Who Manages the Spine? A Survey of Senior Medical Students on Orthopedic vs Neurosurgery Roles

Abstract

Aim: Spine pathologies are a frequent source of clinical referrals and surgical intervention. However, medical students often perceive the roles of orthopedic surgeons and neurosurgeons in managing these conditions differently. To evaluate how senior medical students perceive orthopedic surgery and neurosurgery roles in spine care, and how prior clinical exposure influences their specialty preference across various spinal pathology scenarios. Methods: A cross-sectional survey was administered to 4th–6th year medical students. The questionnaire included 16 clinical spine scenarios, and students indicated which specialty they would refer to. Respondents were grouped based on clinical exposure: both orthopedic and neurosurgery rotations vs. neither. Chi-square tests were used to compare specialty preferences between groups. Results: Among 163 students, those with ortho-neuro rotations were significantly more likely to make referral decisions aligned with real-world clinical practice. For spinal fusion due to degenerative disc disease, 72.8% selected orthopedic surgery vs. 55.4% among those without exposure (p = 0.043). Similar differences were seen in other scenarios, including Scheuermann’s kyphosis (p = 0.007) and cervical tumors (p = 0.016). Conclusion: Clinical exposure meaningfully shapes students’ perceptions of specialty roles in spine surgery. Balanced, integrated teaching may improve referral accuracy and interspecialty understanding.

Keywords

• medical student
• spine surgery
• orthopedic surgery
• neurosurgery
• clinical rotations

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