) regions had the lowest densities. Among countries with training programs, LICs had the poorest availability of subspecialty training and resources such as cadaver laboratories and conference stipends for trainees. Training program accreditation processes were more common in HICs (81.8%) than in low- and middle-income countries (LMICs; 69.2%) with training programs. CONCLUSIONS The authors estimate that there are at least 1261 neurosurgery training programs with 10,546 total trainees worldwide. The density of neurosurgery trainees was disproportionately higher in HICs than LMICs, and the WHO European and Americas regions had the highest trainee densities. The trainee workforce in LICs had the poorest access to subspecialty training and advanced resources.
Gupta, Saksham (56527518600); Gal, Zsombor T. (58669291100); Athni, Tejas S. (57216940413); Calderon, Chrystal (57211851707); Callison, William É. (57188956572); Dada, Olaoluwa E. (57224450781); Lie, Winston (58146576400); Qian, Carolyn (59219162800); Reddy, Ramya (58408225800); Rolle, Myron (57193228668); Baticulon, Ronnie E. (57200079877); Chaurasia, Bipin (57215382617); Dos Santos Rubio, Ellianne J. (35740257700); Esquenazi, Yoshua (22937705000); Golby, Alexandra J. (6602812106); Pirzad, Ahmad F. (57462420900); Park, Kee B. (56680381700); Cheserem, Jebet B. (37058491500); El Ouahabi, Abdesaamad (59219328800); Khan, Tariq (57210311526); Kolias, Angelos (26649956100); Demetriades, Andreas K. (7004877691); Rasulic, Lukas (6507823267); Foroglou, Nicolas (6506201305); Garozzo, Debora (7003555780); Gonzalez-Lopez, Pablo (26324872400); Ivanov, Marcel (7201381973); Lafuente, Jesus (7007026743); Marchesini, Nicoló (57198446954); Olldashi, Fatos (36176244700); Paterno, Vincenzo (11340119300); Petr, Ondra (55657383700); Rotim, Kresimir (6601932997); Rzaev, Jamil (59219328900); Timothy, Jake (56354241100); Tisell, Magnus (6602336224); Visocchi, Massimiliano (7004580824); Esene, Ignatius (56017649400); Qureshi, Mubashir M. (59219244600)
Mapping the global neurosurgery workforce. Part 2: Trainee density
2024
10.3171/2023.9.JNS231616
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85198598024&doi=10.3171%2f2023.9.JNS231616&partnerID=40&md5=f876983d524cec71e3ae23e4044d3b64
Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States; Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Department of Neurosurgery, University of the West Indies, St. Augustine, Trinidad and Tobago; College of Medicine, University of Ibadan, Oyo State, Nigeria; University of Florida College of Medicine, Gainesville, FL, United States; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Department of Neurosciences, Division of Neurosurgery, Philippine General Hospital, University of the Philippines, National Capital Region, Manila, Philippines; Department of Neurosurgery, Neurosurgery Clinic, Madesh Province, Birgunj, Nepal; Department of Neurosurgery, Curaçao Medical Center, Willemstad, Curaçao; Department of Neurosurgery, The University of Texas Health Science Center, Houston, TX, United States; Department of Neurosurgery, Kabul University of Medical Sciences, Kabul, Afghanistan; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya; Department of Neurosurgery, Mohammed Vth University, School of Medicine, Hôpital des Spécialités ONO, Rabat, Morocco; Department of Neurosurgery, Northwest School of Medicine, Khyber Pakhtunkhwa, Peshawar, Pakistan; Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridgeshire, United Kingdom; Department of Neurosurgery, Royal Infirmary, Lothian, Edinburgh, United Kingdom; Department of Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia; Department of Neurosurgery, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece; Department of Neurosurgery, Mediclinic Parkview Hospital, Dubai, United Arab Emirates; Department of Neurosurgery, General University Hospital Alicante, Spain; Department of Neurosurgery, Sheffield Teaching Hospital, NHS Foundation Trust, South Yorkshire, Sheffield, United Kingdom; Spine Center, Hospital Del Mar, Catalonia, Barcelona, Spain; Department of Neurosurgery, University Hospital Borgo Trento, Veneto, Verona, Italy; Department of Neurosurgery, University Hospital of Trauma, Tirana, Albania; Department of Neurosurgery, International Neuroscience Institute, Lower Saxony, Hannover, Germany; Department of Neurosurgery, Medical University Innsbruck, Tyrol, Austria; Department of Neurosurgery, University Hospital Sisters of Mercy, Zagreb, Croatia; Federal Neurosurgical Center, Novosibirsk Oblast, Novosibirsk, Russian Federation; Department of Neurosurgery, Leeds General Infirmary, West Yorkshire, Leeds, United Kingdom; Department of Neurosurgery, Sahlgrenska University Hospital, Västra Götaland, Göteborg, Sweden; Institute of Neurosurgery, Catholic University of Rome, Roma Provincia, Italy; Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
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