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Shortage of neurosurgeons in Pakistan, one per 720,000 people, stems from a lack of trainees. Therefore, it is vital to assess the training experience, career opportunities, and satisfaction levels of neurosurgical trainees in Pakistan. A nationwide survey was conducted, covering 22 CPSP-accredited neurosurgery training programs in Pakistan. Convenience sampling was utilized with a pilot tested questionnaire and responses were analyzed using STATA 15. The response rate was 98% (120/122) with 70.8% male and mean age of 30.4 ± 4.1 years. Training programs included teaching courses (79%) and journal club (66%); however, there was a lack of cadaver workshops (14%) and cranial model-based stimulation (22%). 67% of trainees lacked publications in indexed journals. 69% worked 50–100 h weekly, with 62% experiencing burnout due to workload and hours and a third reporting poor work-life balance. Trainees dedicated more to operating rooms (37%, 10–24 h/week) and clinics (34%, 24–48 h/week) compared to study (42%, <5 h/week) and research (64%, <5 h/week). Gender equality was rated poorly by 50%. Disparities emerged in subspecialty exposure, with over half of trainees lacking exposure to deep brain stimulation (67%), and epilepsy (75%). 52.5% of the training institutes did not offer fellowships and 64.1% of trainees planned to pursue fellowships abroad. Steps need to be taken to improve working hours, gender equity, and increase simulation courses, diversify subspecialty exposure, and promote research initiatives.
Shakir et al. (Sat,) studied this question.