A narrative review of international professionalism standards in neurosurgery

Background: This study seeks to characterize and compare the professionalism standards of neurosurgical societies from around the world and identify key elements common to ideas of neurosurgical professionalism internationally. Methods: This is a narrative review of neurosurgical organizations selected based on size of membership, and size or representative diversity of region served. Societies with publicly-available documents in English were preferred. Organizational documents, including governing documents and explicit professionalism/conduct standards, were reviewed. Identifiable professionalism standards were compared for scope, content, and enforceability, and common elements across societies were abstracted. Results: Fifteen societies were included, comprising one global society, five continental societies, and nine national societies. Ten organizations had some form of explicit professionalism standards, of which seven were dedicated, free-standing documents. Dedicated codes of conduct were more common in Western societies. Among these, seven common themes were identified: disruptive behavior, harassment, discrimination, business/ legal activity, scientific/academic integrity, substance abuse and impairment, and social media use. Conclusion: Professionalism is a critical aspect of modern neurosurgery, and has long-reaching effects on patient care and career success. In an era of unprecedented global connection, universal standards of professionalism are critical to the continued growth and success of our community.