How many residents should we train? The USA experience

Area of Science:

• Neurosurgery
• Medical Education
• Health Workforce Analysis

Background:

• Each year, approximately 135 neurosurgery residents enter training in the U.S. from a pool of 250 applicants.
• The practicing neurosurgeon workforce comprises about 3,260 board-certified individuals and 390 in the certification process.

Purpose of the Study:

• To analyze the current supply and demand of neurosurgeons in the United States.
• To evaluate the adequacy of the existing neurosurgical workforce to meet national needs.
• To discuss the optimal regulation of neurosurgical trainee numbers and workforce size.

Main Methods:

• Analysis of national matching program data for neurosurgical residency applicants and trainees over the past decade.
• Estimation of the active neurosurgeon pool size, accounting for training, retirement, and death rates.
• Assessment of neurosurgeon employment within large Health Maintenance Organizations to gauge demand.

Main Results:

• The U.S. neurosurgeon workforce appears to be appropriately sized for current national demand.
• The net increase in practicing neurosurgeons is less than the number of new trainees due to attrition.
• Market forces, rather than external committees, are suggested as a better long-term regulator of neurosurgeon numbers.

Conclusions:

• The current number of neurosurgeons in the U.S. is sufficient to meet patient needs.
• Future neurosurgeon numbers should not be based on uncertain predictions.
• Restricting trainee numbers to ensure quality training and relying on market dynamics are recommended for workforce management.