A 15-year review of pediatric neurosurgical fellowships: implications for the pediatric neurosurgical workforce

Susan R. Durham M.D.1,2,3 and Scott A. Shipman M.D., M.P.H.2,3
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  • 1 Departments of Surgery (Pediatric Neurosurgery) and
  • | 2 Pediatrics, and
  • | 3 The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, New Hampshire
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Object

The Accreditation Council for Pediatric Neurosurgical Fellowships (ACPNF) was established in 1992 to oversee fellowship training in pediatric neurological surgery. The present study is a review of all graduates from 1992 through 2006 to identify predictors of American Board of Pediatric Neurological Surgery (ABPNS) certification.

Methods

Basic demographic information including sex, year of graduation from residency, residency training program, year of fellowship training, and fellowship program was collected on each graduate from each of the 22 ACPNF programs. Individuals who did not meet ACPNF requirements (39 trainees) and those currently practicing in Canada (11 individuals) were excluded. Univariate and multivariate analysis were used to identify predictors of ABPNS certification.

Results

Of the 193 ACPNF graduates, 143 individuals met the criteria for analysis. Currently, 70 (49%) are ABPNS certified. There is a mean period of 5.1 ± 2.4 years (range 2–13 years) between finishing fellowship and ABPNS certification. If those who are not expected to be sitting for the boards yet (2002–2006 graduates, 57 individuals) are removed, the rate of ABPNS certification is 66.3%. On average, 9.5 ±3.0 (range 4–16) fellows are trained per year. There is no statistically significant relationship between fellowship or residency training program and ABPNS certification.

Conclusions

Although the present training infrastructure has the theoretical capacity to train > 20 pediatric neurosurgeons each year, this analysis suggests that current levels will provide ~ 6 ABPNS-certified pediatric neurosurgeons annually. This raises the question of the sufficiency of the future pediatric neurosurgical workforce.

Abbreviations used in this paper:

AANS = American Association of Neurological Surgeons; ABPNS = American Board of Pediatric Neurological Surgery; ACPNF = Accreditation Council for Pediatric Neurosurgical Fellowships; ASPN = American Society of Pediatric Neurosurgeons; JSP = Joint Section on Pediatrics.

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  • 1

    Albright AL: The past, present, and future of pediatric neurosurgery. Matson lecture, May 4, 2004. J Neurosurg 101:2 Suppl 125129, 2004

    • Search Google Scholar
    • Export Citation
  • 2

    Benzil DL, & Von der Schmidt E III: Toward harnessing forces of change: assessing the neurosurgical workforce. AANS Bulletin 15:711, 2006

    • Search Google Scholar
    • Export Citation
  • 3

    Boop FA, & Seaver MJ: Emergency care for kids: can neurosurgery do even better?. AANS Bulletin 16:712, 2006

  • 4

    Borenstein SH, , To T, , Wajja A, & Langer JC: Effect of subspecialty training and volume on outcome after pediatric inguinal hernia repair. J Pediatr Surg 40:7580, 2005

    • Search Google Scholar
    • Export Citation
  • 5

    Couldwell WT, & Rovit RL: Rethinking neurosurgical subspecialization. Surg Neurol 58:359370, 2002

  • 6

    Flannery AM: Pediatric neurosurgery work force: a pilot study. Pediatr Neurosurg 29:114116, 1998

  • 7

    Friedlich DL, , Feustel PJ, & Popp AJ: Workforce demand for neurosurgeons in the United States of America: a 13-year retrospective study. J Neurosurg 90:993997, 1999

    • Search Google Scholar
    • Export Citation
  • 8

    Gottfried ON, , Rovit RL, , Popp AJ, , Kraus KL, , Simon AS, & Couldwell WJ: Neurosurgical workforce trends in the United States. J Neurosurg 102:202208, 2005

    • Search Google Scholar
    • Export Citation
  • 9

    Humphreys RP: The modernization of pediatric neurosurgery. The Donald D Matson Lecture 2003. Childs Nerv Syst 20:1822, 2004

  • 10

    Lee TT, & Klose JL: Survey on neurosurgery subspecialty fellowship training. Congress of Neurological Surgeons Education Committee. Surg Neurol 52:641645, 1999

    • Search Google Scholar
    • Export Citation
  • 11

    Mainprize TG, , Taylor MD, & Rutka JT: Perspectives in pediatric neurosurgery. Childs Nerv Syst 16:809820, 2000

  • 12

    Mayer ML, & Skinner AC: Too many, too few, too concentrated? A review of the pediatric subspecialty workforce literature. Arch Pediatr Adolesc Med 158:11581165, 2004

    • Search Google Scholar
    • Export Citation
  • 13

    Pranikoff T, , Campbell BT, , Travis J, & Hirschl RB: Differences in outcome with subspecialty care: pyloromyotomy in North Carolina. J Pediatr Surg 37:352356, 2002

    • Search Google Scholar
    • Export Citation
  • 14

    Raimondi AJ: A model fellowship in pediatric neurosurgery. Acta Neurochir Suppl 69 135139, 1997

  • 15

    Scott RM: The fellowship in pediatric neurosurgery. Pediatr Neurosurg 17:281283, 1991

  • 16

    Smith JT, , Price C, , Stevens PM, , Masters KS, & Young M: Does pediatric orthopedic subspecialization affect hospital utilization and charges?. J Pediatr Orthop 19:553555, 1999

    • Search Google Scholar
    • Export Citation
  • 17

    Snow BW: Does surgical subspecialty care come with a higher price?. Curr Opin Pediatr 17:407408, 2005

  • 18

    Somme S, , To T, & Langer JC: Effect of subspecialty training on outcome after pediatric appendectomy. J Pediatr Surg 42:221226, 2007

  • 19

    Stockman JA III: Studies of the pediatric subspecialty workforce: overexposed and underexposed snapshots in time. Arch Pediatr Adolesc Med 158:11851186, 2004

    • Search Google Scholar
    • Export Citation
  • 20

    Stoddard JJ, , Cull WL, , Jewett EA, , Brotherton SE, , Mulvey HJ, & Alden ER: Providing pediatric subspecialty care: a workforce analysis. AAP Committee on Pediatric Workforce Subcommittee on Subspecialty Workforce. Pediatrics 106:13251333, 2000

    • Search Google Scholar
    • Export Citation
  • 21

    Winton P: Who should transfer children with an acute neurosurgical emergency?. Br J Hosp Med (Lond) 66:712, 2005

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