In Reply: Education and Training in Global Neurosurgery: The Quest for Diversity and Equitable Collaborations

To the Editor: We thank Ji Shi et al, for their interest and attentive analysis1 of our paper titled “Education and training in Global Neurosurgery: The quest for diversity and equitable collaborations.2 We read with great interest on China's experience in neurosurgical education, and it is striking how many similarities exist in different regions of the world. What resonates clearly is how standardizing neurosurgical training can be a powerful tool to achieving health equity for our patients. This ensures that each resident has equal exposure to training opportunities for sufficient time to produce a high-caliber neurosurgeon. The centralization of neurosurgical training programs in China is commendable; similarly, Sub-Saharan Africa has moved toward a similar trend by offering regional training programs such as the College of Surgeons of East, Central, and Southern Africa; Colleges of Medicine of South Africa; and the West African College of Surgeons.3,4 The aim would be to consolidate and ensure that such programs are the only conduits to specialist training similar to the systems used by our colleagues in the West. The urban vs rural disparities in training mentioned by Ji Shi et al are a critical barrier to which the global neurosurgical community is primed to tackle.1 As we highlighted in our paper, we can no longer operate in silos, it is our responsibility to improve neurosurgical care in all regions of the globe. The first step would be using education as a vehicle for health equity, and as Ji Shi et al has eloquently put “prioritizing, equity, accessibility, and innovation,”1 the appropriate use of intercontinental collaborations aimed at strengthening educational capacity at an intracontinental level.