The Challenges in Neurosurgery Training in a Third World Country

Neurosurgery in Pakistan is an advanced field with significant challenges. The training program tests one’s endurance, knowledge, empathy, and dedication. The training structure in Pakistan consists of 5 years, of which 2 years are spent in general surgery followed by 3 years of dedicated neurosurgery. This study aimed to conduct a survey to address the quality of neurosurgery training in Pakistan so that its strengths and deficiencies could be identified, recommendations could be made, and actions could be taken toward improvement. A nationwide survey was conducted of neurosurgery residents from all over Pakistan. An e-mail invitation was sent to 177 neurosurgery residents certified by the College of Physicians and Surgeons Pakistan from 22 institutes in all provinces of Pakistan. The questionnaire was divided into the following sections: sociodemographics of participants, infrastructure of training site, clinical skills training and exposure, and knowledge-based education. Data were collected through Google Forms and analyzed using statistical software. A total of 151 residents responded to the survey. More than half of the institutes had >10 neurosurgery residents in their department (59.6%). More than half of the residents did not attend any international conference during their residency (51%). More than one fourth of the residents did not participate in any hands-on workshop during their residency tenure. The neurosurgical training program in Pakistan requires updating of the curriculum with better implementation. These data will help the College of Physicians and Surgeons Pakistan in standardizing neurosurgical training across Pakistan to improve competence among trainees.