Characterization of Geographic Distribution in the Academic Neurosurgery Spine Workforce from Residency to Faculty Position

Introduction: Neurosurgical spine surgeons comprise a large percentage of the spine surgery workforce. This study aims to study the geographic distribution of neurosurgical spine surgeons across the United States from residency to faculty position.

Methods: Demographic analysis was conducted in June 2024 to assess academic neurosurgery faculty at ACGME-accredited residency programs across the United States. Data were collected from publicly available national databases and departmental websites. Training data and current faculty position were collected and correlated to the seven American Medical Association (AMA) geographic regions. Descriptive analysis was performed with Chi-square test (p < 0.05).

Results: 423 academic spine neurosurgeons were identified from 111 programs.
Regarding geographic distribution of residency training, 86 surgeons (20%) trained in Region 7/northeast included, 86 (20%) in Region 6/mid-atlantic, 82 (19%) in Region 1/west , 49 (11%) in Region 2/southern, 44 (10%) in Region 5/great-lakes, 44 (10%) in Region 4/southeastern, and 32 (7.6%) in Region 3/midwestern. Regarding geographic distribution of current faculty, Region 7/northeast included 92 surgeons (22%), Region 1/west included 77 (18%), Region 6/mid-atlantic included 67 (16%), Region 4/southeastern included 56 (13%), Region 2/southern included 48 (11%), Region 5/great-lakes included 44 (10%), and Region 3/midwestern included 39 (9.2%). A statistically significant difference was found in geographic distributions of residency training versus current faculty position (p < 0.001). Practicing as faculty in the same geographic region as prior residency training was most common in Region 7/northeast (59%) and Region 1/west (52%) and was least common in Region 2/southern (35%) and Region 3/midwestern (34%).

Conclusion : Geographic regions in the United States experience various rates of trainee retention post-neurosurgical residency. Understanding these trends is critical for informing distribution of the neurosurgical spine workforce and regional access to spine care.