Neurosurgical services are increasingly recognized as essential components of surgical care worldwide. Degree of interest among neurosurgeons regarding international work, and barriers to involvement in global neurosurgical outreach, are largely unexplored. We distributed a survey to members of the AANS/CNS Joint Section on Pediatric Neurosurgery to assess the state of global outreach among its members and identify barriers to involvement.
An internet-based questionnaire was developed by the International Education Subcommittee of the AANS/CNS Joint Section on Pediatric Neurosurgery, and distributed to pediatric neurosurgeons via the AANS/CNS Joint Section email contact list. Participants were surveyed on involvement in global neurosurgical outreach, geographic location, nature of participation, and barriers to further involvement.
A 35.3% response rate was obtained, with 116 respondents completed the survey. 61% performed or taught neurosurgery in a developing country, 49% traveling at least annually. Africa was the most common region (54%), followed by South America (30%), through 29 separate organizing entities. Hydrocephalus was the most commonly treated condition (88%), followed by spinal dysraphism (74%) and tumor (68%). Most respondents obtained follow-up through communication from local surgeons (77%). 71% believed the international experience improved their practice, and 74% were very or extremely interested in working elsewhere. Interference with current practice (61%), cost (44%), and difficulty identifying international partners (43%) were the most commonly cited barriers to participation.
Any coordinated effort to expand global neurosurgical capacity begins with appreciation for the current state of outreach efforts. Increasing participation in global outreach will require addressing both real and perceived barriers to involvement. Creation and curation of a centralized online database of ongoing projects to facilitate coordination and involvement may be beneficial.