A 15-year review of pediatric neurosurgical fellowships: implications for the pediatric neurosurgical workforce

Object. The Accreditation Council for Pediatric Neurosurgical Fellowships (ACPNF) was established in 1992 to oversee fellowship training in pediatric neurological surgery. The present study is a review of all graduates from 1992 through 2006 to identify predictors of American Board of Pediatric Neurological Surgery (ABPNS) certification. Methods. Basic demographic information including sex, year of graduation from residency, residency training program, year of fellowship training, and fellowship program was collected on each graduate from each of the 22 ACPNF programs. Individuals who did not meet ACPNF requirements (39 trainees) and those currently practicing in Canada (11 individuals) were excluded. Univariate and multivariate analysis were used to identify predictors of ABPNS certification. Results. Of the 193 ACPNF graduates, 143 individuals met the criteria for analysis. Currently, 70 (49%) are ABPNS certified. There is a mean period of 5.1 +/- 2.4 years (range 2-13 years) between finishing fellowship and ABPNS certification. If those who are not expected to be sitting for the boards yet (2002-2006 graduates, 57 individuals) are removed, the rate of ABPNS certification is 66.3%. On average, 9.5 +/- 3.0 (range 4-16) fellows are trained per year. There is no statistically significant relationship between fellowship or residency training program and ABPNS certification. Conclusions. Although the present training infrastructure has the theoretical capacity to train > 20 pediatric neurosurgeons each year, this analysis suggests that current levels will provide similar to 6 ABPNS-certified pediatric neurosurgeons annually. This raises the question of the sufficiency of the future pediatric neurosurgical workforce.