Abstract
Background Pakistan has a significant proportion of medical graduates who intend to leave the
country for better opportunities abroad, leading to a brain drain. However, the push
and pull factors within neurosurgery remain unexplored, emphasizing the need for evaluation
to enact policy changes.
Materials and Methods We conducted a nationwide survey across 22 College of Physicians and Surgeons of
Pakistan accredited neurosurgery training centers in all provinces of Pakistan. SPSS
version 26 and STATA 15 were used for data analysis.
Results We collected responses from 120 neurosurgery trainees across Pakistan. Trainees were
categorized into two groups: those intending to leave (64%) and those intending to
stay (36%) in Pakistan. A significant association was observed between the availability
of fellowship training in the residents' hospital and the decision to leave or remain
in Pakistan (p = 0.034). About 67.5% of our respondents did not have any publication, and among
the intention to leave group, a greater percentage had academic involvement, when
compared with the stay group. A significant association (p = 0.012) was also observed between the decision to leave or remain in Pakistan and
the number of publications in nonindexed journals.
Conclusion There remains a need for improvement in the standard of training provided by neurosurgery
programs across the country. Our study found that disparities in research and academic
exposure, as well as the lack of fellowship opportunities, may serve as stimuli for
residents to leave Pakistan.
Keywords
migration intention - brain drain - trainees - fellowship - neurosurgery
