1Department of Neurosciences, Philippine General Hospital and Department of Anatomy, College of Medicine, University of the Philippines, Manila, Philippines.
2Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
J Neurosurg Pediatr. 2020 Oct 9;27(1):93-101. doi: 10.3171/2020.6.PEDS20399. Print 2021 Jan 1.
There are limited data on the pediatric neurosurgical workforce in Asia and Australasia. The training and clinical practice of pediatric neurosurgeons need to be characterized in order to identify gaps in knowledge and skills, thereby establishing a framework from which to elevate pediatric neurosurgical care in the region.
An online survey for pediatric neurosurgeons was created in REDCap (Research Electronic Database Capture), collecting demographic information and data on pediatric neurosurgical training and clinical practice. The link to answer the survey was sent to the mailing lists of the Asian Australasian Society for Pediatric Neurosurgery and the Japanese Society for Pediatric Neurosurgery, disseminated during the 2019 Asian Australasian Pediatric Neurosurgery Congress, and spread through social media. The survey was open to neurosurgeons who operated on patients ≤ 18 years old in Asian Australasian countries, whether or not they had completed fellowship training in pediatric neurosurgery. Descriptive statistics were computed and tabulated. Data were stratified and compared based on surgeon training and World Bank income group.
A total of 155 valid survey responses were analyzed, representing neurosurgeons from 21 countries. A total of 107 (69%) considered themselves pediatric neurosurgeons, of whom 66 (43%) had completed pediatric neurosurgery training. Neurosurgeons in East Asia commonly undergo a fellowship in their home countries, whereas the rest train mostly in North America, Europe, and Australia. A majority (89%) had operating privileges, and subspecialty pediatric training usually lasted from 6 months to 2 years. On average, trained pediatric neurosurgeons perform a higher number of pediatric neurosurgical operations per year compared with nonpediatric-trained respondents (131 ± 129 vs 56 ± 64 [mean ± SD], p = 0.0001). The mean number of total neurosurgical operations per year is similar for both groups (184 ± 129 vs 178 ± 142 [mean ± SD], p = 0.80). Respondents expressed the desire to train further in pediatric epilepsy, spasticity, vascular malformations, craniofacial disorders, and brain tumors.
Both pediatric and general neurosurgeons provide neurosurgical care to children in Asia and Australasia. There is a need to increase pediatric neurosurgery fellowship programs in the region. Skill sets and training needs in pediatric neurosurgery vary depending on the country's economic status and between pediatric-trained and nonpediatric-trained surgeons.
亚洲和澳大拉西亚地区儿科神经外科学领域的专业人员数量有限。为了确定知识和技能方面的差距，需要对儿科神经外科医生的培训和临床实践进行描述，从而为该地区提升儿科神经外科护理水平建立一个框架。
使用 REDCap（研究电子数据库捕获）创建了一份针对儿科神经外科医生的在线调查，收集人口统计学信息以及儿科神经外科培训和临床实践的数据。该调查链接被发送到亚洲-澳大拉西亚小儿神经外科学会和日本小儿神经外科学会的邮件列表中，在 2019 年亚洲-澳大拉西亚小儿神经外科学术会议期间进行了传播，并通过社交媒体进行了推广。该调查面向在亚洲-澳大拉西亚国家为≤18 岁患者进行手术的神经外科医生开放，无论他们是否完成了小儿神经外科的专业培训。对描述性统计数据进行了计算和制表。根据外科医生的培训和世界银行收入分组对数据进行分层和比较。
共分析了 155 份有效调查回复，代表了来自 21 个国家的神经外科医生。共有 107 名（69%）人认为自己是儿科神经外科医生，其中 66 名（43%）人完成了小儿神经外科培训。东亚的神经外科医生通常在本国完成专业培训，而其他地区的医生则主要在北美、欧洲和澳大利亚接受培训。大多数（89%）人拥有手术权限，小儿神经外科专科培训通常持续 6 个月至 2 年。接受过培训的儿科神经外科医生每年的儿科神经外科手术量平均高于未接受培训的受访者（131±129 比 56±64 [均值±标准差]，p=0.0001）。两组每年的总神经外科手术量相似（184±129 比 178±142 [均值±标准差]，p=0.80）。受访者表示希望进一步培训小儿癫痫、痉挛、血管畸形、颅面畸形和脑肿瘤方面的知识。
亚洲和澳大拉西亚地区的儿科和普通神经外科医生均为儿童提供神经外科护理。该地区需要增加儿科神经外科专业培训项目。儿科神经外科的技能和培训需求因国家的经济状况以及接受过儿科培训和未接受过儿科培训的外科医生的不同而有所不同。
