The WFNS Young Neurosurgeons Survey (Part II): Barriers to Professional Development and Service Delivery in Neurosurgery

WFNS Young Neurosurgeons Committee




Strengthening health systems requires attention to workforce, training needs, and barriers to service delivery. The World Federation of Neurosurgical Societies (WFNS) Young Neurosurgeons committee survey sought to identify challenges for residents, fellows, and consultants within 10 years of training.


An online survey was distributed to various neurosurgical societies, personal contacts, and social media platforms (April-November 2018). Responses were grouped by World Bank Income classification into High (HIC), Upper Middle (UMIC), Lower Middle (LMIC), and Low Income Countries (LIC). Descriptive statistical analysis was performed.


In total, 953 individuals completed the survey. For service delivery, the limited number of trained neurosurgeons was seen as a barrier for 12.5%, 29.8%, 69.2%, and 23.9% of respondents from HIC, UMIC, LMIC, and LIC, respectively (p<0.0001). The most reported personal challenge was the lack of opportunities for research (34.6%, HIC; 57.5%, UMIC; 61.6%, LMIC; and 61.5%, LIC; p=0.03). Other differences by income class included: limited access to advice from experienced/senior colleagues (p<0.001); neurosurgical journals (p<0.0001); and textbooks (p=0.02). Assessing how WFNS could best help young neurosurgeons, the most frequent requests (n=953; 1673 requests) were research (n=384), education (n=296), and subspecialty/fellowship training (n=232). Skills courses and access to cadaver dissection labs were also heavily requested.


Young neurosurgeons globally perceived that additional neurosurgeons are needed, especially in LICs and LMICs, and primarily requested additional resources for research and subspecialty training.