{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:29:57Z","timestamp":1783776597218,"version":"3.55.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Research suggests that there may be a growing disparity between the supply of and demand for both pediatric specialists and neurosurgeons. Whether pediatric neurosurgeons are facing such a disparity is disputable, but interest in pediatric neurosurgery (PNS) has waxed and waned as evidenced by the number of applicants for PNS fellowships. The authors undertook a survey to analyze current neurosurgical residents' perceptions of both benefits and deterrents to a pediatric neurosurgical career.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>All residents and PNS fellows in the United States and Canada during the academic year 2008\u20132009 were invited to complete a Web-based survey that assessed 1) demographic and educational information about residents and their residency training, particularly as it related to training in PNS; 2) residents' exposure to mentoring opportunities from pediatric neurosurgical faculty and their plans for the future; and 3) residents' perceptions about how likely 40 various factors were to influence their decision about whether to pursue a PNS career.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Four hundred ninety-six responses were obtained: 89% of the respondents were male, 63% were married, 75% were in at least their 3rd year of postgraduate training, 61% trained in a children's hospital and 29% in a children's \u201chospital within a hospital,\u201d and 72% were in programs having one or more dedicated PNS faculty members. The residencies of 56% of respondents offered 6\u201311 months of PNS training and nearly three-quarters of respondents had completed 2 months of PNS training. During medical school, 92% had been exposed to neurosurgery and 45% to PNS during a clinical rotation, but only 7% identified a PNS mentor. Nearly half (43%) are considering a PNS career, and of these, 61% are definitely or probably considering post-residency fellowship. On the other hand, 68% would prefer an enfolded fellowship during residency. Perceived strengths of PNS included working with children, developing lasting relationships, wider variety of operations, fast healing and lack of comorbidities, and altruism. Perceived significant deterrents included shunts, lower reimbursement, cross-coverage issues, higher malpractice premiums and greater legal exposure, and working with parents and pediatric health professionals. The intrinsic nature of PNS was listed as the most significant deterrent (46%) followed by financial concerns (25%), additional training (12%), longer work hours (12%), and medicolegal issues (4%). The majority felt that fellowship training and PNS certification should be recommended for surgeons treating of all but traumatic brain injuries and Chiari I malformations and performing simple shunt-related procedures, although they felt that these credentials should be required only for treating complex craniosynostosis.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The nature of PNS is the most significant barrier to attracting residents, although reimbursement, cross-coverage, and legal issues are also important to residents. The authors provide several recommendations that might enhance resident perceptions of PNS and attract trainees to the specialty.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.7.peds12597","type":"journal-article","created":{"date-parts":[[2013,8,30]],"date-time":"2013-08-30T14:01:32Z","timestamp":1377871292000},"page":"422-433","source":"Crossref","is-referenced-by-count":15,"title":["Perceived benefits and barriers to a career in pediatric neurosurgery: a survey of neurosurgical residents"],"prefix":"10.3171","volume":"12","author":[{"given":"Mark S.","family":"Dias","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Pediatrics, Penn State University College of Medicine, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"Sussman","sequence":"additional","affiliation":[{"name":"Heller School for Public Policy and Management, Brandeis University, Waltham, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Durham","sequence":"additional","affiliation":[{"name":"Dartmouth University School of Medicine, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Iantosca","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds12597","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1097\/00006123-200010000-00018","article-title":"Correlation of neurosurgical subspecialization with outcomes in children with malignant brain tumors","volume":"47","author":"Albright","year":"2000"},{"key":"b2-peds12597","series-title":"Adv Health Sci Educ Theory Pract","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1023\/A:1009768526142","article-title":"Attitudes and approaches of influential role models in clinical education","volume":"4","author":"Althouse","year":"1999"},{"key":"b3-peds12597","series-title":"AANS Bulletin","first-page":"7","article-title":"Toward harnessing forces of change: assessing the neurosurgical workforce","volume":"15","author":"Benzil","year":"2006"},{"key":"b4-peds12597","series-title":"AANS Bulletin","first-page":"7","article-title":"Emergency care for kids: can neurosurgery do even better?","volume":"16","author":"Boop","year":"2007"},{"key":"b5-peds12597","series-title":"J Surg Res","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1006\/jsre.2001.6135","article-title":"Do medical school surgical rotations influence subspecialty choice?","volume":"97","author":"Chen","year":"2001"},{"key":"b6-peds12597","series-title":"Med Educ","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1111\/j.1365-2923.1996.tb00736.x","article-title":"Choices of careers in medicine: some theoretical and methodological issues","volume":"30","author":"Dohn","year":"1996"},{"key":"b7-peds12597","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2008.10.PEDS08255","article-title":"The pediatric neurosurgical workforce: defining the current supply. 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