2025 Proffered Presentations
S135: CAREER TRAJECTORY FOR NEUROSURGICAL SKULL BASE FELLOWS: 2019 - 2023
Fatima Gauhar, Dr; Rida Bonday; Harika S Koduru; Robert J Dambrino IV, Dr; Lola B Chambless, Dr; Patrick D Kelly, Dr; Vanderbilt University Medical Center
Introduction: There has been a notable increase in skull-base fellowships nationally, with over 50 identified on the North American Skull Base Society (NASBS) website. However, it remains unclear whether this rise in fellowship programs has been matched by increased job opportunities within the skull base specialty, raising the question of whether graduates of these fellowships are employed in related fields. This cross-sectional study aims to assess the career outcomes of neurosurgery skull-base fellowship graduates.
Methods: Neurosurgery skull base fellowship programs were identified using the ‘Skull Base Fellowship Registry’ on the North American Skull Base Society (NASBS) website (n = 56). Fellows who graduated between 2019 and 2023 were included. Fellowships that did not exist nationally, were not skull base (for example, endonasal/rhinology, cerebrovascular surgery, head and neck oncology), or had no enrolled fellows between 2019 and 2023 were excluded (n = 20). Data on prior training and subsequent employment was collected via web search.
A descriptive analysis of the fellowship program details and fellows was performed. All analyses were conducted using STATA Corp 18.0. This study did not require ethical approval.
Results:
Fellowship Programs
The NASBS Skull Base Fellowship Registry included 56 programs as of July 7, 2024 (https://www.nasbs.org/fellowship-registry/), of which 36 (64.3%) met the inclusion criteria and were included. 11 programs (30.6%) were CAST accredited for skull base fellowships, 6 programs (16.6%) were CAST accredited for neuro-oncology fellowships, and 8 (22.2%) were CAST accredited for both. About two-thirds of the programs participated in the skull base fellowship match (n = 23, 63.9%). Detailed information is presented in Tables 1 and 2.
Participating in Skull Base Match was significantly associated with higher odds of having a privademic job. CAST accreditation was not significantly associated with higher odds of working in an academic skull base position (Table 3).
Fellow Details
40.6% (n = 73) of the fellows' current jobs were in skull base surgery. 14.1% (n = 18) of the fellows practiced at the same institution where they completed their neurosurgical fellowship, while 15.8% (n = 20) practiced where they completed their residency. 26% (n = 33) completed a prior fellowship, and 22% (n = 28) completed a future fellowship after the ones recorded in this five-year duration. At least one-third of skull base fellows for each year were currently in an academic position (mean per year: 31.7%, n = 11), and at least 40% were in a skull base position (mean per year: 40.6%, n = 15). Data for individual years from 2019 – 2023 have been presented in Table 4.
This study's limitation is that the data was collected through web searches. To certify its accuracy, fellowship directors need to corroborate this data.
Conclusion: Approximately one-third of skull base fellows who graduated between 2019 and 2023 are currently in academic positions, and about 40% practice in the skull base specialty. Further research may elucidate the factors influencing the decision to pursue or not pursue a career in this subspecialty, potentially highlighting a gap in employment opportunities.
