Global Neurosurgery Awareness and Perceptions of Collaborative Opportunities: A Multinational Study of Medical Students

Introduction: Global neurosurgery (GNS) is the clinical and public health practice that aims to address worldwide shortages in timely and affordable neurosurgical care. Despite increasing GNS educational and research efforts in the literature, awareness and exposure to this field among medical students outside the United States are not well understood.

Methods: We conducted a multinational survey study on GNS among medical students outside the United States between September and November 2024. Univariable and multivariable logistic regression analyses were conducted to assess associations between demographic, family, mentor, and academic factors and GNS awareness. We also analyzed perceived opportunities for international collaborations between high-income (HIC) and low- and middle-income country (LMIC) teams.

Results: Overall, 322 responses were obtained from international medical students representing 60 countries, including those in Africa (n=108, 33.5%), the Americas (n=70, 21.7%), Eastern Mediterranean (n=34, 10.6%), Europe (n=49, 15.2%), Southeast Asia (n=55, 17.1%), and the Western Pacific (n=15, 4.7%). Among them, 135 (41.9%) were aware of GNS, while 187 (58.1%) were not. Compared to unaware students, aware students had higher proportions of family history with neurosurgical conditions (36.2% vs 27.9%, p=0.019) and mentors in neurosurgery (20.0% vs 16.9%, p=0.049) and public health (56.2% vs 41.2%, p=0.009). On univariable analysis, students from LMIC settings (OR: 1.74, 95% CI: 1.11-2.73) had higher odds of GNS awareness. On multivariable analysis, membership in a neurosurgery student or professional organization (adjusted OR: 3.02, 95% CI: 1.67-5.45) and prior experience with neurosurgery policy or advocacy (aOR: 5.08, 95% CI: 1.74-14.87) were significantly associated with higher odds of GNS awareness. Overall, 63.7% believed institutions supported HIC-LMIC collaborations, with significantly higher agreement among LMIC students (71.5%) compared to HIC students (55.7%, p=0.006).

Conclusion : This multinational study identifies gaps in GNS awareness among medical students globally, with higher awareness among those with family, mentor, or organizational connections in neurosurgery. Increased GNS awareness among LMIC students and those involved in policy work highlights opportunities for targeted initiatives that increase engagement among international students in efforts to reduce disparities in neurosurgical care.