Geographic Distribution in Training and Practice of Academic Neurologic and Orthopedic Spine Surgeons in the United States

Introduction: Academic spine surgeons are an expanding workforce; however, little is known about how geographic regions of training and practice impact academic metrics. This study aimed to stratify the geographic distribution of academic spine surgeons in the United States and analyze how this distribution highlights differences in academic, demographic, professional measures, and gaps in access to spine care.

Methods: 661 spine surgeons (347 neurosurgical; 314 orthopedic) were categorized into geographic regions of training and practice. The American Association of Neurological Surgeons, American Academy of Orthopedic Surgeons, NIH RePort Expenditures and Results (RePORTER), Google Patent, and NIH icite databases were used to query demographic and professional metrics.

Results: Academic spine surgeons are predominately male (95%) and few have patents (23%) or NIH funding (5%). Regionally, the South has the highest proportion of practicing academic spine surgeons (28%), but California is the state with the highest proportion (13%). The Northeast has the greatest regional retention post-residency at 74%, followed by the Midwest (59%), South (48%), and West (42%). Academic spine surgeons in the West and South are more associated with having additional degrees in addition to an MD. Neurosurgery-trained spine surgeons tend to hold more additional degrees (17%) than orthopedic spine surgeons (8%), whereas more orthopedic spine surgeons hold leadership positions at their institution (34%) than neurosurgeons (20%). Lastly, neurosurgery-trained spine surgeons completed residency more recently on average (2010) than orthopedic spine surgeons (1995).

Conclusion : Academic spine surgeons are found at the highest proportion in the South and California, with the Northeast having the greatest regional retention. Spine neurosurgeons tend to have more additional degrees, whereas the spine orthopedic surgeons have more leadership positions and completed residency earlier. These results may be relevant to training programs looking to correct geographic disparities, surgeons in search of training programs, or students in pursuit of careers in spine surgery.