Comparing Factors Influencing the Decision to Pursue a Neurosurgical Career Between Neurosurgery Attendings and Residents

Introduction: Neurosurgery is a highly esteemed surgical specialty that plays an invaluable role in medicine. The reasons why one might choose to pursue a neurosurgical career are often debated due to the specialty’s complexity. There have been some surveys performed gauging medical student and resident perceptions of Neurosurgery. However, there have not been any surveys comparing Neurosurgery attendings and residents regarding factors that influenced their decision to pursue a neurosurgical career.

Methods: Two versions of a survey were sent to Neurosurgery attendings and residents from all 115 neurosurgery residency programs via emails collected from the AANS Residency Program Directory and individual institutional website directories. The survey asked participants to rate the importance of 45 factors on a Likert Scale in their decision to pursue a neurosurgical career with 1= Not Important ranging up to 5 = Extremely Important. Statistical analysis was performed using Mann Whitney U tests.

Results: Complete responses from 145 Neurosurgery attendings and 58 residents were analyzed. Residents and attendings had similar mean ratings in the following categories: Surgical Practice, Patient Care/Clinical Outcomes, Education/Mentorship, Personal/Family Considerations. Similar factors include career satisfaction (4.60 vs 4.46, p=0.268), income (2.97 vs 2.79, p=0.464), length of training (2.26 vs 1.99, p=0.088), ability to have a family (2.88 vs 2.80, p=0.709), precision of operations (4.57 vs 4.32, p=0.053), and long-term relationships with patients (3.57 vs 3.33, p=0.340). Residents and attendings had significantly different (p < 0.005) mean ratings in categories of Administrative/Logistics, and Financial/Time Considerations. Some differing factors include frequency of on-call coverage (2.67 vs 2.12), dealing with patient mortality (3.55 vs 2.87), amount of trauma (3.43 vs 2.55), work-hour flexibility (2.31 vs 1.99), and being geographically close to family (2.64 vs 1.93).

Conclusion : Neurosurgery residents and attendings have similar views on aspects of clinical practice but tend to differ on ancillary factors as it pertains to their career.