Neurosurgery aspirants in UK medical schools: a national cross-sectional analysis of demographics, motivations, and confidence (FAST study)

Neurosurgery is among the most competitive specialties in the UK, yet national data on who aspires to it and why are limited. Using the FAST study, we compared medical students who selected neurosurgery with peers choosing other specialties, examining demographics, extracurricular activity, certainty, confidence, and knowledge of the training pathway. Secondary analysis of the FAST cross-sectional survey of UK medical students conducted December 2023 to March 2024. Responses were collected via an online questionnaire covering demographics, education, extracurricular activity, certainty, confidence, knowledge of training pathways, and factors influencing specialty choice. We compared neurosurgery aspirants with the remaining cohort using descriptive statistics and logistic regression to estimate odds ratios with 95% confidence intervals. Bonferroni corrections were applied where appropriate. Of 8,395 respondents, 212 students selected neurosurgery as their preferred specialty (2.53%). Interest declined sharply with seniority, from 4.5% of first-year students to 0.6% of final-year students. Compared with the national cohort, aspirants were more often male and from non-White ethnic groups. Private schooling was more frequent 29.7% vs 26.0% but not significant. Aspirants reported greater certainty about career choice (OR 2.43, p < 0.0001) and higher self-reported knowledge of the neurosurgery pathway. Confidence in securing a training post was low (20.8% confident) and the odds of low confidence were higher than the national cohort adjusted OR 1.37, p = 0.04. Males reported higher knowledge 67.3% vs 42.7% in females and greater confidence. Factors more strongly associated with choosing neurosurgery included intellectual challenge (OR 2.56, p < 0.0001), research opportunities (OR 4.07, p < 0.0001), and interest in specific conditions (OR 3.12, p < 0.0001). Lifestyle considerations were less influential than in peers: work-life balance (OR 0.33, p < 0.0001), compatibility with family life (OR 0.37, p < 0.0001), and job stress (OR 0.41, p < 0.0001). Despite high levels of certainty and pathway knowledge, neurosurgery aspirants reported low confidence in securing a training post, with marked gender and socioeconomic disparities. Interest declines steeply with seniority, suggesting that early enthusiasm often fades due to limited exposure and perceived inaccessibility. Targeted early interventions, including early and sustained exposure, and visible mentorship, may help ensure informed, sustained interest among those best suited to the field.

Authors

Institutions

Publication Details

Journal
BMC Medical Education
Published
2026-03-13
DOI
https://doi.org/10.1186/s12909-026-08845-0
Primary Topic
Diversity and Career in Medicine
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Neurosurgery aspirants in UK medical schools: a national cross-sectional analysis of demographics, motivations, and confidence (FAST study)

Sakshi Roy, Farah Ahmed, Bethany Mcdermott, Rida Khan et al.
BMC Medical Education
Diversity and Career in Medicine
article

Neurosurgery aspirants in UK medical schools: a national cross-sectional analysis of demographics, motivations, and confidence (FAST study)

Sakshi Roy, Farah Ahmed, Bethany Mcdermott, Rida Khan, Ananya Jain, India Barrons, Amelia Dickson, Daniel Chalk, Olivia Rowe, Bilal Mazhar Qureshi, Jonathan Craven, Kavyesh Vivek, Gregory Rowland, Oliver Y. Feng, Michael E. Bryan, Maisha Hayat, Shereen M. Ahmad, Ben Sweeney, Olivia King, Aleksandra Dunin-Borkowska, Samantha Burley, Tommy Wai Kei Li, Alexa McCloskey, Anushka Gurunath Pujari, Tushar Rakhecha, Daniel Magee, Samuel Foxcroft, Tessa Yuk Lan Yau, Suki Ali, Jessica Sinyor, Andreas Stavrinou, Meghna Sreekumar, Medha Pillaai, Ioan Valnarov-Boulter, Mairi Docherty, Anjali Cyril, Sydney LA Barnes, Anna Collins, Sakshi Garg, Ms. Khyatee Shah, Shama Maliha, Yasmin Owadally, Maeve K. Mulchrone, Leah Njenje, Sara Kidher, Mia Mäntylä, Emily R. Finbow, Vera Onongaya, James A. Cairn, Tan Jit Yih, Vaishvi Dalal, Luke Dcaccia, Hannah Layton-Joyce, Chiamaka Anthony-Okeke, Tawfique Rizwan, Catherine L. Otoibhi, Matilda MA Gardener, Anson Wong, Manuel Giardino, James Brawn, Ayeza Akhtar, Malvi Shah, Hugo Bernie, Katie Appleton, Sophie Kidd, Brandon S. H. Low, Sudhanvita Arun, Jack M. Read, Joseph R. Nicholson, Muhammed Asif, Cameron Thurlow, Safa Razzaq, Alfaiya Hashmi, Pranjil Pokharel, Leya Luhar, Urja Ashish Mhatre, Hesham Zalghana, Sushmhitah Sandanatavan, Tomas Ferreira, Rivya Mathews, Louis Naraine, Alexander M. Collins, Jui Kanetkar, Mayisha Samiha, Molly Doyle, Rachelle Thevathas, Humaira Khanom, Subham Roy, Vyom Patel, Saimathusan Sivakandarajah, Harini Elankhumaren, Mackenzie F Garlick, Lydia Melaku, Emily Carver, Fariha Hasan, Ahamed Hafeezul Nashith Ahamed Rizwaan, Elliot Skittrall, Soo Sun Chong, Chloe Milton, Sundaramoorthy Balasubramanian, Freya F Semple, Rosemary M Davis, Heather A Lewis, Dev Ranka, Nabilah Ali, Ryan White, Rhiannon Tanner, Aryan A Sagdeo, Anhukrisha Karthikeyan, Ibrahem Al-Obaidi, Guilherme Movio, the FAST Collaborative, Daria Maria Bageac, Hannah Bolton, Lubana Hemayet, Sharon Yuen Shan Ho, Timo L Kuerten, Aaliyah J Bax, Michael Y Luo, Sourab Chand Surana, Ajwa Fayaz, Flora E MacInnes, Sewa A Badejo, Saarah Saanan Khan, Megan Fallows, Shiksha Guru, Artemis Prevot, Adam Mohamed Capdevila, Hsuan-Tung Kuo, Abderrahmane El Guernaoui, Ellena K Briggs, Khadijah Khan, Dora Pascoe, Jessica Lo, Krishnika Vetrivel, Iliyah Shahbeik, Pakhi Goel, Harsh Sai Modalavalasa, Nikita Sanctis, Ashleigh Stirling, Basma R Khan, Rakeem Khalid Basith, Laura AE Munn, Emma Marsh, Yasmin Al-Rawi, Ali Hamed Mahmood Al-Nakeeb, Momina Iqbal, Kajoke M S Avolonto, Muhammad Hamza Shah, Maia C Letts, Mohammed Suhaib Amin, Mathumetha Rubaratnam, Carys M. Francis, Ishagit Kaur, Raghad A F Sallama, Muaawiyah Shaheen, Nidhi Sachidananda, Riya Patel, Madison Gill, Alyssa Weissman, Louis R Dowland, Erin Fitzsimons-West, Zoe Mary Constantinou, Ria Bhatt, Beray Berkay, Hannah Glover-Adams, Sophie West, Zulaikha Bibi, Phoebe Hatrick, Lily Chadwick, David Gringras
article en

Abstract

Neurosurgery is among the most competitive specialties in the UK, yet national data on who aspires to it and why are limited. Using the FAST study, we compared medical students who selected neurosurgery with peers choosing other specialties, examining demographics, extracurricular activity, certainty, confidence, and knowledge of the training pathway. Secondary analysis of the FAST cross-sectional survey of UK medical students conducted December 2023 to March 2024. Responses were collected via an online questionnaire covering demographics, education, extracurricular activity, certainty, confidence, knowledge of training pathways, and factors influencing specialty choice. We compared neurosurgery aspirants with the remaining cohort using descriptive statistics and logistic regression to estimate odds ratios with 95% confidence intervals. Bonferroni corrections were applied where appropriate. Of 8,395 respondents, 212 students selected neurosurgery as their preferred specialty (2.53%). Interest declined sharply with seniority, from 4.5% of first-year students to 0.6% of final-year students. Compared with the national cohort, aspirants were more often male and from non-White ethnic groups. Private schooling was more frequent 29.7% vs 26.0% but not significant. Aspirants reported greater certainty about career choice (OR 2.43, p < 0.0001) and higher self-reported knowledge of the neurosurgery pathway. Confidence in securing a training post was low (20.8% confident) and the odds of low confidence were higher than the national cohort adjusted OR 1.37, p = 0.04. Males reported higher knowledge 67.3% vs 42.7% in females and greater confidence. Factors more strongly associated with choosing neurosurgery included intellectual challenge (OR 2.56, p < 0.0001), research opportunities (OR 4.07, p < 0.0001), and interest in specific conditions (OR 3.12, p < 0.0001). Lifestyle considerations were less influential than in peers: work-life balance (OR 0.33, p < 0.0001), compatibility with family life (OR 0.37, p < 0.0001), and job stress (OR 0.41, p < 0.0001). Despite high levels of certainty and pathway knowledge, neurosurgery aspirants reported low confidence in securing a training post, with marked gender and socioeconomic disparities. Interest declines steeply with seniority, suggesting that early enthusiasm often fades due to limited exposure and perceived inaccessibility. Targeted early interventions, including early and sustained exposure, and visible mentorship, may help ensure informed, sustained interest among those best suited to the field.

BMC Medical Education
St Thomas' Hospital (GB), University of Bristol (GB), St. Thomas Hospital (CA), London School of Economics and Political Science (GB)
Openalex Percentile: Top 40%
Diversity and Career in Medicine
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.