262 Identifying Disparity in the Subspecialty of Neurotrauma

INTRODUCTION: Traumatic brain injuries (TBI’s) are a growing problem in the United States. The US census suggests a rise in TBIs between 2014 and 2021. It is unknown whether the neurosurgical subspecialty of Neurotrauma is rising to meet this need. METHODS: We queried publicly available records from CDC, TBI surveillance reports, AANS online directory, AMA and Society of Neurological Surgeons data. We then assessed the geographic distribution of the number of self-identified Neurotrauma specialists relative to the number of level 1 trauma centers reported. RESULTS: We identified a total of 203 Level I trauma centers and 205 level lI trauma centers. A query of the AANS online directory revealed 166 Neurotrauma subspecialists. Our findings suggest that there were 23 states with a lower than expected ratio of level I trauma centers to the reported number of self–identified Neurotrauma subspecialities, i.e. (1:1). Approximately 160 Neurosurgeons graduate every year and about 2.5% (4) begin a fellowship in Neurotrauma. There are currently 5 CAST approved Neurotrauma fellowship programs. To address the discrepancy between the number of trauma centers and numbers of dedicated Neurotrauma neurosurgeons, 37 additional Neurotrauma subspecialists would be needed. Maintaining the current recruitment rate into Neurotrauma fellowships, ∼10 years will be needed to address this discrepancy without accounting for retirements, specialists leaving the field, or growth in the number of trauma centers. CONCLUSIONS: There is a disparity in number and geographic distribution of Neurotrauma neurosurgeons. Measures should be considered to increase interest and retention in the Neurotrauma subspecialty.