Choice of Neurosurgical Subspecialty Among Trainees in Underserved Communities: Influences on Neurosurgical Trainees' Career Decisions in Andean Latin America.

BACKGROUND AND

OBJECTIVES

To investigate the factors that influence subspecialty preferences among neurosurgery trainees in the Andean Community of Latin America and to assess how educational interventions affect subspecialty choices.

METHODS

A total of 132 neurosurgery residents and young practicing neurosurgeons participated in the study. Participants completed surveys before and after educational interventions that included hands-on training, lectures, and online resources. Basic demographic data were collected through an electronic survey, which also included questions regarding participants' desired future subspecialty, including cerebrovascular and skull base (CV/SB) surgery, spine surgery, trauma, pediatric surgery, pain surgery, or neuro-oncology and preferred location of practice, including capital city, urban area, or rural area. Changes in subspecialty preferences and desired locations of practice before and after the intervention were analyzed statistically to assess the correlation between educational interventions and career aspirations.

RESULTS

Before the intervention, 91.0% of participants (120 of 132) expressed interest in cranial subspecialties (CV/SB surgery and neuro-oncology), primarily CV/SB surgery. After the intervention, there was a significant shift in subspecialty interest, with 67% expressing a preference for CV/SB surgery (P < .01, 95% CI: 9.2%-32.8%). Notably, hands-on training was the only intervention that significantly altered participants' subspecialty preferences (r = -0.52; P < .01, 95% CI: -0.63 to -0.38). In addition, 69% preferred practicing in capital cities, with a strong correlation between practice location and subspecialty desire (r = 0.49; P < .01, 95% CI: 0.35-0.61).

CONCLUSION

This study highlights the importance of targeted educational interventions in shaping neurosurgery trainees' subspecialty preferences in the Andean Community. There is a clear inclination toward cranial subspecialties after the educational interventions, particularly CV/SB surgery. Understanding these dynamics is crucial for addressing the lack of neurosurgeons in Latin America and for optimizing resource allocation for residency programs.