Consultant and trainee perspectives on endoscopic spine surgery training in Australia: A cross-sectional survey

BACKGROUND: Endoscopic spine surgery (ESS) is expanding, but training access and educational preferences in Australia remain underexplored. We surveyed consultants and trainees/fellows to identify priorities for ESS education. METHODS: A 17-item cross-sectional online survey was circulated through an Endoscopic Spine Society of Australia (ESSA) professional group and an informal neurosurgical trainee network. Responses were summarised by cohort (consultants and trainees/fellows), and between-cohort comparisons were exploratory. RESULTS: Forty-five surgeons responded (27 consultants, 18 trainees/fellows); 35 (77.8%) were neurosurgical. Twenty-six consultants (96.3%) had performed ESS independently, whereas no trainee/fellow had done so. Lack of access to trained mentors (73.3%) and limited training/observation opportunities (71.1%) were the leading barriers. Support for curricular integration was high (mean 4.44/5). Cadaveric training (57.8%), live observation (55.6%), fellowship-style training (48.9%), and proctored cases (48.9%) were the most preferred formats. Most consultants (55.6%) viewed microscopic proficiency as beneficial but not mandatory; the most common trainee/fellow response (44.4%) was that ESS skills can be learned in parallel or independently. Most respondents in each cohort favoured starting training at or before Surgical Education and Training (SET) 1-3 (consultants 51.9%, trainees/fellows 66.7%), and 72.2% of trainees/fellows wished to learn both uniportal and biportal techniques equally. CONCLUSION: Respondents, predominantly ESS-experienced consultants and neurosurgical trainees/fellows, identified mentorship and training opportunities as shared priorities and supported structured ESS education. Their preferences inform a proposed staged pathway combining early exposure, practical training, and supervised clinical experience, which requires evaluation in broader samples.