Pediatric neurosurgery involves the complex medical and surgical care of children with conditions affecting their nervous system. Understanding the workforce in this highly specialized area provides insight into the accessibility of care for young patients across the nation.
Understanding Pediatric Neurosurgery
A pediatric neurosurgeon is a medical doctor extensively trained to diagnose, treat, and manage neurological conditions in children, from infancy through adolescence. This specialized training includes at least four years of medical school, a surgical internship, five or more years of residency training in neurological surgery, and additional fellowship training in pediatric neurosurgery.
These specialists treat a wide range of conditions affecting the brain, spine, and nerves in children. Common conditions include brain tumors and hydrocephalus, an excess of cerebrospinal fluid in the brain. They also address congenital abnormalities like spina bifida, where the spinal cord does not form properly, and craniosynostosis, a condition where a baby’s skull bones fuse prematurely. Additionally, they treat traumatic brain and spinal cord injuries, and certain types of epilepsy requiring surgical intervention.
Current Number of Pediatric Neurosurgeons in the US
As of May 2022, a study identified a total of 439 actively practicing pediatric neurosurgeons in the United States. This figure was compiled by cross-referencing membership logs from organizations like the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) with the National Plan and Provider Enumeration System (NPPES) National Provider Identifier (NPI) registry.
While the American Board of Pediatric Neurological Surgery (ABPNS) certifies pediatric neurosurgeons, the total number of board-certified individuals can fluctuate. Another study from 2019 estimated approximately 1,300 pediatric neurosurgeons practicing in the United States, which translates to about 4.2 pediatric neurosurgeons per million children. This variation in reported numbers can arise from different methodologies in identifying practitioners, such as including those who dedicate a substantial majority of their practice to pediatric patients versus only those formally board-certified by a specific pediatric neurosurgery board.
Geographic Distribution and Workforce Trends
The distribution of pediatric neurosurgeons across the United States is not uniform, leading to disparities in access to specialized care. A study from October 2023 indicated that 23 states, or 46.9% of states, had five or fewer pediatric neurosurgeons, with some states like North Dakota, Wyoming, and Nevada having none. This uneven distribution means that individuals in certain areas, particularly rural regions, may need to travel significantly farther for care.
For instance, the average person in a “surgeon desert”—a county with significantly fewer providers—was found to be 189.2 miles away from the nearest pediatric neurosurgeon, compared to 39.7 miles in “surgeon clusters.” Higher Rural-Urban Continuum codes and greater percentages of American Indian and Hispanic residents were independently linked to counties where individuals traveled further for access.
The workforce also faces challenges influenced by generational shifts, with younger neurosurgeons potentially anticipating earlier retirement and having lower case volumes compared to older cohorts. The demand for specialized pediatric care continues to grow, yet the number of fellowship-trained pediatric neurosurgeons seeking full-time positions has sometimes outpaced the availability of suitable roles, often due to insufficient patient volume to support a dedicated pediatric practice.