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Surgical Activity of First-Year Canadian Neurosurgical Residents

Published online by Cambridge University Press:  23 September 2016

Aria Fallah ,
Shanil Ebrahim ,
Faizal Haji ,
Christopher Gillis ,
Fady Girgis ,
Kathryn Howe ,
George M. Ibrahim ,
Julia Radic ,
Mehdi Shahideh  and
M. Christopher Wallace
Aria Fallah*
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto
Shanil Ebrahim
Affiliation:
Institute of Medical Science, University of Toronto, Toronto
Faizal Haji
Affiliation:
Division of Neurosurgery, University of Western Ontario, London, ON
Christopher Gillis
Affiliation:
Division of Neurosurgery, University of British Columbia, Vancouver, BC
Fady Girgis
Affiliation:
Division of Neurosurgery, University of Calgary, Calgary, AB
Kathryn Howe
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto
George M. Ibrahim
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto
Julia Radic
Affiliation:
Division of Neurosurgery, Dalhousie University, Halifax, NS, Canada
Mehdi Shahideh
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto
M. Christopher Wallace
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto
*
Division of Neurosurgery, The Hospital for Sick Children, 555 University Avenue, Suite 1503, Toronto, Ontario, M5G 1X8, Canada
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Abstract:

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Introduction:

Surgical activity is probably the most important component of surgical training. During the first year of surgical residency, there is an early opportunity for the development of surgical skills, before disparities between the skill sets of residents increase in future years. It is likely that surgical skill is related to operative volumes. There are no published guidelines that quantify the number of surgical cases required to achieve surgical competency. The aim of this study was to describe the current trends in surgical activity in a recent cohort of first-year Canadian neurosurgical trainees.

Methods:

This study utilized retrospective database review and survey methodology to describe the current state of surgical training for first-year neurosurgical trainees. A committee of five residents designed this survey in an effort to capture factors that may influence the operative activity of trainees.

Results:

Nine out of a cohort of 20 first-year Canadian neurosurgical trainees that began training in July of 2008 participated in the study. The median number of cases completed by a resident during the initial three month neurosurgical rotation was 66, within which the trainee was identified as the primary surgeon in 12 cases. Intracranial hemorrhage and cerebrospinal fluid diversion procedures were the most common operations to have the trainee as primary surgeon.

Conclusion:

Based on this pilot study, it appears that the operative activity of Canadian first-year residents is at least equivalent to the residents of other studied training systems with respect to volume and diversity of surgical activity.

Résumé

RésuméContexte:

L'activité chirurgicale est probablement la composante la plus importante de la formation en chirurgie. La première année de résidence en chirurgie constitue une occasion de développer des habiletés chirurgicales tôt au cours de la formation, avant que les disparités entre les habiletés des résidents n'augmentent avec les années. Il est vraisemblable que les habiletés chirurgicales sont liées au volume chirurgical. Il n'existe pas de lignes directrices publiées qui quantifient le nombre de cas chirurgicaux requis pour parvenir à la compétence en chirurgie. Le but de cette étude était de décrire les tendances actuelles concernant l'activité chirurgicale dans une cohorte récente de résidents canadiens en neurochirurgie au cours de leur première année de formation.

Méthodologie:

Nous avons procédé à une revue rétrospective d'une base de données et à une enquête pour décrire la situation actuelle de la formation en chirurgie chez les résidents de première année en neurochirurgie. Un comité composé de cinq résidents a conçu cette enquête afin d'identifier les facteurs qui pourraient influencer l'activité chirurgicale des résidents.

Résultats:

Neuf de 20 résidents canadiens en neurochirurgie qui ont commencé leur formation en juillet 2008 ont participé à cette étude. Le nombre médian de cas complétés par un résident pendant les 3 premiers mois de la rotation en neurochirurgie était de 66, dont 12 cas au cours desquels le résident était identifié comme étant le chirurgien principal. Les types les plus fréquents d'interventions au cours desquelles le résident était identifié comme le chirurgien principal étaient des interventions pour hémorragie intracrânienne et des dérivations du liquide céphalorachidien.

Conclusion:

Selon cette étude préliminaire, il semble que l'activité chirurgicale des résidents canadiens au cours de leur première année de formation est équivalente à celle de résidents participant à d'autres programmes de formation quant au volume et à la diversité de l'activité chirurgicale.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 6 , November 2010 , pp. 855 - 860
Copyright
Copyright © The Canadian Journal of Neurological 2010

References

1. Mateo-Sierra, O, Delgado, P, Cancela, P, Fernandez-Carballal, C. Surgical activity by Spanish residents in neurosurgery under the training programme in place since 1984 and changes to be implemented under the new training programme. Acta Neurochir (Wien). 2005 Apr;147(4):449–56; discussion 456.10.1007/s00701-004-0459-115627920Google Scholar
2. RCPSC [homepage on the Internet]. Specific standards of accreditation for residency programs in neurosurgery. [updated 2006 Aug 6; cited 2009 Nov 22]; Available from: http://rcpsc.medical.org/residency/accreditation/ssas/neuros_e.html. Google Scholar
3. Long, DM. Competency-based residency training: the next advance in graduate medical education. Acad Med. 2000 Dec;75(12):1178–83.10.1097/00001888-200012000-0000911112714Google Scholar
4. Long, DM. Competency-based training in neurosurgery: the next revolution in medical education. Surg Neurol. 2004 Jan;61(1):5–14; discussion 25.10.1016/j.surneu.2003.08.01914706356Google Scholar
5. Wadey, VM, Dev, P, Buckley, R, Walker, D, Hedden, D. Competencies for a Canadian orthopaedic surgery core curriculum. J Bone Joint Surg Br. 2009 Dec;91(12):1618–22.19949127Google Scholar
6. Bosc, C. Report to the Society of Neurological Surgeons annual meeting. Pasadena, California; 1999.Google Scholar
7. Reulen, HJ, Marz, U. 5 years experience with a structured operative training programme for neurosurgical residents. Acta Neurochir (Wien). 1998;140(11):1197–203.10.1007/s0070100502379870068Google Scholar
8. Lindsay, KW. Neurosurgical training in the United Kingdom and Ireland: assessing progress and attainment. Neurosurgery. 2002 May;50(5):1103–11; discussion 11–13.11950414Google Scholar
9. Desbiens, R, Elleker, MG, Goldsand, G, et al. Current educational issues in the clinical neurosciences. Can J Neurol Sci. 2001 Nov;28(4):299–308.11766773Google Scholar
10. Woodrow, SI, Bernstein, M, Wallace, MC. Safety of intracranial aneurysm surgery performed in a postgraduate training program: implications for training. J Neurosurg. 2005 Apr;102(4):616–21.10.3171/jns.2005.102.4.061615871502Google Scholar
11. Jagannathan, J, Vates, GE, Pouratian, N, et al. Impact of the accreditation council for graduate medical education work-hour regulations on neurosurgical resident education and productivity. J Neurosurg. 2009 May;110(5):820–7.10.3171/2009.2.JNS08144619409028Google Scholar
12. The American board of neurological surgery[homepage on the Internet]. [updated 2005; cited 2009 Nov 22]; Available from: http://www.abns.org/content/primary_certification_process.asp#3a.Google Scholar
13. Calliauw, L. The UEMS model--proposals for classification and training durations of specialties registered in doctors’ directives. European union of medical specialists. Acta Neurochir Suppl. 1997;69:65–9.9253444Google Scholar
14. McCall, T, Rao, G, Kestle, J. Work hour restrictions: impact on neurosurgical resident training at the University of Utah. AANS Bulletin. 2005;14(4):17–22.Google Scholar
15. Martin, MD, Wolfla, CE. ACGME-mandated work hours: implementation at the University of Oklahoma. AANS Bulletin. 2005;14(4):14–6.Google Scholar
16. Tulleken, C. How many residents shall we train? Wien New York: Springer; 1997.Google Scholar
17. Cohen-Gadol, AA, Piepgras, DG, Krishnamurthy, S, Fessler, RD. Resident duty hours reform: results of a national survey of the program directors and residents in neurosurgery training programs. Neurosurgery. 2005 Feb;56(2):398–403; discussion 398–403.10.1227/01.NEU.0000147999.64356.5715670388Google Scholar
18. Jagannathan, J, Vates, GE, Pouratian, N, et al. Impact of the accreditation council for graduate medical education work-hour regulations on neurosurgical resident education and productivity. J Neurosurg. 2009 May;110(5):820–7.10.3171/2009.2.JNS08144619409028Google Scholar
19. Brown, AJ, Friedman, AH. Challenges and opportunities for recruiting a new generation of neurosurgeons. Neurosurgery. 2007 Dec;61(6):1314–9; discussion 1319–21.10.1227/01.neu.0000306111.62797.0818162912Google Scholar
20. Couldwell, WT. Personal perspective. AANS Bulletin. 2005;14(4):11.Google Scholar
21. Korndorffer, JR Jr., Dunne, JB, Sierra, R, Stefanidis, D, Touchard, CL, Scott, DJ. Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg. 2005 Jul;201(1):23–9.10.1016/j.jamcollsurg.2005.02.02115978440Google Scholar
22. Lemole, GM Jr., Banerjee, PP, Luciano, C, Neckrysh, S, Charbel, FT. Virtual reality in neurosurgical education: part-task ventriculostomy simulation with dynamic visual and haptic feedback. Neurosurgery. 2007 Jul;61(1):142–8; discussion 148–9.AMBIGUOUS 17876244,17621029Google Scholar
23. Walker, JB, Perkins, E, Harkey, HL. A novel simulation model for minimally invasive spine surgery. Neurosurgery. 2009 Dec;65 Suppl 6:188–95; discussion 195.19934994Google Scholar
24. Barnes, RW, Whiteside, MF, Eisner, JA, Lang, NP, Campbell, GS. The good ol’ days is now: trends in operative experience of general surgical residents over 25 years. Am Surg. 1988 Jul;54(7):395–401.3389585Google Scholar