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Neurological Surgery Manpower Training and Density in Islamic Republic of Iran: A Population Study Publisher Pubmed



Aarabi B1 ; Tabatabaei SM2 ; Farrokhi MR3 ; Khalili H4 ; Nejat F5 ; Samini F6 ; Akhtardanesh N7
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, United States
  2. 2. Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Tehran, Iran
  3. 3. Department of Neurosurgery, Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Department of Neurosurgery, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5. Department of Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
  7. 7. School of Nursing, McMaster University, Hamilton, Ontario, Canada

Source: Neurosurgery Published:2025


Abstract

BACKGROUND AND OBJECTIVES: Significant disparities in worldwide neurosurgical training and workforce distribution are prominent primarily in low-income and middle-income countries. Although Iran is considered a lower middle-income country, neurosurgical density and distribution in Iran has surpassed the recommended ratio of 1 neurosurgeon for every 100 000 population. The objective was to determine neurological surgery density and distribution in Iran and the factors significant in the relative success in training and allocation of neurosurgeons in Iran. METHODS: Review of PubMed and administration of site surveys of multiple data sources including Neurosurgical Society of Iran, Iranian Board of Neurological Surgery, Medical Council of Islamic Republic of Iran, Universities of Medical Sciences in Iran, and Ministry of Health and Higher Education of Iran. RESULTS: Over the 72-year period from 1952 to 2024, 1200 neurosurgeons have been trained and distributed in 31 provinces in Iran, attaining a ratio of 1.4/100 000 population. All but 40 neurosurgeons were trained after 1981, which coincided with the Iran-Iraq War. Decentralization of medical and neurosurgical residency training programs, resolving the immediate need for neurosurgeons managing penetrating traumatic brain and spinal cord injuries during the 1980 to 1988 Iran-Iraq War, and active participation of legislative and executive branches of government in solving health care disparities were major factors in meeting the needs of the country. At the present time, more than 555 neurosurgeons are practicing in Tehran Province, a proportion of 3.8 neurosurgeons for every 100 000 population, which indicates an element of disparity in density distribution across Iranian land. CONCLUSION: Legislative initiatives and government support of public health care delivery and decentralization of medical and residency training programs after the Iran-Iraq War and introduction of the Ministry of Health and Medical Education are considered the main reasons for the relative success in meeting the neurosurgical demand and manpower density. Still, further adjustment of distribution of manpower is needed. Copyright © Congress of Neurological Surgeons 2024. All rights reserved.