SURG-68. Clinical landscape and perception of surgical neuro oncology among neurosurgical resident trainees of Pakistan: a nationwide analysis

Abstract BACKGROUND AND OBJECTIVE For the development of surgical neuro-oncology program in Pakistan, it is essential to evaluate the current neuro-oncological landscape. The neurosurgical residents can play a major role in identifying the areas of improvements and strengths. We aimed to assess the neurosurgical residents’ perspectives on surgical neuro-oncology practices in Pakistan. METHODOLOGY A nationwide cross-sectional survey was conducted among neurosurgery residents by Punjab Institute of Neurosciences, Pakistan. A structured questionnaire assessing knowledge, training, mentorship, and institutional support in surgical neuro-oncology was disseminated via Google Forms. Data collection took place from January 15 to March 31, 2025, across both public and private sector training institutes. Responses were analyzed using SPSS, with categorical variables presented as frequencies and percentages and continuous variables as means with standard deviations. RESULTS A total of 100 residents responded, with 94% from public sector hospitals and 80% from Punjab. While 90% rated their knowledge of brain and spinal tumors as good or excellent, only 67% felt confident interpreting imaging studies. Notably, 33% had received no formal training in surgical neuro-oncology. Exposure to spinal cord tumor surgeries was limited, with only 14% having participated in such procedures. Mentorship and interdisciplinary collaboration were inadequate; only 20% reported access to dedicated neuro-oncology mentors, and just 12% rated interdepartmental collaboration as excellent. Resources were considered limited or insufficient by 69% of respondents. Despite these challenges, 84% supported the establishment of a dedicated neuro-oncology fellowship, and 67% expressed definite interest in pursuing such training. CONCLUSION While the majority of residents demonstrated enthusiasm and self-reported strong theoretical knowledge, substantial gaps were identified in hands-on experience, formal training, mentorship, and access to specialized resources, particularly in spinal neuro-oncology. Limited interdisciplinary collaboration and insufficient institutional support further hinder comprehensive skill development. National-level reforms are essential to align with global standards in surgical neurooncological education and care.