Exploring perspectives and boundaries in neurosurgical career pathways for generation Z in German-speaking countries

Generation Z (born 1997-2010) is the first generation to grow up entirely in the digital age. This study investigates how this generation perceives neurosurgery as a career path in German-speaking countries.

What are the motivations, barriers, and expectations of Generation Z regarding a career in neurosurgery, and how do these differ between medical students and residents?

A 20-item online survey (including Likert scales, single-choice, and numeric rating scales) was distributed via professional and student associations in Germany and Switzerland between February 9 and March 30, 2025. Participants included medical students and residents. Data were analyzed using Stata 18.0.

A total of 351 responses were analyzed (65 % students, 35 % residents; mean age 25 years; 58 % female). Interest in neurosurgery was significantly higher among residents (80 %) than students (52 %, p < 0.001), especially in clinical semesters (57 % vs. 36 %, p = 0.006). The average likelihood of pursuing neurosurgery was 70/100, higher among residents (90 vs. 56, p < 0.001). Key motivations included fascination with surgery (students: 58 %, residents: 62 %), scientific interest, and clinical variety. Deterrents were a lack of mentorship (13 % vs. 24 %) and rigid hierarchies. Students prioritized flexibility (37 %), while residents favored more hands-on training (35 %, p = 0.002). Work-life balance was a major concern for both groups (≥74 %). Structured mentorship was important to 88 % (p = 0.024).

Generation Z demonstrates above-average interest in neurosurgery but emphasizes the need for better mentorship, work-life balance, and training reforms. Tailored educational strategies and modernized work models may enhance recruitment and long-term engagement in neurosurgical careers.