In Reply: Costs of Academic Engagement in Organized Neurosurgery in the United States

To the Editor: The authors enjoyed reading the commentary from Mitre and Chandra regarding our recent manuscript.1 Their considerations about costs of engagement in organized neurosurgery offer unique contributions to an ongoing dialogue.2 The authors highlight the stark disparity between costs of engagement for traditional avenues to Continuing Medical Education (CME) with those of virtual settings. They offer literature supporting downsides of virtual CME, including decreased financial revenue and questionable information legitimacy. We understand that financial burden is only one of many considerations when engaging in academic neurosurgery, as in-person engagement offers multifactorial benefits that may be worth the cost. The authors present three potential solutions to address inequities in these costs. First, they suggest virtual engagement as a standard. This would expand access to scientific exchange that is paramount to informing modern neurosurgical practice. Second, they propose tiered and transparent pricing models, which are often present on society websites, and may allow attendees to allocate their budget across an academic year more appropriately. Last, they suggest the development of equity-focused scholarships, which may increase representation at national meetings from neurosurgeons from low-middle income countries. We appreciate the ongoing dialogue provided by Mitre and Chandra surrounding costs of academic engagement in organized neurosurgery. We believe that the benefits of in-person academic discourse at leading neurosurgery meetings are critical to advance our field. Our manuscript, in addition to discourse provided in such commentary, may continue the conversation as to how we may best promote neurosurgical scholarship and collaboration in an accessible and sustainable manner.