Workforce Analysis of Spine Surgeons Involved with Neurological and Orthopedic Surgery Residency Training

• Published in: World neurosurgery 2019-02, Vol.122, p.e147-e155
• Main Authors: Post, Alexander F., Dai, Jennifer B., Li, Adam Y., Maniya, Akbar Y., Haider, Syed, Sobotka, Stanislaw, Germano, Isabelle M., Choudhri, Tanvir F.
• Format: Article
• Language: English
• Subjects: Academic neurosurgery; Academic orthopedic surgery; Bibliometrics; Gender; h-Index; Spine surgery; Workforce analysis
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.09.152

Spinal surgery is taught and practiced within 2 different surgical disciplines: neurological surgery and orthopedic surgery. We have provided a unified analysis of spine-focused faculty at U.S. residency programs. A total of 278 Accreditation Council for Graduate Medical Education training programs were assessed to identify 923 full-time faculty members with a spinal surgery designation, defined by spine fellowship training or surgeon case volume >75% spine surgeries. Faculty were assessed with respect to parent discipline, years of fellowship training, academic rank, gender, and academic productivity (h-index). The spine-teaching workforce contains 55% orthopedic surgeons and 45% neurosurgeons with wide gender asymmetry overall and at all faculty ranks. Of the female spine surgeons, those with neurosurgical training (64.44%) nearly doubled the number with orthopedic training (35.56%). Academic productivity increased with academic rank similarly for both genders and subspecialties. Orthopedic spine surgeons had a greater mean fellowship number compared with the neurological spine surgeons. Fellowship time of completion (intraresidency/infolded vs. postresidency) did not significantly affect the h-indexes. Addition of fellowship conferred academic productivity benefit for orthopedic surgeons only. Neurological and orthopedic spine surgery showed similar patterns for the spread of faculty across academic ranks and trends in academic productivity. Marked gender disparity was seen in both neurosurgical and orthopedic surgery, with fewer female spine surgeons seen at every academic rank. Orthopedic spine surgeons had a greater mean fellowship number than did their neurosurgical counterparts, and a lack of fellowship correlated with lower academic productivity in orthopedic, but not neurological, spine surgery. •The spine-teaching workforce contained 923 surgeons, 55% of whom were orthopedic surgeons.•Of the neurological spine surgeons and orthopedic spine surgeons 7.0% and 3.2% were women, respectively.•Academic productivity was not different between male and female spine surgeons.•Intra- versus postresidency fellowship timing did not affect academic productivity.•Orthopedic spine surgeons without a fellowship had a lower mean h-index.