Training Neurosurgeons in Myanmar and Surrounding Countries: The Resident Perspective

Abstract

In recent decades there has been a significant expansion of neurosurgical capabilities in low- and middle-income countries, particularly in Southeast Asia. Despite these developments, little is known about the structure and quality of local neurosurgical training paradigms. A 36-question survey was administered to neurosurgical trainees in person at the Southeast Asian Neurosurgical Bootcamp to assess demographics, structure, and exposure of neurosurgical training in Southeast Asia. A total of 45 out of 47 possible respondents participated in the survey; 78% were men, with an age range of 26-40 years. Neurosurgical training most commonly consisted of 3 (n= 22, 49%) or 6 years (n= 14, 31%). The majority of respondents (70.5%) were from Myanmar, with the remainder coming from Indonesia, Cambodia, Thailand, and Nepal. Most residents (n= 38, 84%) used textbooks as their primary study resource. Only 24 (53%) residents indicated that they had free access to online neurosurgical journals via their training institution. The majority (n= 27, 60%) reported that fewer than 750 cases were performed at their institution per year; with a median of 70% (interquartile range: 50%-80%) being emergent. The most commonly reported procedures were trauma craniotomies and ventriculoperitoneal shunting. The least commonly reported procedures were endovascular techniques and spinal instrumentation. Although the unmet burden of neurosurgical disease remains high, local training programs are devoting significant efforts to provide a sustainable solution to the problem of neurosurgical workforce. High-income country institutions should partner with global colleagues to ensure high-quality neurosurgical care for all people regardless of location and income.