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Omer M, Machetanz K, Lawson McLean AC, Ahmed M, Fadlalla M, Farzullayev J, Maurer S, Alhamdan AA, Nguyen TL, Beck J, Posti JP. Challenges and aspirations of neurosurgery residents in Germany: Insights from a questionnaire-based survey. Clin Neurol Neurosurg 2024; 245:108477. [PMID: 39098248 DOI: 10.1016/j.clineuro.2024.108477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE Neurosurgery residents in Germany face numerous challenges including receiving comprehensive surgical training with adequate learning opportunities, achieving balanced work life equilibrium, maintaining a positive work environment and navigating career prospects. The objectives of this study are to assess overall satisfaction with the training program, identify factors contributing to dissatisfaction, explore various dimensions of the training program, evaluate the psychological well-being of residents, and ascertain their preferences for future subspecialties. METHODS A questionnaire-based survey was conducted anonymously among neurosurgery residents from various training hospitals, nationwide. The survey utilized a quantitative questionnaire as data collection tool. The data collection took place from June 2021 to January 2023. RESULTS The survey encompassed 120 neurosurgery residents, with a gender distribution of 55 % male and 45 % female. The respondents were primarily from university hospitals (53 %), followed by community hospitals (38 %) and private hospitals (9 %). In terms of training program satisfaction, 37 % reported moderate satisfaction, 39 % indicated below-moderate satisfaction, and 28 % experienced above-moderate satisfaction. The predominant causes of dissatisfaction identified were insufficient surgical exposure (reported by 39 % of respondents), suboptimal educational content (38 %), and inadequate research opportunities (32 %). Additionally, 24 % of respondents highlighted psychological stress, and 36 % reported frequent experiences of burnout. A majority (63 %) indicated a workload of 60-80 h weekly. About half of the residents indicated a future specialization interest in neurosurgical oncology. CONCLUSION The results of the survey findings provide valuable insights into the challenges and aspirations of neurosurgery trainees in Germany. These results serve as a basis for improving the training system, enhancing the working environment, and guiding future planning in this field. To optimize the training of residents, it is important to address issues such as limited surgical and research opportunities and psychological well-being. The expressed interest in subspecializing offers guidance for shaping the training program's future direction.
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Affiliation(s)
- Mazin Omer
- Department of Neurosurgery, University of Freiburg, Freiburg, Germany.
| | - Kathrin Machetanz
- Department of Neurosurgery, Tubingen University Hospital, Tubingen, Germany
| | | | - Mamoun Ahmed
- Department of Neurosurgery, Sana Kliniken Duisburg, Duisburg, Germany
| | - Mohamed Fadlalla
- Department of Neurosurgery, Sanderbuch Hospital, Sanderbuch, Germany
| | - Jeyhun Farzullayev
- Department of Neurosurgery, Gottingen University Hospital, Gottingen, Germany
| | - Stefanie Maurer
- Department of Neurosurgery, St Barbara Klinik, Hamm, Germany
| | - Akram A Alhamdan
- Department of Neurosurgery, Helios-klinik Wiesbaden, Wiesbaden, Germany
| | - Thuy Linh Nguyen
- Department of Neurosurgery, Nordstadt-Hospital Hannover, Hannover, Germany
| | - Jürgen Beck
- Department of Neurosurgery, University of Freiburg, Freiburg, Germany
| | - Jussi P Posti
- Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
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Smith MJ, Yuen HK, Davenport-Landry L, O'Donnell J, Abdi I, Josephat F, Gao J. Attitudes toward research and scholarly activities among medical laboratory science professionals in the United States. Lab Med 2024; 55:405-412. [PMID: 38431783 DOI: 10.1093/labmed/lmad120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Medical laboratory science (MLS) professionals play a crucial role in health care teams. However, research culture in the profession has not been well developed or studied. It is necessary to characterize attitudes toward research and scholarly activities among MLS professionals and identify ways to promote research in the profession. METHODS A cross-sectional survey was administered through American Society for Clinical Laboratory Science channels. Survey responses were summarized using descriptive statistics, and linear regression models were constructed to identify characteristics that predicted 2 research attitudes: "valuing the role of research" and "perceived research environment" in the profession. RESULTS Of the 116 MLS professionals in this study, 53% reported currently participating in research activities. Opinions toward research were generally positive, although many respondents were not currently conducting research. Individuals with education and research practice focuses tended to place greater value on research, and education level was a significant predictor of perceived research environment. Dedicated research time and mentorship were cited as effective ways for employers to promote research in MLS. CONCLUSION Overall, respondents had favorable attitudes toward research in MLS, but approximately half of participants noted a lack of incentives to conduct research. This study highlights several initiatives that may be effective for promoting increased research activity among MLS professionals.
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Affiliation(s)
- Melissa J Smith
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, US
| | - Hon K Yuen
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, US
| | | | - Julia O'Donnell
- American Society for Clinical Laboratory Science, Reston, VA, US
| | - Ibsa Abdi
- Emory University Hospital, Atlanta, GA, US
| | - Floyd Josephat
- Clinical and Diagnostic Science, University of Alabama at Birmingham, Birmingham, AL, US
| | - Jie Gao
- Clinical and Diagnostic Science, University of Alabama at Birmingham, Birmingham, AL, US
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Mangham W, Parikh KA, Motiwala M, Gienapp AJ, Roach J, Barats M, Lillard J, Khan N, Arthur A, Michael LM. A Scoping Review of Professionalism in Neurosurgery. Neurosurgery 2024; 94:435-443. [PMID: 37819083 DOI: 10.1227/neu.0000000000002711] [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: 04/17/2023] [Accepted: 08/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education's Milestones provides a foundation for professionalism in residency training. Specific professionalism concepts from neurosurgery could augment and expand milestones for the specialty. We reviewed the current literature and identified professionalism concepts within the context of neurosurgical practice and training. METHODS We used a scoping review methodology to search PubMed/MEDLINE and Scopus and identify English-language articles with the search terms "professionalism" and "neurosurgery." We excluded articles that were not in English, not relevant to professionalism within neurosurgery, or could not be accessed. Non-peer-reviewed and qualitative publications, such as commentaries, were included in the review. RESULTS A total of 193 articles were included in the review. We identified 6 professionalism themes among these results: professional identity (n = 53), burnout and wellness (n = 51), professional development (n = 34), ethics and conflicts of interest (n = 27), diversity and gender (n = 19), and misconduct (n = 9). CONCLUSION These 6 concepts illustrate concerns that neurosurgeons have concerning professionalism. Diversity and gender, professional identity, and misconduct are not specifically addressed in the Accreditation Council for Graduate Medical Education's Milestones. This review could be used to aid the development of organizational policy statements on professionalism.
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Affiliation(s)
- William Mangham
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Kara A Parikh
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Mustafa Motiwala
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Andrew J Gienapp
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis , Tennessee , USA
| | - Jordan Roach
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Michael Barats
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Jock Lillard
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Nickalus Khan
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - Adam Arthur
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - L Madison Michael
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
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Hulou MM, Samaan CA, McLouth CJ, Madriñán-Navia HJ, Benner D, Park MT, Essibayi MA, Howshar JT, Dornbos D, Graffeo CS, Lawton MT. Competitive neurosurgery residency programs: Predictors of matching outcome and research productivity. Clin Neurol Neurosurg 2023; 232:107884. [PMID: 37467577 DOI: 10.1016/j.clineuro.2023.107884] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE The aim of this study was to provide a comprehensive assessment of preresidency research and school as predictors of competitive neurosurgery matching and to assess for any correlations between preresidency and intraresidency research productivity. METHODS Individuals who graduated from US neurosurgery programs from 2018 through 2020 were assessed for medical school, degree (MD, DO, or PhD), preresidency versus intraresidency publications, author order, article type, and neurosurgery matching outcomes. RESULTS Medical school ranking (top 50) and the number of published papers (≥3) before intern year were predictors for matching to a top-25 residency program after adjusting for other covariates (p < 0.001, p = 0.002, respectively). On average, individuals who published more papers before residency published more papers during residency. For the comprehensive clinical papers category, there was a significant difference between individuals from the top 25 residency programs and others, with a stronger correlation between the number of preresidency publications and intraresidency publications for neurosurgeons who attended a top-25 residency program (r = 0.378 and r = 0.179, respectively; p = 0.02). CONCLUSION Medical school ranking and research productivity as measured by the number of published papers were independently associated with matching to the top 25 residency programs. In addition, high research productivity in the preresidency years was associated with continued productivity during residency, especially in the category of comprehensive clinical papers.
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Affiliation(s)
- M Maher Hulou
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | | | | | - Humberto José Madriñán-Navia
- Center for Research and Training in Neurosurgery, Department of Neurosurgery, Hospital Universitario de la Samaritana, Bogota, Colombia
| | - Dimitri Benner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Marian T Park
- Creighton University School of Medicine, Phoenix, AZ, USA
| | - Muhammed Amir Essibayi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Jacob T Howshar
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - David Dornbos
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | - Christopher S Graffeo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 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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Selden NR, Barbaro NM, Barrow DL, Batjer HH, Branch CL, Burchiel KJ, Byrne RW, Dacey RG, Day AL, Dempsey RJ, Derstine P, Friedman AH, Giannotta SL, Grady MS, Harsh GR, Harbaugh RE, Mapstone TB, Muraszko KM, Origitano TC, Orrico KO, Popp AJ, Sagher O, Selman WR, Zipfel GJ. Neurosurgery residency and fellowship education in the United States: 2 decades of system development by the One Neurosurgery Summit organizations. J Neurosurg 2021; 136:565-574. [PMID: 34359022 DOI: 10.3171/2020.10.jns203125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/05/2020] [Indexed: 11/06/2022]
Abstract
The purpose of this report is to chronicle a 2-decade period of educational innovation and improvement, as well as governance reform, across the specialty of neurological surgery. Neurological surgery educational and professional governance systems have evolved substantially over the past 2 decades with the goal of improving training outcomes, patient safety, and the quality of US neurosurgical care. Innovations during this period have included the following: creating a consensus national curriculum; standardizing the length and structure of neurosurgical training; introducing educational outcomes milestones and required case minimums; establishing national skills, safety, and professionalism courses; systematically accrediting subspecialty fellowships; expanding professional development for educators; promoting training in research; and coordinating policy and strategy through the cooperation of national stakeholder organizations. A series of education summits held between 2007 and 2009 restructured some aspects of neurosurgical residency training. Since 2010, ongoing meetings of the One Neurosurgery Summit have provided strategic coordination for specialty definition, neurosurgical education, public policy, and governance. The Summit now includes leadership representatives from the Society of Neurological Surgeons, the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, the American Board of Neurological Surgery, the Review Committee for Neurological Surgery of the Accreditation Council for Graduate Medical Education, the American Academy of Neurological Surgery, and the AANS/CNS Joint Washington Committee. Together, these organizations have increased the effectiveness and efficiency of the specialty of neurosurgery in advancing educational best practices, aligning policymaking, and coordinating strategic planning in order to meet the highest standards of professionalism and promote public health.
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Affiliation(s)
- Nathan R Selden
- 1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
| | - Nicholas M Barbaro
- 2Department of Neurosurgery, University of Texas, Dell Medical School, Austin, Texas
| | - Daniel L Barrow
- 3Department of Neurosurgery, Emory University, Atlanta, Georgia
| | - H Hunt Batjer
- 4Department of Neurological Surgery, UT Southwestern Medical Center, Dallas, Texas
| | - Charles L Branch
- 5Department of Neurosurgery, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Kim J Burchiel
- 1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
| | - Richard W Byrne
- 6Department of Neurosurgery, Rush University, Chicago, Illinois
| | - Ralph G Dacey
- 7Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | - Arthur L Day
- 8Department of Neurosurgery, University of Texas Houston Health Science Center, Houston, Texas
| | - Robert J Dempsey
- 9Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin
| | - Pamela Derstine
- 10Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Allan H Friedman
- 11Department of Neurosurgery, Duke University Health System, Durham, North Carolina
| | - Steven L Giannotta
- 12Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - M Sean Grady
- 13Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Griffith R Harsh
- 14Department of Neurological Surgery, University of California Davis, Sacramento, California
| | - Robert E Harbaugh
- 15Department of Neurosurgery, Pennsylvania State University, Hershey, Pennsylvania
| | - Timothy B Mapstone
- 16Department of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Karin M Muraszko
- 17Department of Neurological Surgery, University of Michigan, Ann Arbor, Michigan
| | - Thomas C Origitano
- 18Neuroscience and Spine Institute, Kalispell Regional Healthcare, Kalispell, Montana
| | | | - A John Popp
- 20Department of Neurosurgery, Albany Medical College and Albany Medical Center Hospital, Albany, New York; and
| | - Oren Sagher
- 17Department of Neurological Surgery, University of Michigan, Ann Arbor, Michigan
| | - Warren R Selman
- 21Department of Neurosurgery, University Hospitals Cleveland and Case Western Reserve University, Cleveland, Ohio
| | - Gregg J Zipfel
- 7Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
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Khalafallah AM, Jimenez AE, Shlobin NA, Larkin CJ, Mukherjee D, Zygourakis CC, Lo SF, Sciubba DM, Bydon A, Witham TF, Dahdaleh NS, Theodore N. Predictors of an academic career among fellowship-trained spinal neurosurgeons. J Neurosurg Spine 2021; 35:251-258. [PMID: 34116505 DOI: 10.3171/2020.12.spine201771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/03/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although fellowship training is becoming increasingly common in neurosurgery, it is unclear which factors predict an academic career trajectory among spinal neurosurgeons. In this study, the authors sought to identify predictors associated with academic career placement among fellowship-trained neurological spinal surgeons. METHODS Demographic data and bibliometric information on neurosurgeons who completed a residency program accredited by the Accreditation Council for Graduate Medical Education between 1983 and 2019 were gathered, and those who completed a spine fellowship were identified. Employment was denoted as academic if the hospital where a neurosurgeon worked was affiliated with a neurosurgical residency program; all other positions were denoted as nonacademic. A logistic regression model was used for multivariate statistical analysis. RESULTS A total of 376 fellowship-trained spinal neurosurgeons were identified, of whom 140 (37.2%) held academic positions. The top 5 programs that graduated the most fellows in the cohort were Cleveland Clinic, The Johns Hopkins Hospital, University of Miami, Barrow Neurological Institute, and Northwestern University. On multivariate analysis, increased protected research time during residency (OR 1.03, p = 0.044), a higher h-index during residency (OR 1.12, p < 0.001), completing more than one clinical fellowship (OR 2.16, p = 0.024), and attending any of the top 5 programs that graduated the most fellows (OR 2.01, p = 0.0069) were independently associated with an academic career trajectory. CONCLUSIONS Increased protected research time during residency, a higher h-index during residency, completing more than one clinical fellowship, and attending one of the 5 programs graduating the most fellowship-trained neurosurgical spinal surgeons independently predicted an academic career. These results may be useful in identifying and advising trainees interested in academic spine neurosurgery.
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Affiliation(s)
- Adham M Khalafallah
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Adrian E Jimenez
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nathan A Shlobin
- 2Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
| | - Collin J Larkin
- 2Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
| | - Debraj Mukherjee
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Sheng-Fu Lo
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel M Sciubba
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ali Bydon
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Timothy F Witham
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nader S Dahdaleh
- 2Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
| | - Nicholas Theodore
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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ReFaey K, Freeman WD, Tripathi S, Guerrero-Cazares H, Eatz TA, Meschia JF, Carter RE, Petrucelli L, Meyer FB, Quinones-Hinojosa A. NIH funding trends for neurosurgeon-scientists from 1993-2017: Biomedical workforce implications for neurooncology. J Neurooncol 2021; 154:51-62. [PMID: 34232472 PMCID: PMC8684039 DOI: 10.1007/s11060-021-03797-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/16/2021] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Neurosurgeons represent 0.5% of all physicians and currently face a high burden of disease. Physician-scientists are essential to advance the mission of National Academies of Science (NAS) and National Institutes of Health (NIH) through discovery and bench to bedside translation. We investigated trends in NIH neurosurgeon-scientist funding over time as an indicator of physician-scientist workforce training. METHODS We used NIH Research Portfolio Online Reporting Tools (RePORTER) to extract grants to neurosurgery departments and neurosurgeons from 1993 to 2017. Manual extraction of each individual grant awardee was conducted. RESULTS After adjusting for U.S. inflation (base year: 1993), NIH funding to neurosurgery departments increased yearly (P < 0.00001). However, neurosurgeon-scientists received significantly less NIH funding compared to scientists (including basic scientists and research only neurosurgeons) (P = 0.09). The ratio of neurosurgeon-scientists to scientists receiving grants was significantly reduced (P = 0.002). Interestingly, the percentage of oncology-related neurosurgery grants significantly increased throughout the study period (P = 0.002). The average number of grants per neurosurgeon-scientists showed an upward trend (P < 0.001); however, the average number of grants for early-career neurosurgeon-scientists, showed a significant downward trend (P = 0.05). CONCLUSION Over the past 23 years, despite the overall increasing trends in the number of NIH grants awarded to neurosurgery departments overall, the proportion of neurosurgeon-scientists that were awarded NIH grants compared to scientists demonstrates a declining trend. This observed shift is disproportionate in the number of NIH grants awarded to senior level compared to early-career neurosurgeon-scientists, with more funding allocated towards neurosurgical-oncology-related grants.
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Affiliation(s)
- Karim ReFaey
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
| | - William D Freeman
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.,Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Shashwat Tripathi
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.,Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Tiffany A Eatz
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - James F Meschia
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.,Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Rickey E Carter
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Alfredo Quinones-Hinojosa
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. .,Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA.
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Kanmounye US, Robertson FC, Thango NS, Doe AN, Bankole NDA, Ginette PA, Ondoma S, Balogun JA, Opoku I, Jokonya L, Mbaye T, Shabhay ZA, Ashour AM, Silva ACV, Cheserem B, Karekezi C, Hassani FD, Mentri N, Laeke T, Aklilu AT, Sanoussi S, Musara A, Ntalaja J, Ssenyonga P, Bakhti S, El Abbadi N, Mahmud MR, El-Ghandour NMF, Al-Habib A, Kolias AG, Servadei F, Fieggen G, Qureshi M, Esene I. Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study. Front Surg 2021; 8:647279. [PMID: 34124134 PMCID: PMC8193351 DOI: 10.3389/fsurg.2021.647279] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/22/2021] [Indexed: 01/30/2023] Open
Abstract
Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice. Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant. Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category. Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group.
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Affiliation(s)
- Ulrick S Kanmounye
- Research Department, Association of Future Africa Neurosurgeons, Yaoundé, Cameroon
| | - Faith C Robertson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
| | - Nqobile S Thango
- Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Alvin Nah Doe
- Neurosurgery Sub-Unit, Department of Surgery, John F. Kennedy Medical Center, Monrovia, Liberia
| | - Nourou Dine Adeniran Bankole
- Neurosurgery Department, Centre Hospitalier Universitaire Ibn Sina Rabat- Mohamed V University of Rabat, Rabat, Morocco
| | - Pape Aicha Ginette
- Division of Neurosurgery, Felix Houphouet Boigny University of Abidjan, Abidjan, Côte d'Ivoire
| | - Solomon Ondoma
- Mercy One Neurosurgery, Mercy One Hospital of North Iowa, Mason, IA, United States
| | - James A Balogun
- Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Isabella Opoku
- Department of Neurosurgery, China International Neuroscience Institute (China-INI), Beijing, China
| | - Luxwell Jokonya
- Division of Neurosurgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Thioub Mbaye
- Department of Neurosurgery, Centre Hospitalier Universitaire Fann, Dakar, Senegal
| | - Zarina A Shabhay
- Division of Neurosurgery, Department of Surgery, Muhimbili Orthopedic Institute, Dar es Salaam, Tanzania
| | - Ahmed M Ashour
- Department of Neurosurgery, Ain Shams University, Cairo, Egypt
| | | | - Beverly Cheserem
- Department of Neurosurgery, Aga Khan University Hospital, Nairobi, Kenya
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Fahd Derkaoui Hassani
- Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco
| | - Nesrine Mentri
- Department of Neurosurgery, Bejaia University Hospital, Béjaïa, Algeria
| | - Tsegazeab Laeke
- Neurosurgery Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abenezer Tirsit Aklilu
- Neurosurgery Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Samuila Sanoussi
- Department of Neurosurgery, Niamey National Hospital, Niamey, Niger
| | - Aaron Musara
- Division of Neurosurgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jeff Ntalaja
- Department of Neurosurgery, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Peter Ssenyonga
- Department of Neurosurgery, CURE Children's Hospital of Uganda, Mbale, Uganda
| | - Souad Bakhti
- Pediatric Neurosurgery Division, Department of Neurosurgery, Academic Hospital Mustapha Pacha, Algiers, Algeria
| | - Najia El Abbadi
- Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco
| | - Muhammad Raji Mahmud
- Neurosurgery Unit, Department of Surgery, Ahmadu Bello University, Zaria, Nigeria
| | | | - Amro Al-Habib
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Angelos G Kolias
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Franco Servadei
- Department of Neurosurgery, Humanitas University and Research Hospital, Milan, Italy
| | - Graham Fieggen
- Division of Neurosurgery, Neurosciences Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Mahmood Qureshi
- Department of Neurosurgery, Aga Khan University Hospital, Nairobi, Kenya
| | - Ignatius Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
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10
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Wang K, Bhandarkar AR, Bauman MMJ, Riviere-Cazaux C, Rotter J, Scheitler KM, Renfrow JJ, Clarke MJ. International trends in grant and fellowship funding awarded to women in neurosurgery. Neurosurg Focus 2021; 50:E5. [PMID: 33789231 DOI: 10.3171/2020.12.focus20846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/15/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Metric tracking of grant funding over time for academic neurosurgeons sorted by gender informs the current climate of career development internationally for women in neurosurgery. METHODS Multivariate linear trend analysis of grant funding awarded to neurosurgeons in the NIH and World Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) was performed. Traveling fellowships for international neurosurgery residents sponsored by the AANS and Congress of Neurological Surgeons (CNS) were also analyzed. RESULTS Within the US, funding awarded to female neurosurgeons has remained static from 2009 to 2019 after adjusting for inflation and overall trends in NIH funding (β = -$0.3 million per year, p = 0.16). Internationally, female neurosurgeons represented 21.7% (n = 5) of project leads for World RePORTER grants. Traveling fellowships are also an important building block for young international female neurosurgeons, of which 7.4% (n = 2) of AANS international traveling fellowships and 19.4% (n = 7) of AANS/CNS pediatrics international traveling fellowships are women. CONCLUSIONS Over the past decade, funding has increased in neurosurgery without a concordant increase in funding awarded to women. Recognition of this trend is essential to focus efforts on research and career development opportunities for women in neurosurgery. Worldwide, female neurosurgeons head one-fifth of the funded project leads and constitute a minority of international traveling fellowships awarded by organized neurosurgery.
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Affiliation(s)
- Kimberly Wang
- 1Mayo Clinic Department of Neurologic Surgery, and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Archis R Bhandarkar
- 1Mayo Clinic Department of Neurologic Surgery, and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Megan M J Bauman
- 1Mayo Clinic Department of Neurologic Surgery, and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Cecile Riviere-Cazaux
- 1Mayo Clinic Department of Neurologic Surgery, and.,2Mayo Clinic Alix School of Medicine, Rochester, Minnesota
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11
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Khalafallah AM, Jimenez AE, Caplan JM, McDougall CG, Huang J, Mukherjee D, Tamargo RJ. Predictors of an academic career among fellowship-trained open vascular and endovascular neurosurgeons. J Neurosurg 2021; 134:1173-1181. [PMID: 32302986 DOI: 10.3171/2020.2.jns2033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 02/11/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although previous studies have explored factors that predict an academic career among neurosurgery residents in general, such predictors have yet to be determined within specific neurosurgical subspecialties. The authors report on predictors they identified as correlating with academic placement among fellowship-trained vascular neurosurgeons. METHODS A database was created that included all physicians who graduated from ACGME (Accreditation Council for Graduate Medical Education)-accredited neurosurgery residency programs between 1960 and 2018 using publicly available online data. Neurosurgeons who completed either open vascular or endovascular fellowships were identified. Subsequent employment of vascular or endovascular neurosurgeons in academic centers was determined. A position was considered academic if the hospital of employment was affiliated with a neurosurgery residency program; all other positions were considered non-academic. Bivariate analyses were conducted using Fisher's exact test or the Mann-Whitney U-test, and multivariate analysis was performed using a logistic regression model. RESULTS A total of 83 open vascular neurosurgeons and 115 endovascular neurosurgeons were identified. In both cohorts, the majority of neurosurgeons were employed in academic positions after training. In bivariate analysis, only 2 factors were significantly associated with a career in academic neurosurgery for open vascular neurosurgeons: 1) an h-index of ≥ 2 during residency (OR 3.71, p = 0.016), and 2) attending a top 10 residency program based on U.S. News and World Report rankings (OR 4.35, p = 0.030). In bivariate analysis, among endovascular neurosurgeons, having an h-index of ≥ 2 during residency (OR 4.35, p = 0.0085) and attending a residency program affiliated with a top 10 U.S. News and World Report medical school (OR 2.97, p = 0.029) were significantly associated with an academic career. In multivariate analysis, for both open vascular and endovascular neurosurgeons, an h-index of ≥ 2 during residency was independently predictive of an academic career. Attending a residency program affiliated with a top 10 U.S. News and World Report medical school independently predicted an academic career among endovascular neurosurgeons only. CONCLUSIONS The authors report that an h-index of ≥ 2 during residency predicts pursuit of an academic career among vascular and endovascular neurosurgeons. Additionally, attendance of a residency program affiliated with a top research medical school independently predicts an academic career trajectory among endovascular neurosurgeons. This result may be useful to identify and mentor residents interested in academic vascular neurosurgery.
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12
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Academic productivity of neurosurgery residents in Europe. Acta Neurochir (Wien) 2020; 162:245-246. [PMID: 31863298 DOI: 10.1007/s00701-019-04181-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
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13
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Chai Y, Liu W, Wang C, Rao M, Zhang Y. Prognostic Role of Chicken Ovalbumin Upstream Promoter Transcription Factor II in Isocitrate Dehydrogenase-Mutant Glioma with 1p19q Co-Deletion. J Mol Neurosci 2019; 68:234-242. [PMID: 30929126 DOI: 10.1007/s12031-019-01281-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/18/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Chicken ovalbumin upstream promoter transcription factor II is known to play a crucial role in the tumor microenvironment. However, the role of NR2F2 in gliomas is unknown. METHODS The genomic and clinical data of 530 cases of lower grade gliomas (LGGs) patients and 167 cases of glioblastoma (GBM) patients in The Cancer Genome Atlas (TCGA) were extracted for analysis. R2 and UCSC Xena browser were used for Kaplan-Meier survival in the GSE16011 dataset and TCGA dataset, respectively. GraphPad Prism 7 was used to compare the differences in NR2F2 expression between various groups and subtypes. RESULTS LGG patients with low NR2F2 expression had a significantly favorable outcome compared with those with high NR2F2 expression (p < 0.05). By matching histological subtypes and gene expression profiles of LGG patients, grade II glioma group showed lowest levels of NR2F2 expression compared with grade III gliomas and GBM. Patients diagnosed with astrocytoma have highest expression of NR2F2 but lowest OS (p < 0.05). In LGGs, NR2F2 expression was significantly downregulated in patient group with IDH mutation and 1p19q co-deletion (p < 0.05). CONCLUSION Our study suggests that NR2F2 can be used as a prognostic marker in LGG patients with IDH mutation and 1p19 co-deletion.
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Affiliation(s)
- Yi Chai
- School of Clinical Medicine and Department of Neurosurgery, Yuquan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wei Liu
- School of Clinical Medicine and Department of Neurosurgery, Yuquan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Caixia Wang
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Minchao Rao
- Department of Oncology, Shangrao People Hospital, Shangrao, Jiangxi, China
| | - Yuqi Zhang
- School of Clinical Medicine and Department of Neurosurgery, Yuquan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China. .,Department of Neurosurgery, Yuquan Hospital, Tsinghua University, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100040, China.
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