A Nationwide Survey of the Spine Education of Medical Students

Introduction Spinal disease is prevalent, yet education regarding these disorders in undergraduate medical education is limited. Objective This study assesses medical students' exposure, confidence, competence, and attitudes regarding their spine anatomy and pathology curricula. Methods US allopathic and osteopathic medical students completed an anonymous, uncompensated survey, including 17 questions on attitudes towards spine education and 15 on spine anatomy and pathology. Surveys completed in <180 seconds or <80% complete were excluded. Students estimated their hours of spine education and rated their comfort in diagnosing spine pathology. Data was analyzed using Stata (StataCorp, College Station, TX, USA) and RStudio (Posit PBC, Boston, MA, USA). Results Of 491 survey respondents, 252 (51.2% allopathic, 48.8% osteopathic) met the inclusion criteria. Surgery and medicine were the most common specialty interests. Students scored significantly higher in lumbar competence (2.20 vs. 1.96; p<0.001, F = 7.40) and confidence (1.72 vs. 0.82; p<0.001, F = 38.66) questions than in cervical spine. Students who reported over 20 hours of spine anatomy teaching answered more lumbar spine questions correctly and reported more confidence answering both cervical and lumbar spine questions. Students with reported interest in either neurosurgery or orthopedics had a non-significant trend to answer more questions correctly overall but were significantly more confident with cervical spine questions (p=0.02, x² = 19.58, df = 4). A majority (59.1%) of participants wished for more didactic time on spine pathology, and 39.5% of participants expressed dissatisfaction with clinical rotation didactics. Conclusions US medical students demonstrated disparity in recognizing cervical versus lumbar spine pathologies. Most respondents desired more spine-focused didactics, suggesting an area of improvement in medical education by balancing spine education to reflect disease prevalence.