Comparison of opportunities and perceptions towards neurosurgery between the public and private sector in Pakistan: a national survey of medical students and recent graduates.

Public and private medical institutes must adhere to the same standards of quality set by the Pakistan Medical & Dental Council (PMDC). However, studies have noted varied learning environments. The current study aims to assess opportunities and compare the differences in perceptions between the two sectors. An online survey was conducted among medical students, interns, and medical officers across Pakistan. Respondents were divided into two groups: private and public sector and the survey responses of the two groups were compared. Descriptive statistical analyses of responses were performed, and a chi-square test was used to obtain the p-values. 2,481 responses were collected (48.6% public vs 51.3% private sector). A higher proportion of public sector respondents reported neurosurgery within their curriculum (71.2% public, 58.9% private) ( p < 0.001), while a greater proportion of private sector respondents had less exposure to neurosurgery clerkships (58.5% public, 71.9% private). A higher proportion from the private sector reported that sufficient mentorship opportunities (38.3% private, 29.5% public) (p < 0.001) were provided by their medical college. More private sector respondents reported lack of work-life balance (39.5% public, 42.4% private), competitive work environment (55.9% public, 61.3% private) (p < 0.001) and financial burden (67.3% private, 60.8% public) (p < 0.001) as major barriers towards pursuing neurosurgery. Our study outlines key areas for improvement from the perspective of the learners themselves. These include increasing exposure to neurosurgery in medical colleges and affiliated hospitals and improving post-graduate training among all sectors. Addressing these concerns of the medical students, interns, recent graduates and medical officers can foster the pursuit of neurosurgery as a career in Pakistan. It is crucial to further investigate medical education in Pakistan and study differences in the public and private education sector globally.