Surgical Autonomy and Resource Availability in Andean Neurosurgical Residencies: Implications for Academic Excellence

This study sought to evaluate disparities in operative autonomy among young neurosurgical trainees in Andean Latin America. It also explored the distribution of operative resources in the Andean Community and their association with neuroanatomic excellence and operative autonomy.

Neurosurgical residents from training programs in Andean Latin America participated in a comprehensive survey to assess demographic information and their experiences with operative autonomy. The survey included inquiries regarding the cases performed autonomously, the availability of operative resources, and the locations of practice. Data were collected at 2 distinct time points: at the beginning and at the conclusion of the different educational interventions.

A total of 132 neurosurgery residents participated in this study, with the majority being residents (108; 81.8%). Surgical autonomy varied significantly, with chief residents in capital programs performing 351 of 1108 (31.7%) reported cases independently (mean [SD], 11 [11] cases per chief resident) compared with only 23 of 185 (12.4%) in urban programs (mean [SD], 2.5 [1.3] cases per chief resident). In addition, access to functional operative resources correlated with autonomy; residents with working surgical microscopes (n = 59) and powered drills (n = 110) reported higher autonomy, emphasizing the critical role of these resources in enhancing operative experiences.

This study highlights the importance of surgical autonomy in neurosurgical training within low- and middle-income countries, particularly in the Andean region. Moreover, there is a clear disparity in operative resources distribution among different locations of practice. Addressing these barriers can promote greater autonomy, ultimately improving surgical outcomes and education in global neurosurgery.