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Neurosurg Focus. 2018 Oct;45(4):E17. doi: 10.3171/2018.7.FOCUS18288.

Neurosurgical digital teaching in low-middle income countries: beyond the frontiers of traditional education.

Author information

Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano (MI).
Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele (MI), Italy.
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge.
NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom; and.
World Federation of Neurosurgical Societies, Nyon, Switzerland.



Neurosurgical training is usually based on traditional sources of education, such as papers, books, direct surgical experience, and cadaveric hands-on courses. In low-middle income countries, standard education programs are often unavailable, mainly owing to the lack of human and economic resources. Introducing digital platforms in these settings could be an alternative solution for bridging the gap between Western and poor countries in neurosurgical knowledge.


The authors identified from the Internet the main digital platforms that could easily be adopted in low-middle income countries. They selected free/low-cost mobile content with high educational impact.


The platforms that were identified as fulfilling the characteristics described above are WFNS Young Neurosurgeons Forum Stream, Brainbook, NeuroMind, UpSurgeOn, The Neurosurgical Atlas, Touch surgery, The 100 UCLA Subjects in Neurosurgery, Neurosurgery Survival Guide, EANS (European Association of Neurosurgical Societies) Academy, Neurosurgical.TV, 3D Neuroanatomy, The Rhoton Collection, and Hinari. These platforms consist of webinars, 3D interactive neuroanatomy and neurosurgery content, videos, and e-learning programs supported by neurosurgical associations or journals.


Digital education is an emerging tool for contributing to the spread of information in the neurosurgical community. The continuous improvement in the quality of content will rapidly increase the scientific validity of digital programs. In conclusion, the fast and easy access to digital resources could contribute to promote neurosurgical education in countries with limited facilities.


EANS = European Association of Neurosurgical Societies; ETV = endoscopic third ventriculostomy; FIENS = Foundation for International Education in Neurological Surgery; LMIC = low-middle income country; LMICs; NETS = Neurosurgery Education and Training School; NREF = Neurosurgery Research and Education Foundation; UN = United Nations; WFNS = World Federation of Neurosurgical Societies; digital neurosurgical learning; e-learning; global neurosurgery; networking; simulation


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