Future Directions for Global Clinical Neurosurgical Training: Challenges and Opportunities


Caitlin Hoffman, Department of Neurological Surgery, Weill Cornell Medicine, New York, NY, USA.
Roger Härtl, Department of Neurological Surgery, Weill Cornell Medicine, New York, NY, USA.
Nathan A. Shlobin, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: nathan.shlobin@northwestern.edu.
Tshibambe N. Tshimbombu, Department of Neurosurgery, Geisel School of Medicine, Dartmouth University, Hannover, NH, USA.
Samer K. Elbabaa, Section of Pediatric and Fetal Neurosurgery, Orlando Health Arnold Palmer Hospital for Children, Orlando, FL, USA.
Michael M. Haglund, Division of Global Neurosurgery and Neurology and Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Andrés M. Rubiano, Neurosciences Institute, Neurosurgery Service, El Bosque University, El Bosque Clinic, MEDITECH-INUB Research Group, Bogotá, Colombia.
Michael C. Dewan, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Martina Stippler, Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Muhammad Raji Mahmud, Neurosurgery Unit, Department of Surgery, Ahmadu Bello University, Zaria Kaduna, Nigeria.
Richard Wohns, NeoSpine, Pallyup, WA, USA.
Hamisi K. Shabani, Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
Brandon Rocque, Division of Pediatric Neurosurgery, Department of Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, Alabama, USA.
David I. Sandberg, Division of Pediatric Neurosurgery, University of Texas Health Sciences Center, McGovern Medical School and Children's Memorial Hermann Hospital, Houston, TX, USA.
Jesús Lafuente, Department of Neurosurgery, Hospital Universitario del Mar, Barcelona, Spain.
Robert Dempsey, Department of Neurological Surgery, University of Wisconsin, WI, USA.
Gail Rosseau, Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Electronic address: gailrosseaumd@gmail.com.

Document Type

Journal Article

Publication Date



World neurosurgery




global health; global neurosurgery; global surgery; international development; public health


OBJECTIVE: Expanded access to training opportunities is necessary to address 5 million essential neurosurgical cases not performed annually, nearly all in low- and middle-income countries (LMICs). To target this critical neurosurgical manpower issue and advance positive collaborations developed the "Global Neurosurgery 2019: A Practical Symposium," a summit was designed to assemble stakeholders in global neurosurgical clinical education to discuss innovative platforms for clinical neurosurgery fellowships. METHODS: The Global Neurosurgery Education Summit was held in November 2021, with a total of 30 presentations from directors and trainees in existing global neurosurgical clinical fellowships. Presenters were selected based on chain referral sampling from suggestions made primarily from young neurosurgeons in LMIC. Presentations focused on the perspectives of hosts, local champions and trainees on clinical global neurosurgery fellowships and virtual learning resources. This conference sought to identify factors for success in overcoming barriers to improving access, equity, throughput, and quality of clinical global neurosurgery fellowships. A pre-conference survey was disseminated to attendees. RESULTS: Presentations included in-country training courses, twinning programs, provision of surgical labs and resources, existing virtual educational resources, and virtual teaching technologies, with reference to their applicability to hybrid training fellowships. Virtual learning resources developed during the COVID-19 pandemic and high-fidelity surgical simulators were presented, some for the first time to this audience. CONCLUSION: The summit provided a forum for discussion of current challenges and opportunities for developing a collaborative consortium capable of designing a pilot program for efficient, sustainable, accessible, and affordable clinical neurosurgery fellowship models for the future.


Neurological Surgery