Geographic and Educational Determinants of Academic Neurosurgery Faculty

Introduction: Anecdotal evidence suggests that academic neurosurgery departments frequently recruit from their own residency program or geographic region. Educational backgrounds, including advanced degrees, are also suggested to play a role in determining career outcomes. We aimed to study geographic and educational associations within academic neurosurgery by conducting a census of academic neurosurgery faculty in the USA.

Methods: We conducted a systematic search of all AANS-accredited neurosurgery residency programs in the United States. Departmental websites were queried to identify individual neurosurgery faculty and cross-linked with other sources to extract individuals’ characteristics. Data extracted included gender, geographic locations (Midwest, Northeast, South, West), educational background, advanced degrees, and leadership positions. Geographic, educational, and demographic factors were studied. Categorical variables were compared using the Pearson’s Chi-square test.

Results: In total, 1784 neurosurgery faculty from 115 departments were included, of whom 183 (10.3%) were female.
Neurosurgery departments in the Northeast were more likely to recruit faculty who had completed residency in the same region, and same state, compared to other regions (p < 0.001 for both). Departments in the Northeast were also more likely to recruit faculty who had completed medical school in the same region (p < 0.001). Faculty were not more likely to have completed residency at their current department between regions (p=0.378). No gender differences were observed between regions.
Faculty chairs were more likely to have advanced degrees including master’s degrees (p < 0.001), PhDs (p=0.041), and MBAs (p < 0.001), while residency directors were not. Female faculty were more likely to have master’s degrees (p=0.034). Faculty were not more likely to have advanced degrees between regions. Faculty with a PhD were less likely to be faculty at the same program (p=0.003), state (p=0.006), or region (p=0.014) where they completed residency.

Conclusion : Geographic and educational factors play roles in determining career outcomes among faculty at academic neurosurgery departments.