Letter: A Novel Neurosurgery Virtual Interest Group for Disadvantaged Medical Students: Lessons Learned for the Postpandemic Era

To the Editor: The coronavirus disease-19 (COVID-19) pandemic has had a deleterious impact on medical students interested in neurosurgery, most notably from cancellation or curtailment of clinical rotations.1,2 Despite this, these challenges led to novel innovations for training future neurosurgeons.3 This comes with a dedicated effort to recruit highly talented and diverse populations to the specialty.4,5 Here, we report our experience starting a novel multi-institutional neurosurgery virtual interest group (VIG) for medical students who may have had difficulty engaging with neurosurgery otherwise during the pandemic. Although we feel this program was a success, there were lessons learned which can inform future VIGs even after the pandemic subsides. The inaugural Neurosurgery Education and Research Group (NERG) was started in July 2020. We placed an emphasis on recruiting potential members who were in their preclinical years and were primarily considering a career in neurosurgery, did not have a home neurosurgery residency program, and/or identified with an under-represented group in subspecialty medicine. Meeting content was driven by 5 competency domains: clinical knowledge, technical skills, professional development, research skills, and applied mentorship. We also conducted 6 journal clubs, where members and invited attendings or residents could give presentations, as well as held research “lab” meetings to update projects. After the academic calendar year, we conducted a brief anonymized postparticipation survey of our members to assess their perceptions of VIG quality and curricula. Questions were asked in binary or modified Likert format (1 – worse; 5 – improved). This survey was evaluated by the Colorado Multiple Institutional Review Board and was determined to be exempt from review as a category 1 project, and subsequently sent to members in May 2021. Written informed consent to participate and for publication was obtained by all survey members. All materials and data are deidentified to protect anonymity and privacy standards. There were 18 inaugural members, 16 (89%) of whom did not have a home neurosurgery residency program. A total of 13 members responded to the survey, with 7 (54%) female and 5 (38.5%) non-White race (2 Black, 2 Asian, and 1 Pacific Islander). All were first-generation medical students. Ten (77%) were in their preclinical years (MS1/MS2) and 7 (54%) planned to pursue a neurosurgery career (the other 6 were also interested in various other surgical subspecialties or neurology). All members had at least some previous research experience. After 10 mo of VIG participation, 9 (69%) reported that their neurosurgery clinical knowledge improved, 10 (77%) reported that their competency in professional development improved (ie, progressing through medical school, creating a Curriculum Vitae), 10 (77%) reported that their competency in academic understanding improved (ie, preparation for exams and clinical rotations), 11 (85%) reported that their competency and interest in research improved (ie, study design, statistics, and research writing), 10 (77%) reported that their involvement improved their engagement with neurosurgery research and education during the COVID-19 pandemic, and 11 (85%) reported that their feelings of preparation for residency improved. Eleven (85%) had published, presented, or submitted a research item because of the group, with 6 projects under review or finished by the time of the survey. Twelve (92%) felt that the level of mentorship was adequate. Seven (54%) members were more likely to pursue neurosurgery as a career after their VIG participation and 12 (92%) stated they would recommend VIGs to a colleague. We also surveyed perceptions of VIG programming. Ten (77%) preferred a mix of virtual and in-person programming while 3 (23%) preferred only virtual. None preferred in-person only. Research skills training and output, mentorship facilitation, and professional development were the 3 most cited competencies to prioritize in future VIG curricula. For those who wish to initiate or join such groups, we have several recommendations to optimize the experience: (1) facilitate mentorship through shared goals and projects rather than through facilitated relationships; (2) prospectively identify faculty and resident champions who can provide research and clinical expertise; (3) incentivize members to conceptualize their own research ideas; (4) emphasize participation from student groups across multiple institutions which are at a disadvantage (ie, those without home programs or American Association of Neurological Surgeons student chapters or socioeconomically) or who are under-represented in neurosurgery (ie, women or Black and Hispanic students); (5) have rising MS4s or research fellows lead the group and encourage active participation among members; and (6) focus primarily on research skills training (ie, study design, scientific writing, and statistics) and professional career development (ie, how to perform on rotations or board preparation) over clinical knowledge and technical skills. We also suggest that participants come from the same time zone and coordinate with their institutions to provide subscriptions to professional video conferencing and sponsored educational content. The pandemic has spurred numerous innovations and utilization of the virtual space. Neurosurgery is among the leaders in this move and our experience suggests that VIGs and remote-based research collaboration and mentorship facilitation have a role in future medical student education. Indeed, previous studies have observed that interest groups improve recruitment to neurosurgery and that scholarly activity is related to residency candidacy success.6,7 We have preliminarily observed that VIGs or combined in-person/virtual groups can adequately provide remote learning, mentorship, and research collaboration, while recruiting medical students to neurosurgery, especially those from disadvantaged or under-represented backgrounds. Whether such programs improve match outcomes is yet to be determined. Funding This study did not receive any funding or financial support. Disclosures Michael Kortz and Edwin McCray are the founders and leaders of the NERG VIG.