Early-career training in neurosurgery post-COVID: simulation, mentorship, and minimal case-volume concerns

Early-career neurosurgeon training has not yet fully recovered from the decrease in operative exposure that began during the early COVID era. Elective case cancellations, redeployment, and limited staff access to operating rooms reduced the chances of graduated responsibility across a variety of settings and widened existing gaps in the global workforce. Much of this was addressed by numerous programs that reinforced the application of simulation using inexpensive models and virtual environments, helping keep skills developing in the absence of practical experience. It was reported that simulator hours and trainee confidence improved, although practical surgery was needed to consolidate them. Online instruction, video-conferencing dissections, and organized mentoring also assisted learning, particularly in areas where training facilities are not evenly distributed. New interest in digital tools and early uses of artificial intelligence were indicative of a larger project to create flexible training systems. Developing a systematic roadmap that brings together case-log surveillance, simulation, video assessment, stratified mentorship, and partners in networks can help stabilize and modernize early career neurosurgical education.