Background: The American Board of Neurological Surgeons (ABNS) made persons beginning neurosurgical training in Canada after 1997 ineligible for ABNS board exams and certification in the United States (US). We set out to track employment outcomes for graduates who are “ABNS ineligible.” Methods: Graduates from Canadian neurosurgical programs who began training from 1998 to 2008 (ABNS ineligible) were followed regarding their employment status (n=143). Data was obtained from public-domain websites and direct connections though Canadian Neurosurgical Society (CNSS) members. Association between pursuit of research during residency (MSc, PhD, or ≥ 2 years of non-degree research) and full employment was determined by Fisher’s exact test. Results: 60% and 26% of graduates currently have full-time staff positions in Canada and the US, respectively. “Underemployment,” defined as failure to secure a full-time position in neurosurgery despite a desire to do so (including locums, additional fellowship positions, unemployment and career changes) is currently seen in 12% of graduates, with 20% having been underemployed at some point within 5 years of graduation. Pursuit of research during residency was significantly associated with obtaining full employment (94% vs. 73%, p=0.011). Conclusions: Underemployment is a significant issue in recent neurosurgical graduates from Canadian training programs. Research training during residency appears strongly associated with obtaining full employment.