Analysis of perceptions regarding career prospects and professional barriers in neurosurgery among generation Z

Introduction. The generational shift in the higher medical education system highlights the need to study the career expectations and professional preferences of Generation Z, whose members constitute the majority of students and early-career specialists.

The aim. To analyze the perception of neurosurgery as a specialty among Generation Z as a direction for further professional choice, assessing attitudes, motivational factors, expectations, and perceived barriers.

Materials and methods. An online survey was conducted among 149 respondents (4–6th-year students, residents, postgraduate students, general practitioners, and early-career neurosurgeons). The questionnaire consisted of 23 items covering sociodemographic characteristics, factors influencing the choice of neurosurgery, barriers, expectations from professional activity, as well as engagement with social media and innovative technologies.

Results. It was found that 48 % of students consider neurosurgery as a potential career path. The key motivating factors are the uniqueness of surgical procedures (78.5 %), the diversity of subspecialties (58.9 %), and the technological nature of the profession. The main barriers include psychosocial factors (responsibility, risk of burnout), and among residents – paperwork (51 %) and a lack of mentorship (44.8 %). A high demand was identified for international internships (87 %), rotations, and financial support during training. High levels of engagement with social media (76.4 %) and use of artificial intelligence (75.7 %) were recorded.

Conclusion. The data obtained in the study demonstrate the need for active modernization of educational programs, taking into account the value orientations of the new generation. Priority areas should include: developing mentorship systems, integrating active rotations and internships into the curriculum, reducing documentation burdens, and introducing digital technologies into simulation-based training.

1. Bikhatova ET. Characteristics of Generation Z medical students as a basis for developing readiness to work with Artificial Intelligence in future professional practice. Scientific Notes of P.F. Lesgaft University. 2026; 2(252): 202-212. (In Russ.). https://doi.org/10.5930/1994-4683-2026-2-202-211

2. Mingazova EN, Sadykova RN, Bezymyannyy AS, Mingazov RN. «Generation Z» in medicine: The problem of burnout in the early stages of professional activity. Bulletin of Semashko National Research Institute of Public Health. 2025; (3): 149-153. (In Russ.). https://doi.org/10.69541/NRIPH.2025.03.001

3. Motov S, Stienen MN, Stengel FC, Schwake M, Schuss P, Ridwan S. Exploring perspectives and boundaries in neurosurgical career pathways for generation Z in German-speaking countries. Brain Spine. 2025; 5: 104382. https://doi.org/10.1016/j.bas.2025.104382

4. Ozhiganova EM. The theory of generations by N. Howe and V. Strauss. Possibilities of practical application. Business Educ Knowl Econ. 2015; 1(1): 94-97.

5. Amelicheva DV, Semenova EA, Belova OR, Tikhanov NE. Values and career preferences of Generation Z: Economic changes expected from the younger generation. Bulletin of the Academy of Knowledge. 2021; 6(47): 24-30. (In Russ.).

6. Sevastyanova NV, Proshchaev KI, Ilnitsky AN, Mokicheva NA, Lokinskaya LS, Shaposhnikova MYu. Ageism patterns in generation Z cohort in the context of soft skill development as exemplified by medical students. Cardiovascular Therapy and Prevention. 2023; 22(3S): 3766. (In Russ.). https://doi.org/10.15829/1728-8800-2023-3766

7. Klimo P Jr, DeCuypere M, Ragel BT, McCartney S, Couldwell WT, Boop FA. Career satisfaction and burnout among U.S. neurosurgeons: A feasibility and pilot study. World Neurosurg. 2013; 80(5): e59-e68. https://doi.org/10.1016/j.wneu.2012.09.009

8. Rodrigues H, Cobucci R, Oliveira A, Cabral JV, Medeiros L, Gurgel K, et al. Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS One. 2018; 13(11): e0206840. https://doi.org/10.1371/journal.pone.0206840

9. Zaed I, Jaaiddane Y, Chibbaro S, Tinterri B. Burnout among neurosurgeons and residents in neurosurgery: A systematic review and meta-analysis of the literature. World Neurosurg. 2020; 143: e529-e534. https://doi.org/10.1016/j.wneu.2020.08.005

10. Cherebillo VYu, Kovalenko RA, Solntsev VN. Assessment of life quality and job satisfaction of neurosurgeons in the Russian Federation (a sociological study). Burdenko’s Journal of Neurosurgery. 2018; 82(2): 5-16. (In Russ.). https://doi.org/10.17116/oftalma20188223-16

11. Zhou AY, Panagioti M, Esmail A, Agius R, Van Tongeren M, Bower P. Factors associated with burnout and stress in trainee physicians: A systematic review and meta-analysis. JAMA Netw Open. 2020; 3(8): e2013761. https://doi.org/10.1001/jamanetworkopen.2020.13761

12. Entezami P, Franzblau LE, Chung KC. Mentorship in surgical training: A systematic review. Hand (N Y). 2012; 7(1): 30-36. https://doi.org/10.1007/s11552-011-9379-8

13. Thakur A, Fedorka P, Ko C, Buchmiller-Crair TL, Atkinson JB, Fonkalsrud EW. Impact of mentor guidance in surgical career selection. J Pediatr Surg. 2001; 36(12): 1802-1804. https://doi.org/10.1053/jpsu.2001.28842

14. Pavlova II, Nazarova EA. Human resource management in Russian healthcare: An analysis of the “brain drain” problem. Modern Trends in Management, Economics, and Entrepreneurship: From Theory to Practice: Proceedings of the III All-Russian Scientific and Practical Conference with International Participation (Ulyanovsk, November 11–13, 2025). Cheboksary; 2025: 212-215. (In Russ.). https://doi.org/10.31483/r-151735

15. Kovalenko RA, Cherebillo VYu, Mukhitova YuV, Isayeva ER, Kurnukhina MYu, Chemurzieva FA, bet al. Sexism in Russian neurosurgery. Bulletin of Neurology, Psychiatry and Neurosurgery. 2021; (6): 475-486. (In Russ.). https://doi.org/10.33920/med-01-2106-07

16. Shortell CK, Cook C. Importance of gender-specific role models in vascular surgery. Vascular. 2008; 16(3): 123-129. https://doi.org/10.2310/6670.2008.00024

17. Omerhodzic I, Tonge M, Matos B, Musabeliu E, Raspanti C, Ferdinandov D, et al. Neurosurgical training programme in selected European countries: From the young neurosurgeons’ point of view. Turk Neurosurg. 2012; 22(3): 286-293. https://doi.org/10.5137/1019-5149.JTN.5133-11.0

18. Zakondyrin DE. Legal aspects of the employment and work of trainee physicians and mentor physicians in the field of neurosurgical care. Medical Law. 2024; (3): 35-39. (In Russ.).

19. Alekseeva MG, Zubov AI, Novikov MYu. Artificial intelligence in medicine. International Research Journal. 2022; 7-2(121): 10-13. (In Russ.). https://doi.org/10.23670/IRJ.2022.121.7.038

20. Reyes JS, Lohia VN, Almeida T, Niranjan A, Lunsford LD, Hadjipanayis CG. Artificial intelligence in neurosurgery: A systematic review of applications, model comparisons, and ethical implications. Neurosurg Rev. 2025; 48(1): 455. https://doi.org/10.1007/s10143-025-03597-9

21. Iop A, El-Hajj VG, Gharios M, de Giorgio A, Monetti FM, Edström E, et al. Extended reality in neurosurgical education: A systematic review. Sensors (Basel). 2022; 22(16): 6067. https://doi.org/10.3390/s22166067