Challenges in Residency Recruitment and Neurosurgical Workforce Trends: Insights from a Centralized Allocation System in Türkiye.

Abstract

There is growing global concern that the shortage of qualified neurosurgeons may become increasingly pronounced over time. However, studies analyzing the proportion of medical graduates applying for neurosurgical residency programs relative to overall specialty program demand and trends over time are particularly scarce for low- and middle-income countries, including Türkiye. In this cross-sectional research conducted in Türkiye, data from ten Medical Specialty Training Entrance Examinations between 2019 and 2023 were retrieved from the National Selection and Placement Center database. Neurosurgery residency filling rates were compared with both the overall rates for all specialties and those of selected surgical specialties. The repeated measures ANOVA test was performed to assess statistical significance. P < 0.05 was considered significant. The percentage of filled positions in neurosurgery residency programs in Türkiye has lagged far behind the average fill rate across all medical specialties (69% vs. 87%, respectively). Neurosurgery's recruitment challenges become even more apparent when compared to other surgical and non-surgical specialties on a specialty-by-specialty basis. For example, surgical fields, such as ENT and ophthalmology, as well as non-surgical fields, such as cardiology, psychiatry, and dermatology, achieved nearly 100% fill rates in almost every exam session, including during the peak of the COVID-19 pandemic (p < 0.001). The percentage of filled positions in neurosurgery residency programs in Türkiye has consistently lagged far behind the average fill rate across all medical specialties. Neurosurgery's recruitment challenges become even more concerning when assessed on a specialty-by-specialty basis.