Guest Post from Clemens M. Schirmer, MD, PhD, FAANS, FAHA
Vice-Chair, AANS/CNS Communications and Public Relations Committee
Geisinger Health System
Wilkes Barre, PA
Neurosurgery is a noble profession, and for most of us, choosing this specialty for our career was a calling. However, the training required is a long and arduous pathway with many potential obstacles. Perhaps the greatest of these hurdles for aspiring medical students is to gain one of the coveted graduate medical education (GME) training positions via The Match.
Match Day 2016 was on March 18, and neurosurgery remains highly competitive — attracting the best and the brightest into our ranks and preserving the high level of skill and competence long associated with our specialty. GME positions in neurosurgery are few in number with only small increases over the years. This year, 216 positions were offered to fill residency slots in 105 training programs, representing just 0.8 percent of all GME positions. Despite a long list of superb neurosurgeons with international training background, given the scarcity of positions, it is no surprise that most neurosurgical residents came from U.S. medical schools. This year only two neurosurgical positions went unfilled and nearly 93 percent of these went to U.S. medical school graduates.
The significant demands of a seven-year residency and the subsequent neurosurgical career attract a special kind of student. In general, these students are very confident that this is the only career they would like to pursue; thus, the overwhelming majority of U.S. medical students who matched into a neurosurgical position indicated that neurosurgery was their only choice. Unfortunately, despite considerable dedication, 15 to 20 percent of U.S. medical students and 65-75 percent of international graduates pursuing neurosurgery, did not match into a GME position. So with an impending shortage of physicians in the U.S., state and federal policymakers need to do more to expand the number of funded residency training slots.
Despite the overall competitive GME process in neurosurgery, there is still room for improvement. For example, women fill only a small minority of neurosurgical GME slots, averaging just over 10 percent of matched applicants per year during this decade. While the percentage of women entering neurosurgery has slowly risen, it remains disproportionately small as compared to the overall number — 50 percent — of women in medical school. Furthermore, retaining women for the duration of GME training can be challenging.
We congratulate all the hard-working medical students offered a GME slot within neurosurgery and look forward to them joining our profession!