title: Unemployment in an underserviced specialty?: The need for co-ordinated workforce planning in Canadian neurosurgery.
abstract: BACKGROUND
  A recent report suggested that newly trained Canadian neurosurgeons are experiencing difficulty finding employment in Canada. Such occurrences, in combination with recent certification restrictions imposed in the US, have resulted in increasing concern that we will shortly be seeing a surplus of graduating neurosurgeons in Canada. The purpose of this study was to develop a better understanding of training and employment patterns in the Canadian neurosurgical workforce.
  
  
  METHODS
  Using a database provided by the Royal College of Physicians and Surgeons of Canada, the current practice location of recent (1990-2002) neurosurgical certificants and a list of all neurosurgeons practicing in Canada were generated. From these data the number of surgeons per 100,000 patient population, and the number of residents required to maintain this workforce were determined.
  
  
  RESULTS
  Practice location could be identified for 183/189 individuals who passed their qualifying examination in neurosurgery during this time. Only 45% of them are currently practicing in Canada. The current service ratio for this specialty is 0.65 per 100,000 population overall. Although 14.6 residents/year are being trained, only 6.5/year are required to maintain the existing neurosurgical workforce.
  
  
  CONCLUSIONS
  Our data supports the concern about an imminent employment crisis for young neurosurgeons in Canada with more than twice the required number of residents being trained. However, this shortfall of staff positions is at a time when the specialty may be underservicing the country's population. These results highlight the necessity for more cohesive workforce planning in Canada, and in particular, ensuring the appropriate balance between training and need.
authors.affiliation: Department of Surgery, Wilson Centre for Research in Education, Faculty of Medicine, University of Toronto, Toronto, ON.
authors.forename: S I
authors.initials: SI
authors.lastname: Woodrow
authors.forename: C
authors.initials: C
authors.lastname: O'Kelly
authors.forename: S J
authors.initials: SJ
authors.lastname: Hamstra
authors.forename: M C
authors.initials: MC
authors.lastname: Wallace
mesh_terms: D002170:Canada; D004651:Employment / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007396:Internship and Residency / Q000639:trends; D008507:Medically Underserved Area; D009313:National Health Programs / Q000458:organization & administration*; D009493:Neurosurgery / Q000193:education* / Q000639:trends; D011365:Professional Practice Location / Q000706:statistics & numerical data; D000078329:Workforce