Shakir Muhammad, Altaf Ahmed, Irshad Hammad Atif, Khan Muhammad Ali Akbar, Enam Syed Ather
Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Medical Student, Medical College, Aga Khan University, Karachi, Pakistan.
Asian J Neurosurg. 2024 May 10;19(2):160-167. doi: 10.1055/s-0043-1778086. eCollection 2024 Jun.
Pakistan has a significant proportion of medical graduates who intend to leave the country for better opportunities abroad, leading to a brain drain. However, the push and pull factors within neurosurgery remain unexplored, emphasizing the need for evaluation to enact policy changes. We conducted a nationwide survey across 22 College of Physicians and Surgeons of Pakistan accredited neurosurgery training centers in all provinces of Pakistan. SPSS version 26 and STATA 15 were used for data analysis. We collected responses from 120 neurosurgery trainees across Pakistan. Trainees were categorized into two groups: those intending to leave (64%) and those intending to stay (36%) in Pakistan. A significant association was observed between the availability of fellowship training in the residents' hospital and the decision to leave or remain in Pakistan ( = 0.034). About 67.5% of our respondents did not have any publication, and among the intention to leave group, a greater percentage had academic involvement, when compared with the stay group. A significant association ( = 0.012) was also observed between the decision to leave or remain in Pakistan and the number of publications in nonindexed journals. There remains a need for improvement in the standard of training provided by neurosurgery programs across the country. Our study found that disparities in research and academic exposure, as well as the lack of fellowship opportunities, may serve as stimuli for residents to leave Pakistan.
巴基斯坦有相当一部分医学毕业生打算前往国外寻求更好的机会，导致人才外流。然而，神经外科领域的推拉因素仍未得到探索，这凸显了进行评估以制定政策变革的必要性。我们在巴基斯坦所有省份的22个巴基斯坦医师和外科医生学院认可的神经外科培训中心进行了一项全国性调查。使用SPSS 26版和STATA 15进行数据分析。我们收集了巴基斯坦120名神经外科实习生的反馈。实习生被分为两组：打算离开巴基斯坦的（64%）和打算留在巴基斯坦的（36%）。住院医师所在医院是否提供专科培训与离开或留在巴基斯坦的决定之间存在显著关联（P = 0.034）。约67.5%的受访者没有任何出版物，与留任组相比，打算离开的组中学术参与度更高的比例更大。在离开或留在巴基斯坦的决定与非索引期刊上的出版物数量之间也观察到显著关联（P = 0.012）。全国神经外科项目提供的培训标准仍有改进的必要。我们的研究发现，研究和学术接触方面的差异以及缺乏专科培训机会可能促使住院医师离开巴基斯坦。
