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Operative Landscape at Canadian Neurosurgery Residency Programs

  • Michael K. Tso (a1), Ayoub Dakson (a2), Syed Uzair Ahmed (a3), Mark Bigder (a4), Cameron Elliott (a5), Daipayan Guha (a6), Christian Iorio-Morin (a7), Michelle Kameda-Smith (a8), Pascal Lavergne (a9), Serge Makarenko (a10), Michael S. Taccone (a11), Bill Wang (a12), Alexander Winkler-Schwartz (a13), Tejas Sankar (a5) and Sean D. Christie (a2)...

Abstract

Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Methods: Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Results: Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. Conclusions: This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

Panorama canadien des interventions réalisées dans le cadre des programmes de résidence en neurochirurgie. Contexte: La littérature scientifique manque à l’heure actuelle de données fiables en ce qui regarde le nombre d’interventions réalisées dans le cadre des programmes de résidence en neurochirurgie. Notre objectif est ici de présenter un aperçu de cette question au moyen de données du Canadian Neurosurgery Research Collaborative, organisation dirigée par des médecins résidents. Méthodes: Du 1er janvier au 31 janvier 2014, nous avons collecté des données administratives anonymes au sein de chaque programme de résidence en neurochirurgie. De façon générale, l’ensemble des interventions chirurgicales a été réparti en interventions crâniennes, en interventions de la colonne vertébrale, en interventions des nerfs périphériques et en interventions diverses. Nous avons aussi consigné un certain nombre d’interventions préétablies propres à diverses sous-spécialités. Le rapport entre le nombre d’opérations effectuées et le nombre de médecins résidents en neurochirurgie nous a permis de définir l’indice des cas se rapportant aux médecins résidents. À noter que les effectifs du programme de résidence incluaient à la fois des diplômés canadiens en médecine et des titulaires d’un diplôme en médecine délivré à l’étranger. Tant les médecins résidents des services de neurochirurgie que ceux étant absents ou en congé pour mener des recherches ou pour d’autres motifs personnels ont été inclus. Résultats: Au total, on a observé une moyenne de 1845 interventions par programme. Le nombre moyen d’interventions crâniennes, de la colonne vertébrale, des nerfs périphériques et d’interventions diverses a été respectivement de 725, 466, 48 et 193. À l’échelle pancanadienne, l’indice des cas se rapportant aux médecins résidents dans le cas d’interventions crâniennes, de la colonne vertébrale, des nerfs périphériques et d’interventions diverses a été respectivement de 90, 58, 5 et 196. On a aussi pu observer une certaine variation de cet indice en ce qui concerne les interventions spécifiques se rapportant à des sous-spécialités, certains programmes ne procédant pas, par exemple, à des endartériectomies carotidiennes ou à des interventions endoscopiques par voie trans-sphénoïdale. Conclusions: Cette étude a donc voulu présenter l’étendue de la formation offerte dans les programmes canadiens de résidence en neurochirurgie. À un moment où, sous l’impulsion du Collège royal des médecins et chirurgiens du Canada, ces programmes sont en train d’évoluer vers un curriculum axé sur les compétences, il se pourrait que nos conclusions soient utiles à leur mise en œuvre.

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Copyright

Corresponding author

Correspondence to: Michael Tso, Division of Neurosurgery, University of Calgary, Foothills Medical Centre, 1403 29 St. NW, Calgary, AB T2N 2T9. Email: michael.k.tso@gmail.com

References

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