Perceptions and Likelihood of Medical Students to Pursue a Career in Neurosurgery: Findings from the Philippines.

BACKGROUND: The number of neurosurgeons in the Philippines is less than ideal for its population, so there is a need to recruit and train more. This study aimed to determine medical students' perception of neurosurgery and their likelihood of pursuing a career in this specialty. METHODS: A cross-sectional survey was conducted of medical students in the Philippines to assess their perceptions and likelihood of pursuing a career in neurosurgery. Data obtained were analyzed using descriptive statistics and a χ2 test with a significance level of 0.05. RESULTS: A total of 627 medical students completed the survey, with a response rate of 72.4%. The mean age was 23.8 years, and almost half (49.1%) were women. They had mostly negative perceptions of neurosurgery, and only 18.7% were likely to pursue a career in this specialty. Reasons included poor work-life balance, poor understanding of neuroscience and neurosurgery, and the self-perceived lack of manual dexterity. The most common sources of their perceptions included lectures, movies, and neurosurgery residents and consultants whom they met in hospital. Previous exposure to neurosurgery lectures or rotations, going back to their hometown to work, and having a physician parent were associated with a higher likelihood of pursuing neurosurgery. CONCLUSIONS: Our study showed that medical students' perceptions of neurosurgery were generally negative and that only 18.7% were likely to pursue it as a career. Major changes would have to be made to improve students' perceptions to attract more students to the field and increase the neurosurgical workforce.

Hydranencephaly: Clinical Features and Survivorship in a Retrospective Cohort.

OBJECTIVE: Hydranencephaly is a congenital central nervous system disorder characterized by the complete or near-complete absence of the cerebral cortex and basal ganglia. Because of its rarity, data on the clinical features and survivorship remain sparse. We aim to determine the clinical features and survivorship of a cohort of patients with hydranencephaly. METHODS: We performed a retrospective cohort study of all patients diagnosed with hydranencephaly at our institution from 2008 to 2018. Data on demographics, clinical features, presence of comorbidities, surgical operations performed, and status on last follow-up were collected. Survival curves were generated using Kaplan-Meier analysis. RESULTS: Fifty patients were included in the cohort, who had a median age at diagnosis of 4 months and a female predilection. The most common clinical manifestations were macrocephaly (92%) and seizures or myoclonic movements. Infection was present in 36% of cases, endocrinopathies in 22%, dysmorphisms in 20%, and cardiac disease in 8%. Twenty patients underwent shunt insertion, with half developing a postoperative complication at a mean follow-up of 14.9 months. The median survival of the cohort was not reached at 7.5 years. Among the patients with follow-up, characteristics were similar between the surgical and nonsurgical groups, except for the greater incidence of infections in the nonsurgical group. The survival curves among the groups were significantly different, with a hazard ratio of 3.731 in the nonsurgical group. CONCLUSIONS: In this large single-center retrospective cohort of patients with hydranencephaly, novel findings are presented regarding the clinical manifestations and survivorship of this condition.