A Nationwide Workforce Characterization of Neurosurgical Care in Postwar Vietnam.

Abstract

Vietnam, a lower-middle-income country in Southeast Asia with 100.3 million people, faces a significant public health burden, with 6 of its 10 leading causes of mortality relevant to neurosurgery. To date, there has been no comprehensive study on the Vietnamese neurosurgical system. The purpose of this study is to comprehensively characterize the country's neurosurgical workforce to inform national planning and policy development for equitable neurosurgical care. We estimated the total number of practicing neurosurgeons using attendee lists from the Vietnam Neurosurgery Society annual meetings in 2023 and 2024. Data on neurosurgical residency enrollment from 2000 to 2024, annual case logs, and training curricula were obtained directly from residency programs. Vietnam's workforce is characterized by 2 parallel training pathways: a 3-year neurosurgery residency program (the formal neurosurgery residency program) and a shorter specialist level 1 program. Between 2000 and 2024, 172 neurosurgeons entered training through the the formal neurosurgery residency program pathway, representing 18% of the national workforce. As of 2024, there are 977 neurosurgeons distributed across 139 hospitals in 56 of the country's 63 provinces, corresponding to 9.7 neurosurgeons per million population. The majority (88%) have a primary affiliation with a public hospital. Seven provinces, collectively home to approximately 5 million people, lack access to a neurosurgeon within their provincial boundaries. Vietnam's diverse approaches to neurosurgical training have produced a heterogeneous workforce. Workforce distribution remains heavily skewed toward major urban centers. Structural barriers-including high training costs, limited residency training centers, and low financial incentives-further constrain efforts to expand access to high-quality neurosurgical services.