Background and objectives: Neurosurgery chairs and program directors (PDs) play a critical role in shaping the next generation of neurosurgeons while driving academic advancements through research, innovation, and advocacy. However, the career trajectories leading to these esteemed positions remain inadequately defined. This study characterizes the demographics, educational backgrounds, and academic productivity of US neurosurgery chairs and PDs.
Methods: We conducted a comprehensive review of all Accreditation Council for Graduate Medical Education-accredited neurosurgery residency programs, identifying chairs and PDs. Demographic data, educational backgrounds, training institutions, prior institutional experience, and research productivity metrics were meticulously extracted from publicly available sources. Leaders at top 20 National Institutes of Health (NIH)-funded programs per Blue Ridge and Doximity-ranked programs were compared with those at other institutions.
Results: A total of 114 chairs (median appointment age: 48 [IQR: 45-54] years, 4.4% female) and 119 PDs (median appointment age: 44 [40-47] years, 10.1% female) were identified. International medical graduates constituted 14.9% of chairs and 9.2% of PDs. Advanced degrees were held by 40.4% of chairs and 25.2% of PDs. Johns Hopkins and Columbia University were the most frequently attended medical schools for chairs and PDs, respectively. Massachusetts General Hospital was the predominant residency training site for chairs, whereas the University of Pittsburgh was most common for PDs. Most leaders pursued fellowship training (78.9% of chairs, 81.5% of PDs), with vascular neurosurgery being the most common subspecialty. Internal hires accounted for most appointments. Leaders at top 20 programs had significantly higher Hirsch index, NIH funding, R01-equivalent grant acquisition, and patent contributions than their counterparts at other institutions.
Conclusion: Our findings offer critical insights for neurosurgical trainees and junior faculty navigating the path to academic leadership. By identifying key factors associated with success-such as high-impact research, NIH funding, and institutional engagement-this study informs mentorship programs and career development initiatives aimed at fostering future leaders in academic neurosurgery.
Keywords: Academic career trajectories; Chairs; Neurosurgical education; Neurosurgical leadership; Program directors; Residency.
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