title: A critical analysis of the current state of neurosurgery training in Pakistan.
abstract: OBJECTIVE
  To observe interdepartmental variation in the availability of resources and academic activities within the various neurosurgery programs of Pakistan.
  
  
  METHODS
  This was a proforma-based survey of neurosurgery trainees and young neurosurgeons of Pakistan, looking at the academic infrastructure and output of their programs. The proforma was filled by 36 respondents from 11 neurosurgery centers of the country. All these centers were accredited for neurosurgery training in Pakistan.
  
  
  RESULTS
  Out of the 36 respondents, 30 were completing a Fellowship training (FCPS) and six were enrolled for a Master in Surgery (MS) program. About 80% of the participants used the Youman's Textbook of Neurosurgery as a reference book. Only 40% of the candidates had access to more than one indexed neurosurgery journal. Structured academic sessions (e.g., journal clubs and neuropathology meetings) were lacking in a majority of the training institutes, 95% of the trainees had no microsurgical laboratory experience, and modern neurosurgical tools (frameless neuronavigation system, neuroendoscopy) were in use at a few centers only.
  
  
  CONCLUSIONS
  Neurosurgery training in Pakistan is not uniform and wide variations exist between the programs at the centers evaluated. We recommend exchange programs between centers at national and international levels, to allow trainees to gain first-hand exposure to training components not available in their own center.
authors.affiliation: Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: M Shahzad
authors.initials: MS
authors.lastname: Shamim
authors.forename: M Zubair
authors.initials: MZ
authors.lastname: Tahir
authors.forename: Saniya Siraj
authors.initials: SS
authors.lastname: Godil
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Arshad Ali
authors.initials: AA
authors.lastname: Siddiqui