Costs of Academic Engagement in Organized Neurosurgery in the United States

Organized neurosurgery offers innumerable opportunities for scientific exchange, networking, and continuing medical education (CME). National, regional, and state societies and meetings have rapidly proliferated across neurosurgery, as have neurosurgical-associated publications and journals. This study sought to review individual costs incurred by neurosurgeons seeking engagement in organized neurosurgery to illustrate the costs associated with participation.

National, regional, and state neurosurgery societies were identified, and associated annual meetings were recorded. Leading neurosurgery journals, as determined by reputation and impact factor, were selected. Data unavailable online were acquired through direct communication with the respective organization. American Board of Neurological Surgeons board-certification costs were acquired and compared with board-certification costs in comparable specialties (orthopedic surgery (Ortho), plastic surgery (PS), general surgery (GS), neurology). Baseline academic engagement was defined as two general society memberships, two annual meeting registrations, and respective board certification. A CME credit-per-dollar value was created to measure the relative financial value of CME.

A total of 31 societies, 23 meetings, and 18 journals were identified. Society membership costs included American Association of Neurological Surgeons ($1100), Congress of Neurological Surgeons ($990), Society of NeuroInterventional Surgery ($775), and Cervical Spine Research Society ($950). Meetings with the greatest registration fees included the Society of Neurological Surgeons ($1800) and the American Society of Pediatric Neurosurgeons ($1675) annual meetings. Individual journal subscription costs included Journal of Neurosurgery ($636), Neurosurgery ($643), Spine ($1188), and World Neurosurgery ($909). In our limited comparison, the specialty of neurosurgery had the greatest baseline academic engagement cost ($11,588; PS: $8105; Ortho: $7013; GS: $5570; neurology: $4640). Costs of nontraditional CME are significantly less compared with traditional, meeting-driven CME opportunities.

Organized neurosurgery incurs major individual costs by way of society membership, meeting registration, and journal subscriptions. Rising costs for engagement are substantial and may not be sustainable when contrasted with unchanged CME reimbursement, prompting dialog to identify sources of subsidization.