Towards a collaborative-integrative model of education and training in neurosurgery in low and middle-income countries

Background: Neurosurgery inequity between High-Income Countries and Low- and Middle-Income Countries is striking. Currently, several models of education and training are available each has advantages and limitations. Our goal is to suggest an integrative model of Education and Training with international collaboration which will assure the most cost-effective Training Model. Materials and Methods: The authors reviewed the literature narratively and examined in broad stroke the different existing models of international education and training programs to analyze their strengths, limitations, and cost-effectiveness in addressing the needs of Neurosurgery in Low and middle-Income Countries. Results: Several international institutions have been involved in Education and Training in Global Neurosurgery. The most common models for international education include short-term surgical mission and boot camps, a full residency training program in HICs, and a full residency training Program in Local or regional World Federation of Neurosurgical Societies (WENS) reference centers in Low and Middle-Income Countries, and online education. In Africa, both Local residency training centers and WENS reference centers are available and provide full training programs in Neurosurgery. Among them, WENS Rabat Training Center is the first established center in Africa in 2002. This program is supported by the WENS Foundation and by the Africa 100 Project. Some of these education models face currently challenges such as sustainability, financial support, and ethical issues. Conclusion: Training neurosurgeons from Low and Middle-Income countries in local and regional WENS Training centers might be the most cost-effective model of training that helps close the gap in neurosurgery. This training Model is duplicable and may be integrated into a global cohesive and collaborative model of education with international institutions.