A Survey of Applicant Views Regarding the Neurosurgical Fellowship Application Process

The process of fellowship selection remains unclear and heterogeneous among subspecialties in neurosurgery. We surveyed neurosurgical residents applying for subspecialty fellowships about their experiences to evaluate the process and find areas for improvement.

We distributed an online, nationwide survey to 153 U.S. neurosurgical residents (postgraduate years 5-7) identified via the American Association of Neurological Surgeons resident database.

Sixty-nine residents responded to the survey, representing a variety of subspecialties. Most residents applied for 2-5 programs (45%) and completed 2-5 interviews (45%). The primary methods of finding fellowships were via word of mouth (68%) and faculty mentors (67%), followed by Web sites and reaching out to fellowship directors (54%) and online database searching (46%). Although many residents applied for fellowships in postgraduate year 5 of training (39%), there was significant variability in times for interviews and offer letters. Most residents accepted their first offer (75%). Most respondents (93%) believed that national neurosurgical societies should help improve the fellowship application process, with reasons including a common application and due dates (29%), fellowship database with program details (29%), and improved coordination of interviews (23%). Regarding a nationalized match system, residents were roughly split among opposed (38.6%), neutral (26.3%), and supportive (35.1%).

These survey results suggested that the neurosurgical fellowship application process could be improved by a common application, public listing of programs, standardized dates for application, and improved coordination of interviews. Residents are generally supportive of having an improved organization of the match and/or a national fellowship match.