Akshitkumar M. Mistry, Nishant Ganesh Kumar, Rebecca A. Reynolds, Andrew T. Hale, John C. Wellons, Robert P. Naftel

To quantify the proportion of academic neurosurgeons in the United States (U.S.) who acquired residency training outside of the U.S. and compare their training backgrounds and academic success to those who received their residency training in the U.S. We identified 1338 clinically-active academic neurosurgeons from 104 programs that participated in the neurosurgery residency match in the U.S. from January to February 2015. Their training backgrounds, current academic positions, and history of NIH grant awards from 2005-2014 were retrieved from publicly-accessible sources. Eighty-four U.S. academic neurosurgeons (6.3%) received their residency training in 20 different countries outside of the U.S./Puerto Rico, representing all major regions of the world. The majority had trained in Canada (n=48). No major difference was noted between the foreign-trained and U.S.-trained neurosurgeons in their male to female ratio, year of starting residency, proportion with positions in medical schools ranked in the top 15 by the U.S. News and World Report, general distribution of academic positions, proportion with an NIH grant. Compared to U.S.-trained, foreign-trained academic neurosurgeons had significantly more Ph.D. degrees (32.1% vs. 12.3%; p<0.0001) and held more associate professor positions (34.5% vs. 23.1%; p=0.02). The academic practices of the foreign-trained neurosurgeons were distributed throughout many states in the U.S. There is a small group of the U.S. academic neurosurgeons (6.3%) who have acquired residency training outside of the U.S., representing all major regions of the world. Their general demographics and academic successes are comparable to U.S.-trained neurosurgeons.