Future Directions for Global Clinical Neurosurgical Training: Challenges and Opportunities

OBJECTIVE: Expanded access to training opportunities is necessary to address 5 million essential neurosurgical cases not performed annually, nearly all in low- and middle-income countries (LMICs). To target this critical neurosurgical manpower issue and advance positive collaborations developed the Global Neurosurgery 2019: A Practical Symposium, a summit was designed to assemble stakeholders in global neurosurgical clinical education to discuss innovative platforms for clinical neurosurgery fellowships. METHODS: The Global Neurosurgery Education Summit was held in November 2021, with a total of 30 presentations from directors and trainees in existing global neurosurgical clinical fellowships. Presenters were selected based on chain referral sampling from suggestions made primarily from young neurosurgeons in LMIC. Presentations focused on the perspectives of hosts, local champions and trainees on clinical global neurosurgery fellowships and virtual learning resources. This conference sought to identify factors for success in overcoming barriers to improving access, equity, throughput, and quality of clinical global neurosurgery fellowships. A pre-conference survey was disseminated to attendees. RESULTS: Presentations included in-country training courses, twinning programs, provision of surgical labs and resources, existing virtual educational resources, and virtual teaching technologies, with reference to their applicability to hybrid training fellowships. Virtual learning resources developed during the COVID-19 pandemic and high-fidelity surgical simulators were presented, some for the first time to this audience. CONCLUSION: The summit provided a forum for discussion of current challenges and opportunities for developing a collaborative consortium capable of designing a pilot program for efficient, sustainable, accessible, and affordable clinical neurosurgery fellowship models for the future