724 Population Per State Served by a Neurosurgery Resident: A National Review

INTRODUCTION: Neurosurgery residency remains challenging, with 7-years of post-graduate training offered at only 116 locations. It's typically the longest route to board certification of all surgical and medical specialties, yet its programs often consist of the smallest cohorts. Furthermore, the breadth of pathology and populations served by each neurological residency varies significantly. METHODS: Doximity residency “navigator” was used to query total residency programs that entered the 2022-2023 match cycle. U.S. state populations were collected from World Population Review Census January 2023. States were arranged from highest to lowest by census population. Each state population was divided by the NS resident positions in that state. The population per resident (PPR) were compared. RESULTS: California and Wyoming contained the largest and smallest state populations, respectively at 40,223,504 and 580,817. Vermont was the smallest state to contain a NS program with a population of 648,279 and 7 residency positions or roughly 92,611 PPR. California comparatively contained 151 positions or 266,381 PPR. Interestingly, New York and Florida each contain roughly 21 million people, yet they respectively contained 115,527 and 354,909 PPR. In total 65% of residents served between 127,920 to 306,528 people depending on the state. CONCLUSIONS: There is a wide range in the number of people served by each NS resident throughout the USA. Neurological Surgery residencies are not located uniformly by population and patients are free to travel across state boundaries. Currently the ACGME determines program expansion and creation by uniform specialty specific standards. Our data presents a new lens for discussing maximization of training opportunities across the continental United States.