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Online sessions offer less face-to-face and hands-on time in comparison with physical conferences and symposia. As such, they cannot be a substitute to in-person and hands-on experiences but they are and should be complements. ResearchAfrican residents and young neurosurgeons equally face significant challenges in research. While it is true that the contribution of Africa to global neurosurgical research has increased over the past two decades, it still has a long way to go (29). One of the barriers to African neurosurgical research is protected time.
These webinars facilitate education, peer mentorship, and collaboration among participants. Telesimulation is a good complement to hands-on courses. It reduces geographical barriers but cannot substitute hands-on lab courses. It is unlikely that every African neurosurgical center will have all the necessary resources in the near future. In the meantime, these centers must leverage inter-African partnerships and collaborations with non-African institutions to tackle the challenges to research and education that we have identified. The partnerships between LMIC and high-income institutions must be based on equity and have frequent monitoring and evaluation (41, 42).
Protected time is indispensable for the development of neurosurgeon-scientists (30). Most American residency programs encourage their residents to pursue research activities. Most American residents have a year or more of protected research time (31). Similarly, 45. 0% of residents in Latin America are enrolled in a program with protected research time (32). These figures contrast starkly with 29. 5% of residents in Africa who have protected research time. In addition, 65.
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9%) (Table 3). Most participants reported hands-on courses as their preferred method of training (91. 1%), 80 respondents preferred personal attendance (71. 4%), and less than half (44. 6%) chose web-based lectures. Table 3Perceived barriers to day-to-day practice. BarrierFrequency (Percentage)Inadequate or no insurance coverage63 (56. 3)Limited number of trained neurosurgeons57 (50. 9)Limited number of neurosurgical beds52 (46. 4)Limited number of ICU beds81 (72. 3)Lack of access to equipment necessary for microsurgery67 (59. 8)Lack of regular/consistent access to CT19 (17. 0)Lack of regular access to MRI45 (40. 2)Lack of organized primary care46 (41. 1)Lack of organized pre-hospital/emergency hospital care60 (53.
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All authors contributed to the article and approved the submitted version. Conflict of InterestThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. AcknowledgmentsSincere appreciation to all members of the WFNS and CAANS Young Neurosurgeons forums that responded to the survey. References1. Santos MM, Qureshi MM, Budohoski KP, Mangat HS, Ngerageza JG, Schöller K, et al.. The growth of neurosurgery in east Africa: Challenges. World Neurosurg.
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Residency programs and professional societies in high-income countries offer dissection labs to their residents and young neurosurgeons but 89. 3% of African residents and neurosurgeons did not have dissection labs at their home institutions. The cost of dissection labs can be prohibitive for LMIC neurosurgical centers and, in effect, constitutes a barrier to the training of neurosurgeons.
Countries represented in the e-survey and the number of respondents per country. Sixty-six (58. 9%) were from lower-middle-income countries, and 63 (56. 3%) were from Sub-Saharan Africa. Ninety-eight (87. 5%) respondents were male, 79 (70. 5%) were aged between 30 and 40 years, and 52 (46. 4%) were neurosurgery residents. Although 76 respondents (67. 9%) worked in a university teaching hospital, only 33 (29. 5%) declared being paid to do clinical work and research.
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