Introduction: Recruiting the brightest students is an important goal of all neurosurgery residency programs. How factors influence medical students’ decision to pursue neurosurgery is understudied.
Methods: A survey was distributed to all US medical schools with AANS chapters. Students were asked to rate the strength of a factor’s influence towards (positive) or away (negative) from their interest in neurosurgery using a Likert scale in 6 domains (Personal, Exposure/Mentorship, Research/Innovation, Residency Training, Financial Burden, and Practice). Data analysis was performed using Python and Excel. Principal component analysis was conducted to create weighted evaluations in each factor. After stratifying by participants’ gender, race/ethnicity, and geographic region, p-values were calculated using two-tailed T-tests and multivariate analysis.
Results: We received 314 responses. 149 Male (47%), 161 Female (52%), and 4 other/unknown (1%). 27% identified as URiM. Responses analyzed per ERAS region included West (Mountain, Pacific, West North Central, West South Central; 16%) and East (East North Central, South North Central, Middle Atlantic, South Atlantic, New England; 84%). Attributes in the Personal, Mentorship, and Practice domains decreased female participants' desire to pursue neurosurgery, while those factors had positive effects for male students’ interest in neurosurgery. Within these categories, the greatest determining factors included the number of on-call hours as an attending, representation in the field and stigma surrounding the field, perceived fit into the culture, and length and stress of residency respectively. There were also significant differences by URiM status in Practice and by region in Exposure/Mentorship and Training (p < 0.05).
Conclusion : Our findings indicate that gender disparities, URiM status, and region in neurosurgery are critical diversifying factors and are strongly associated with distinct experiences and perceptions regarding practice, personal factors, exposure/mentorship, and training factors. Our findings underline the vector for targeted efforts within the most meaningful domains to diversify neurosurgical programs.
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