Reappraising Neurosurgical Residency in Nepal-Stepping Stone for Paradigm Shift from Its Current Perspectives.

Abstract

Nepal has a critical shortage of health workers for achieving its projected sustainable development goals pertaining to its health sector. To counteract this crisis and reduce the morbidity and mortality associated with untreated brain injuries secondary to inadequate access, it is pivotal to generate solutions through the establishment of improved educational and training objectives. Objectives must align themselves with achieving equitable access to neurologic health. To that end, the cadre of health professionals able to treat neurologic disease should be sharply skilled and increased in number. We outline potential sustainable solutions at the training level to address this public health problem. Demanding and limitless working hours, burnout, social stressors, and minimal monthly stipend likely contribute to limited applications for neurosurgery residency programs. Measures should be taken to improve participation and access to extracurricular nonwork activities so as to improve resident well-being and avoid burnout. Moreover, gender inequality has also become a matter of concern as there were no females among 31 new specialist registrations in neurosurgery in 2017 and only 5 female neurosurgeons in practice to date in Nepal as per the NMC registration. Every effort should be directed toward honing the "value of neurosurgeon" among residents and promoting and nurturing their capabilities thereby maximizing sustainability in our health care system.