234. Influence of Pediatric Neurosurgical Education During Residency Training On Choosing to Pursue a Pediatric Neurosurgery Fellowship

Authors: Natalie Limoges, DO; Cormac Maher, MD; Michael Scott, MD; Mark Krieger, MD; Dave Limbrick, MD; Gerald Grant, MD; Susan Durham, MD (Burlington, VT)


The purpose of this study was to determine whether there are specific attributes of pediatric neurosurgical education during residency training that influence a resident’s choice to pursue a pediatric neurosurgery fellowship.


Existing program-specific data from a survey of pediatric neurosurgical education in all ACGME-approved training programs were utilized for this study, including pediatric hospital type, number of pediatric neurosurgical faculty, number of pediatric cases/year, presence of a pediatric neurosurgical fellowship, number of residents/year and length of required rotation in pediatric neurosurgery. In addition, a listing of all residency training programs that had produced five or more pediatric neurosurgery fellows since 1993 (23 programs) was obtained from the ACPNF. Comparisons were then made between programs that produced five or more pediatric neurosurgery fellows vs. those programs with fewer than five fellows.


Hospital type (freestanding children’s hospital vs. children’s hospital within an adult hospital/general hospital) or timing of the pediatric neurosurgery rotation was not associated with producing more pediatric neurosurgery fellows. Those programs which produced more pediatric neurosurgery fellows had significantly higher numbers of pediatric neurosurgical faculty, pediatric neurosurgical cases/year and number of residents/year in the training program. Programs with pediatric neurosurgery fellowships also produced more pediatric neurosurgery fellows, but programs with longer lengths of mandatory pediatric neurosurgical rotations did not produce higher numbers of pediatric neurosurgical fellows. Ninety percent of the programs who produced 5 or more fellows had a formal pediatric neurosurgery rotation (compared to 74% of programs who produced fewer than 5 fellows). 


Training programs with greater numbers of residents, pediatric neurosurgery staff and pediatric neurosurgical cases are more likely to have graduates that pursue a pediatric neurosurgery fellowship. Training in a free-standing children’s hospital or in longer pediatric neurosurgery rotations was not associated with graduates pursuing pediatric neurosurgery fellowship.