Survey on neurosurgery subspecialty fellowship training. Congress of Neurological Surgeons Education Committee.

BACKGROUND: The ongoing controversy on the certification of neurosurgery subspecialties has not been settled. There has been no detailed report on why a resident chooses to undergo further training in the form of a postgraduate fellowship. A survey was devised to investigate the reasons, as well as factors, that prompt the resident to pursue fellowship training.
METHODS: The names of the surveyed residents were obtained from the Congress of Neurological Surgeons database, and the names of the neurosurgery fellows were obtained from individual program coordinators by phone. A survey, a cover letter, and a return envelope were mailed to each prospective respondent. The data were entered on the Paradox for Windows program, and multiple queries were run to obtain tabulated results.
RESULTS: The overwhelming majority (84.6%) of the resident respondents considered fellowship a possibility. Academic medicine was also the choice of career for most (60.3%). The most popular reported fellowships were spine (25.6%), pediatric (16.5%), and vascular (16.1%). The three top reasons for pursuing fellowship training were "personal interest for knowledge," "job market demand," and "academic prestige." "Inadequate training during residency" was a distant fourth. For respondents citing "inadequate training during residency" as one of the top three reasons, there were proportionally higher respondents in the fields of peripheral nerve, endovascular, and skull base neurosurgeries.
CONCLUSION: A significant number of residents consider fellowship a way to further their personal interest and knowledge, as well as increase their marketability. Relatively few from the surveyed group considered their residency training experience deficient in the subspecialty areas, with the exception of peripheral nerve, endovascular, and possibly skull base neurosurgery.