Perceived Effects of Socioeconomic Status on Pursuing a Career in Neurosurgery Among Medical Students and Unspecialized Residents in 8 Countries

Introduction: The application process for neurosurgical residency has historically been more expensive than for other surgical residencies, and the length of neurosurgical training may further delay income-earning potential.

Methods: A survey on the perceived effects of socioeconomic status (SES) on pursuing a career in neurosurgery was distributed to medical students and unspecialized residents in 8 countries.

Results: 894 responses (805 complete, 89 partial) were received.

79.4% (n=653) of respondents believed a person’s SES affected their ability to pursue a career in neurosurgery in their respective countries. This varied significantly by country, with the largest proportion of trainees from Uganda indicating that SES has an effect (96.0%, n=168) and the largest proportion of trainees from Saudi Arabia indicating that SES does not have an effect (57.4%, n=54) (p= < 0.0001). 81.0% (n=665) of respondents reported that there was a moderate or extreme advantage associated with coming from a high-income background, and 77.9% (n=636) of respondents reported that there was some disadvantage associated with coming from a low-income background.

In the United States, 91.6% (n=98) of respondents reported that a person’s SES probably or definitely affected their ability to pursue a career in neurosurgery, with 91.6% (n=98) of respondents associating some disadvantage with coming from a low-income background compared to 92.5% (n=99) of respondents associating some advantage with coming from a high-income background. The role of SES was universally acknowledged, regardless of whether the respondent was carrying any student loan debt (p=0.7576).

Conclusion : Overall, trainees viewed SES as a factor that influenced an individual’s ability to pursue a career in neurosurgery, but this varied significantly by country. Additional research is needed to understand how SES affects trainees’ ability to pursue neurosurgery and to determine what can be done to ameliorate any potential disadvantages associated with coming from a low-income background.