Recent trends in North American pediatric neurosurgical fellowship training

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The goal of this study was to evaluate trends in pediatric neurosurgical fellowship training in North America.


From a database maintained by the Accreditation Council for Pediatric Neurosurgery Fellowships (ACPNF), all graduates of ACPNF-accredited pediatric neurosurgery fellowships were identified, and an Internet search was conducted to determine sex, undergraduate and graduate degrees, location and dates of residency and fellowship training, current practice/employment environment, American Board of Neurological Surgery (ABNS) or Fellowship of the Royal College of Surgeons certification status, American Board of Pediatric Neurological Surgery (ABPNS) certification status, and extent of current pediatric-focused practice. The graduates were further studied to determine whether they had completed a neurosurgical residency at a program with an affiliated ACPNF-accredited pediatric neurosurgery fellowship program, and their residency training programs were further classified by whether the program was ranked in the top 50 by NIH funding awards. Each fellowship graduate’s current practice was also ranked in a similar fashion.


There were 391 graduates of ACPNF-accredited pediatric neurosurgery fellowship programs from 1993 to 2018. The number of graduates per year has grown steadily over time, as has the percentage of women, now over 40% compared to zero in the first 3 years of fellowship accreditation in the mid-1990s. Approximately 71% of graduating fellows have a pediatric-focused practice, but only 63% went on to attain ABPNS certification. Of all graduates practicing in the United States, 68% practice in academic settings. Ninety-five percent of graduating fellows who were ABNS board eligible were ABNS certified.


A study of the graduates of accredited pediatric neurosurgical fellowships from 1993 to 2018 has revealed a growth in the number of graduates from ACPNF-accredited fellowship programs over time. A substantial portion of graduates will practice at least some adult neurosurgery and not go on to obtain ABPNS board certification.

ABBREVIATIONS ABNS = American Board of Neurological Surgery; ABPNS = American Board of Pediatric Neurological Surgery; ACPNF = Accreditation Council for Pediatric Neurosurgery Fellowships.

Article Information

Correspondence Cormac O. Maher: University of Michigan, Ann Arbor, MI.

INCLUDE WHEN CITING Published online January 4, 2019; DOI: 10.3171/2018.10.PEDS18106.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.



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    Number of fellowship graduates per year from programs that are accredited by the ACPNF.

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    Percentage of fellowship graduates who are women per year.

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    Percentage of fellowship graduates who have an additional nonmedical graduate degree per year.

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    Percent of fellowship graduates practicing in a top 50–ranked pediatric neurosurgery program.

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    ABNS and ABPNS certification by year. Figure is available in color online only.


  • 1

    Albright ALSposto RHolmes EZeltzer PMFinlay JLWisoff JH: Correlation of neurosurgical subspecialization with outcomes in children with malignant brain tumors. Neurosurgery 47:8798872000

  • 2

    American Association of Neurological Surgeons: Statement of the American Association of Neurological Surgeons, American Board of Neurological Surgery, Congress of Neurological Surgeons, Society of Neurological Surgeons before the Institute of Medicine: ensuring an adequate neurosurgical workforce for the 21st century. ( [Accessed November 16 2018]

  • 3

    Benzil DLAbosch AGermano IGilmer HMaraire JNMuraszko K: The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery. J Neurosurg 109:3783862008

  • 4

    Bonura EMLee ESRamsey KArmstrong WS: Factors influencing internal medicine resident choice of infectious diseases or other specialties: a national cross-sectional study. Clin Infect Dis 63:1551632016

  • 5

    Chernov MF: The impact of provider volume on mortality after intracranial tumor resection and outcome and cost of craniotomy performed to treat tumors in regional academic referral centers. Neurosurgery 54:102710282004

  • 6

    DeLong MRHughes DBTandon VJChoi BDZenn MR: Factors influencing fellowship selection, career trajectory, and academic productivity among plastic surgeons. Plast Reconstr Surg 133:7307362014

  • 7

    Dias MSSussman JSDurham SIantosca MR: Perceived benefits and barriers to a career in pediatric neurosurgery: a survey of neurosurgical residents. J Neurosurg Pediatr 12:4224332013

  • 8

    Durham SRLane JRShipman SA: The pediatric neurosurgical workforce: defining the current supply. Clinical article. J Neurosurg Pediatr 3:1102009

  • 9

    Durham SRShipman SA: A 15-year review of pediatric neurosurgical fellowships: implications for the pediatric neurosurgical workforce. J Neurosurg Pediatr 1:4294322008

  • 10

    Kavolus JJMatson APByrd WABrigman BE: Factors influencing orthopedic surgery residents’ choice of subspecialty fellowship. Orthopedics 40:e820e8242017

  • 11

    Klingensmith MECogbill THLuchette FBiester TSamonte KJones A: Factors influencing the decision of surgery residency graduates to pursue general surgery practice versus fellowship. Ann Surg 262:4494552015

  • 12

    Long DMGordon TBowman HEtzel ABurleyson GBetchen S: Outcome and cost of craniotomy performed to treat tumors in regional academic referral centers. Neurosurgery 52:105610652003

  • 13

    Nakayama DK: Workforce issues in pediatric surgery. Am Surg 83:6606652017

  • 14

    Nakayama DKBurd RSNewman KD: Pediatric surgery workforce: supply and demand. J Pediatr Surg 44:167716822009

  • 15

    Nakayama DKNewman KD: Pediatric surgery workforce: population and economic issues. J Pediatr Surg 43:142614322008

  • 16

    National Institutes of Health: NIH awards by location & organization, fiscal year 2017. ( [Accessed November 16 2018]

  • 17

    Odetola FOMiller WCDavis MMBratton SL: The relationship between the location of pediatric intensive care unit facilities and child death from trauma: a county-level ecologic study. J Pediatr 147:74772005

  • 18

    Pollack MMAlexander SRClarke NRuttimann UETesselaar HMBachulis AC: Improved outcomes from tertiary center pediatric intensive care: a statewide comparison of tertiary and nontertiary care facilities. Crit Care Med 19:1501591991

  • 19

    Ramenofsky MLLuterman AQuindlen ERiddick LCurreri PW: Maximum survival in pediatric trauma: the ideal system. J Trauma 24:8188231984

  • 20

    Sheldon GFSchroen AT: Supply and demand—surgical and health workforce. Surg Clin North Am 84:14931509viii–ix 2004

  • 21

    Smith ERButler WEBarker FG II: Craniotomy for resection of pediatric brain tumors in the United States, 1988 to 2000: effects of provider caseloads and progressive centralization and specialization of care. Neurosurgery 54:5535652004




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