Neurosurgery is a specialized medical discipline focused on the diagnosis and surgical treatment of conditions affecting the central and peripheral nervous systems, including the brain, spinal cord, and spinal column. This demanding field addresses complex disorders, such as traumatic brain injuries, spinal degeneration, brain tumors, and aneurysms. Understanding the current count, distribution, and demographics of these specialists is important for public health planning to ensure the United States healthcare system can meet the growing needs of its population.
The Current Number of Practicing Neurosurgeons
Current estimates indicate there are approximately 5,258 patient-care practicing neurosurgeons in the United States, excluding those in residency or other non-patient-facing roles. This figure measures the active surgical workforce available to treat the nation’s patients. This small number of specialists translates to a ratio of roughly one neurosurgeon for every 65,580 people in the US population. Historically, workforce analysis suggested a ratio of one neurosurgeon per 100,000 people, but the actual ratio has consistently been higher. The total pool of neurosurgeons, including those in administration, research, or teaching roles, is slightly larger, nearing 6,000 individuals.
How Neurosurgery Workforce Data is Tracked
Tracking the neurosurgical workforce relies on data collected by authoritative medical bodies and professional organizations. The American Board of Neurological Surgery (ABNS) maintains records on physicians who have completed the certification process. This certification provides one measure of the available workforce.
Professional groups, such as the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), also track their membership, representing over 4,000 neurosurgeons in the US. Additionally, organizations like the American Medical Association (AMA) collect broader data on all practicing physicians, categorizing them by specialty and practice status. Analyzing these data sets, which differentiate between certified physicians and those actively engaged in patient care, is essential for accurate workforce assessment.
Geographic Distribution and Access to Care
The distribution of neurosurgeons across the United States is uneven, creating disparities in patient access to care. Neurosurgeons typically cluster in major urban centers and academic medical hubs, which have high population density and specialized hospital resources. This concentration leaves many rural and underserved areas with shortages, often forcing patients to travel long distances for necessary procedures.
This maldistribution negatively impacts health outcomes, as patients in low-density areas may experience increased wait times for non-emergent procedures. A shortage of neurosurgeons also affects trauma care, as these specialists handle emergent neurosurgical issues in trauma centers. The ratio of neurosurgeons to the population varies dramatically by state.
Demographics of the Neurosurgery Workforce
Gender Distribution
Neurosurgery remains one of the most male-dominated medical specialties. Women currently represent approximately 10% of the total practicing neurosurgical workforce nationally. This low representation exists despite women accounting for over half of all medical school students in the US.
There is a trend toward increased female representation within the training pipeline. Recent data show that the proportion of women in neurosurgery residency programs is increasing, with female residents comprising between 21.5% and 29.8% of the total resident population. Projections estimate that the female share of the neurosurgical workforce may reach 30% by 2039.
Age and Retirement Trends
The neurosurgical workforce is facing an age shift, often called the “graying” of the profession, which raises concerns about future supply. The average age of physicians is over 51 years old, and a large segment of the current neurosurgical workforce is nearing retirement age. As of 2020, over 56% of neurosurgeons had been in practice for more than 20 years.
An estimated two in five physicians are expected to reach retirement age within the next decade. This wave of retirements creates a substantial demand for new surgeons to enter the field to maintain the current workforce size and address growing patient need. Burnout, which can be high in this specialty, may also accelerate early retirement for some practitioners.
Racial and Ethnic Diversity
The neurosurgical field struggles with a lack of racial and ethnic diversity, lagging behind the demographics of the overall US population. White and Asian individuals make up the majority of practicing neurosurgeons, accounting for approximately 64.5% and 21% of the workforce, respectively.
Underrepresented in medicine (URIM) groups, including Black, Hispanic, and Native American individuals, are underrepresented compared to their proportion in the US population. For example, Black individuals represented 3.8% of all active neurosurgeons in 2018. Similarly, within the resident workforce, Black and Latinx individuals account for 4.8% and 5.8% of the total, respectively. This lack of diversity can hinder efforts to reduce healthcare disparities and may contribute to a lack of trust among diverse patient populations.
The Neurosurgery Training Pipeline and Future Supply
Becoming a neurosurgeon requires four years of medical school followed by a residency that typically lasts seven years. The number of new neurosurgeons entering the workforce is controlled by the number of available residency positions. There are approximately 117 accredited neurosurgery residency programs in the US, collectively offering around 230 to 250 residency slots each year.
This limited capacity serves as a bottleneck for the future supply of neurosurgeons. Given projected retirement rates and increasing demand, the current rate of new graduates is insufficient to meet future workforce needs. Analysts project a deficit of up to 1,200 neurosurgeons by 2025, indicating the training pipeline is not expanding fast enough to compensate for the aging workforce and rising patient demand.
Factors Driving the Demand for Neurosurgical Services
The existing number of neurosurgeons is under pressure from demographic and technological forces that are increasing the demand for their specialized services. The most significant factor is the aging of the US population, as older individuals have a higher incidence of neurosurgical conditions. Conditions such as degenerative spine disorders, brain tumors, and traumatic subdural hematomas become more common with advancing age, directly increasing the need for surgical intervention.
Population growth is also a contributing factor, as a larger population inherently requires more medical services. Technological advances have expanded the scope of what is treatable by a neurosurgeon. Innovations like minimally invasive techniques, advanced neuroimaging, and robotic-assisted surgery allow a wider range of conditions to be treated surgically, increasing the overall demand for neurosurgical expertise.