Comparing neurosurgery training in Pakistan: a cross-sectional study of public and private institutions

Abstract Background Neurosurgical training in Pakistan differs between public and private institutions. This study aims to evaluate these differences, examining how the sector affects the quality and scope of medical education across the country. Methods A nationwide survey was conducted in Pakistan, covering 22 College of Physicians and Surgeons of Pakistan (CPSP) accredited training programs. We used convenience sampling with a validated questionnaire and analyzed data using STATA 17. Results The response rate was 98% with a mean age of 30.4 ± 4.1 years. 30.6% females and 69.4% males were from public institutions, and 22.7% females and 77.3% males from private. Trainees in both sectors had limited exposure to advanced subspecialties, including endovascular (53.1% public and 22.7% private) and deep brain stimulation (26.5% public and 22.7% private). Both sectors lacked publications in indexed journals, with 71.4% in the public and 50% in the private sector having none. Public sector trainees reported more hands-on experience and longer working hours than private. In the public sector, there were more live surgery workshops (56.1% vs. 31.8% in private) and neurosurgical conferences (83.7% vs. 72.7% in private). However, cadaveric workshops were significantly lacking (15.3% vs. 9.1% in private). Access to simulation-based modalities, including cranial (16.3% vs. 50.0% in private) was limited. Educational activities were similar in both sectors, including tumor board meetings, journal clubs, and case-based sessions. Half of the programs had a regular trainees’ evaluation system (50.0% public and 55.5% private), with a smaller proportion offering a fellowship program in the public sector (43.9% public and 63.6% private). Conclusion The findings highlight the importance of comprehensive training programs with diverse teaching methods. These insights provide a groundwork for improving neurosurgical training across different sectors.