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Background <p>Neurosurgery is among the most competitive specialties in the UK, yet national data on who aspires to it and why are limited. Using the FAST study, we compared medical students who selected neurosurgery with peers choosing other specialties, examining demographics, extracurricular activity, certainty, confidence, and knowledge of the training pathway.</p> Methods <p>Secondary analysis of the FAST cross-sectional survey of UK medical students conducted December 2023 to March 2024. Responses were collected via an online questionnaire covering demographics, education, extracurricular activity, certainty, confidence, knowledge of training pathways, and factors influencing specialty choice. We compared neurosurgery aspirants with the remaining cohort using descriptive statistics and logistic regression to estimate odds ratios with 95% confidence intervals. Bonferroni corrections were applied where appropriate.</p> Results <p>Of 8,395 respondents, 212 students selected neurosurgery as their preferred specialty (2.53%). Interest declined sharply with seniority, from 4.5% of first-year students to 0.6% of final-year students. Compared with the national cohort, aspirants were more often male and from non-White ethnic groups. Private schooling was more frequent 29.7% vs 26.0% but not significant. Aspirants reported greater certainty about career choice (OR 2.43, <i>p</i> &lt; 0.0001) and higher self-reported knowledge of the neurosurgery pathway. Confidence in securing a training post was low (20.8% confident) and the odds of low confidence were higher than the national cohort adjusted OR 1.37, <i>p</i> = 0.04. Males reported higher knowledge 67.3% vs 42.7% in females and greater confidence. Factors more strongly associated with choosing neurosurgery included intellectual challenge (OR 2.56, <i>p</i> &lt; 0.0001), research opportunities (OR 4.07, <i>p</i> &lt; 0.0001), and interest in specific conditions (OR 3.12, <i>p</i> &lt; 0.0001). Lifestyle considerations were less influential than in peers: work-life balance (OR 0.33, <i>p</i> &lt; 0.0001), compatibility with family life (OR 0.37, <i>p</i> &lt; 0.0001), and job stress (OR 0.41, <i>p</i> &lt; 0.0001).</p> Conclusion <p>Despite high levels of certainty and pathway knowledge, neurosurgery aspirants reported low confidence in securing a training post, with marked gender and socioeconomic disparities. Interest declines steeply with seniority, suggesting that early enthusiasm often fades due to limited exposure and perceived inaccessibility. Targeted early interventions, including early and sustained exposure, and visible mentorship, may help ensure informed, sustained interest among those best suited to the field.</p>

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Neurosurgery aspirants in UK medical schools: a national cross-sectional analysis of demographics, motivations, and confidence (FAST study)

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  • 发表日期：

    2026年3月13日

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  • Tomas Ferreira,
  • Alexander M. Collins,
  • Oliver Feng,
  • Megan Fallows,
  • Ioan Valnarov-Boulter,
  • Hsuan-Tung Kuo,
  • Aryan A Sagdeo,
  • Bethany McDermott,
  • Michael Y Luo,
  • Anson Wong,
  • Erin Fitzsimons-West,
  • Sharon Yuen Shan Ho,
  • Lubana Hemayet,
  • Meghna Sreekumar,
  • Samantha Burley,
  • Andreas Stavrinou,
  • Heather A Lewis,
  • Hugo Bernie,
  • Olivia Rowe,
  • Catherine L Otoibhi,
  • Dora Pascoe,
  • Leya Luhar,
  • Rakeem Khalid Basith,
  • Mayisha Samiha,
  • Tushar Rakhecha,
  • Mia Mäntylä,
  • Molly Doyle,
  • Chiamaka Anthony-Okeke,
  • Basma R Khan,
  • Safa Razzaq,
  • Malvi Shah,
  • Ryan White,
  • Brandon S H Low,
  • Olivia King,
  • Flora E MacInnes,
  • Yasmin Al-Rawi,
  • Hannah Layton-Joyce,
  • Manuel Giardino,
  • Maisha Hayat,
  • Anjali Cyril,
  • Rivya Mathews,
  • Ashleigh Stirling,
  • Adam Mohamed Capdevila,
  • Laura AE Munn,
  • Sara Ali,
  • Zulaikha Bibi,
  • Mackenzie F Garlick,
  • Lily Chadwick,
  • Bilal Qureshi,
  • Fariha Hasan,
  • Zoe Mary Constantinou,
  • Beray Berkay,
  • Daniel C Chalk,
  • Joseph Nicholson,
  • Sakshi Garg,
  • Jessica Sinyor,
  • Louis R Dowland,
  • Alfaiya Hashmi,
  • Freya F Semple,
  • Tan Jit Yih,
  • Dev Ranka,
  • Kajoke M S Avolonto,
  • Elliot Skittrall,
  • Madison Gill,
  • Ben Sweeney,
  • Ria Bhatt,
  • Humaira Khanom,
  • Jonathan Craven,
  • Harini Elankhumaren,
  • Hannah Glover-Adams,
  • Ishagit Kaur,
  • Maia C Letts,
  • Krishnika Vetrivel,
  • Hesham Zalghana,
  • Ananya Jain,
  • Anna Collins,
  • Sophie West,
  • Muhammed Asif,
  • Yasmin Owadally,
  • Urja Ashish Mhatre,
  • Nikita Sanctis,
  • Ahamed Hafeezul Nashith Ahamed Rizwaan,
  • Carys M. Francis,
  • Rida Khan,
  • Vaishvi Dalal,
  • Sundaramoorthy Balasubramanian,
  • Ayeza Akhtar,
  • Sudhanvita Arun,
  • Saimathusan Sivakandarajah,
  • Sourab Chand Surana,
  • Rosemary M Davis,
  • Daria Maria Bageac,
  • Ibrahem Al-Obaidi,
  • Daniel Magee,
  • Ali Hamed Mahmood Al-Nakeeb,
  • Katie Appleton,
  • Amelia Dickson,
  • Subham Roy,
  • Mohammed Suhaib Amin,
  • Sakshi Roy,
  • Tessa Yau,
  • Pakhi Goel,
  • Abderrahmane El Guernaoui,
  • David Gringras,
  • Soo Sun Chong,
  • Sara Kidher,
  • Aaliyah J Bax,
  • Rachelle Thevathas,
  • Ajwa Fayaz,
  • Cameron Thurlow,
  • Vera Onongaya,
  • Pranjil Pokharel,
  • Shama Maliha,
  • Phoebe Hatrick,
  • Rhiannon Tanner,
  • India R Barrons,
  • Louis Naraine,
  • Artemis Prevot,
  • Muaawiyah Shaheen,
  • Farah Ahmed,
  • Mathumetha Rubaratnam,
  • Michael E Bryan,
  • Harsh Sai Modalavalasa,
  • Sushmhitah Sandanatavan,
  • Aleksandra Dunin-Borkowska,
  • Kavyesh Vivek,
  • Anhukrisha Karthikeyan,
  • James Brawn,
  • Sophie Kidd,
  • Jack M Read,
  • Saarah Saanan Khan,
  • Gregory A Rowland,
  • Tawfique Rizwan,
  • Khyatee Shah,
  • Alexa McCloskey,
  • Nidhi Sachidananda,
  • Lydia Melaku,
  • Vyom Patel,
  • Alyssa Weissman,
  • Iliyah Shahbeik,
  • Maeve K Mulchrone,
  • Medha Pillaai,
  • Emily R Finbow,
  • Jessica Lo,
  • Jui Kanetkar,
  • Hannah Bolton,
  • Timo L Kuerten,
  • Leah Njenje,
  • Matilda Gardener,
  • Emily Carver,
  • Mairi C Docherty,
  • Nabilah Ali,
  • Shereen Ahmad,
  • Shiksha Guru,
  • Luke Dcaccia,
  • Guilherme Movio,
  • Anushka Pujari,
  • Sydney LA Barnes,
  • Tommy Wai Kei LI,
  • Khadijah Khan,
  • Riya Patel,
  • Momina Iqbal,
  • Samuel Foxcroft,
  • Sewa A Badejo,
  • Chloe Milton,
  • Ellena K Briggs,
  • Raghad A F Sallama,
  • Emma Marsh,
  • Muhammad Hamza Shah,
  • James A Cairn

摘要

Background

Neurosurgery is among the most competitive specialties in the UK, yet national data on who aspires to it and why are limited. Using the FAST study, we compared medical students who selected neurosurgery with peers choosing other specialties, examining demographics, extracurricular activity, certainty, confidence, and knowledge of the training pathway.

Methods

Secondary analysis of the FAST cross-sectional survey of UK medical students conducted December 2023 to March 2024. Responses were collected via an online questionnaire covering demographics, education, extracurricular activity, certainty, confidence, knowledge of training pathways, and factors influencing specialty choice. We compared neurosurgery aspirants with the remaining cohort using descriptive statistics and logistic regression to estimate odds ratios with 95% confidence intervals. Bonferroni corrections were applied where appropriate.

Results

Of 8,395 respondents, 212 students selected neurosurgery as their preferred specialty (2.53%). Interest declined sharply with seniority, from 4.5% of first-year students to 0.6% of final-year students. Compared with the national cohort, aspirants were more often male and from non-White ethnic groups. Private schooling was more frequent 29.7% vs 26.0% but not significant. Aspirants reported greater certainty about career choice (OR 2.43, p < 0.0001) and higher self-reported knowledge of the neurosurgery pathway. Confidence in securing a training post was low (20.8% confident) and the odds of low confidence were higher than the national cohort adjusted OR 1.37, p = 0.04. Males reported higher knowledge 67.3% vs 42.7% in females and greater confidence. Factors more strongly associated with choosing neurosurgery included intellectual challenge (OR 2.56, p < 0.0001), research opportunities (OR 4.07, p < 0.0001), and interest in specific conditions (OR 3.12, p < 0.0001). Lifestyle considerations were less influential than in peers: work-life balance (OR 0.33, p < 0.0001), compatibility with family life (OR 0.37, p < 0.0001), and job stress (OR 0.41, p < 0.0001).

Conclusion

Despite high levels of certainty and pathway knowledge, neurosurgery aspirants reported low confidence in securing a training post, with marked gender and socioeconomic disparities. Interest declines steeply with seniority, suggesting that early enthusiasm often fades due to limited exposure and perceived inaccessibility. Targeted early interventions, including early and sustained exposure, and visible mentorship, may help ensure informed, sustained interest among those best suited to the field.