Training Neurosurgeons in Myanmar and Surrounding Countries: The Resident Perspective.

INTRODUCTION: In recent decades there has been a significant expansion of neurosurgical capabilities in low-and-middle income countries and particularly in Southeast Asia. Despite these developments, little is known about the structure and quality of local neurosurgical training paradigms. METHODS: A 36-question survey was administered to neurosurgical trainees in-person at the Southeast Asian Neurosurgical Bootcamp to assess demographics, structure, and exposure of neurosurgical training in Southeast Asia. RESULTS: 45 out of 47 possible respondents participated in the survey. 78% were male with an age range of 26-40 years. Neurosurgical training most commonly consisted of three (n=22, 49%) or six years (n=14, 31%). The majority of respondents (70.5%) were from Myanmar with the remainder coming from Indonesia, Cambodia, Thailand, and Nepal. Most residents (n=38, 84%) used textbooks as their primary study resource. Only 24 (53%) residents indicated that they had free access to online neurosurgical journals via their training institution. The majority (n=27, 60%) reported that less than 750 cases were performed at their institution per year; with a median of 70% (interquartile range: 50-80%) being emergent. The most commonly reported procedures were trauma craniotomies and ventriculoperitoneal shunting. The least commonly reported procedures were endovascular techniques and spinal instrumentation. CONCLUSIONS: While the unmet burden of neurosurgical disease remains high, local training programs are devoting significant efforts to provide a sustainable solution to the problem of neurosurgical workforce. High income country institutions should partner with global colleagues to ensure high-quality neurosurgical care for all people regardless of location and income.