Lubelski Daniel, Xiao Roy, Mukherjee Debraj, Ashley William W, Witham Timothy, Brem Henry, Huang Judy, Wolfe Stacey Quintero
1Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland.
2Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
J Neurosurg. 2019 Aug 9;133(3):848-854. doi: 10.3171/2019.5.JNS1987. Print 2020 Sep 1.
Neurosurgery seeks to attract the best and brightest medical students; however, there is often a lack of early exposure to the field, among other possible barriers. The authors sought to identify successful practices that can be implemented to improve medical student recruitment to neurosurgery.
United States neurosurgery residency program directors were surveyed to determine the number of medical student rotators and medical students matching into a neurosurgery residency from their programs between 2010 and 2016. Program directors were asked about the ways their respective institutions integrated medical students into departmental clinical and research activities.
Complete responses were received from 30/110 institutions. Fifty-two percent of the institutions had neurosurgery didactic lectures for 1st- and 2nd-year medical students (MS1/2), and 87% had didactics for MS3/4. Seventy-seven percent of departments had a neurosurgery interest group, which was the most common method used to integrate medical students into the department. Other forms of outreach included formal mentorship programs (53%), lecture series (57%), and neurosurgery anatomy labs (40%). Seventy-three percent of programs provided research opportunities to medical students, and 57% indicated that the schools had a formal research requirement. On average, 3 medical students did a rotation in each neurosurgery department and 1 matched into neurosurgery each year. However, there was substantial variability among programs. Over the 2010-2016 period, the responding institutions matched as many as 4% of the graduating class into neurosurgery per year, whereas others matched 0%-1%. Departments that matched a greater (≥ 1% per year) number of medical students into neurosurgery were significantly more likely to have a neurosurgery interest group and formal research requirements. A greater percentage of high-matching programs had neurosurgery mentorship programs, lecture series, and cadaver training opportunities compared to the other institutions.
In recent decades, the number of applicants to neurosurgery has decreased. A major deterrent may be the delayed exposure of medical students to neurosurgery. Institutions with early preclinical exposure, active neurosurgery interest groups, research opportunities, and strong mentorship recruit and match more students into neurosurgery. Implementing such initiatives on a national level may increase the number of highly qualified medical students pursuing neurosurgery.
神经外科致力于吸引最优秀、最聪明的医学生；然而，除了其他可能的障碍外，医学生对该领域的早期接触往往不足。作者试图确定可以实施的成功做法，以改善神经外科医学生的招募情况。
对美国神经外科住院医师培训项目主任进行调查，以确定2010年至2016年间其项目中轮转的医学生数量以及匹配到神经外科住院医师培训项目的医学生数量。项目主任被问及各自机构将医学生纳入科室临床和研究活动的方式。
110所机构中有30所给出了完整回复。52%的机构为大一和大二医学生（MS1/2）开设了神经外科理论讲座，87%的机构为MS3/4开设了理论讲座。77%的科室设有神经外科兴趣小组，这是将医学生纳入科室最常用的方法。其他形式的推广活动包括正式的导师计划（53%）、系列讲座（57%）和神经外科解剖实验室（40%）。73%的项目为医学生提供研究机会，57%表示学校有正式的研究要求。平均而言，每个神经外科科室每年有3名医学生轮转，每年有1名医学生匹配到神经外科。然而，各项目之间存在很大差异。在2010 - 2016年期间，回复的机构每年将多达4%的毕业班学生匹配到神经外科，而其他机构的匹配率为0% - 1%。每年将更多（≥1%）医学生匹配到神经外科的科室更有可能设有神经外科兴趣小组和正式的研究要求。与其他机构相比，高匹配率项目中有更高比例设有神经外科导师计划、系列讲座和尸体培训机会。
近几十年来，申请神经外科的人数有所减少。一个主要的阻碍可能是医学生对神经外科的接触延迟。早期临床前接触、活跃的神经外科兴趣小组、研究机会和强大的导师指导的机构能招募并使更多学生匹配到神经外科。在全国范围内实施这些举措可能会增加追求神经外科的高素质医学生数量。
