Fellowship Training Trends Among Spine Neurosurgeons in Florida: A Cross-Sectional Analysis

Introduction: Neurosurgical fellowships to obtain additional surgical training after residency are a career option widely available to the newer generation of neurosurgeons. This study aims to analyze current trends in fellowship training among spine neurosurgeons in Florida and factors that influence the choice of fellowship based on year, location, and academic trajectory. Methods: This retrospective cross-sectional study collected demographic data and bibliometric information on neurosurgeons specializing in spine, comparing those with fellowship training and those without. The information was gathered from the American Association of Neurological Surgeons and the Florida Department of Health databases. Results: A total of 113 spine-specialized neurosurgeons with active medical licenses were identified in the state of Florida at the time of this study in 2026. A proportion (23.53%; n = 12) of Florida-based spine neurosurgeons obtained their fellowship training in Florida, most commonly at the University of Miami/Jackson Health System. Out of a total of 113, only two (1.77%) spine neurosurgeons are female, and four (3.54%) have osteopathic doctoral degrees (D.O.). In 1960-1964 and 1975-1979, none (n = 0) had completed a spine fellowship, while 33.33% (n = 1) had done so in 1970-1974. The proportion was 28.57% (n = 2) in 1980-1984 and 16.67% (n = 2) in 1985-1989. An overall increase was observed in subsequent years: 23.53% (n = 4) in 1990-1994, 47.83% (n = 11) in 1995-1999, 50.00% (n = 4) in 2000-2004, 62.50% (n = 5) in 2005-2009, and 75.00% (n = 6) in 2010-2014. The highest percentage was observed in 2015-2019 at 73.33% (n = 11), followed by 66.67% (n = 6) in 2020-present. Conclusion: Over the past 60+ years, there has been an increase in the number of Florida-based spine neurosurgeons pursuing fellowship training, with the highest percentage seen in those graduating from 2015-2019. However, there is still a low representation of female and osteopathic spine neurosurgeons in Florida. This growing trend of spine-specialization highlights a potential shift in neurosurgery career trajectories and has important implications for future workforce planning and patient care in spine surgery.