Efficacy of Neurosurgery Resident Education in the New Millennium

Abstract

Neurosurgical residency training paradigms have changed in response to Accreditation Council for Graduate Medical Education mandates and demands for quality patient care. Little has been done to assess resident education from the perspective of readiness to practice. To assess the efficacy of resident training in preparing young neurosurgeons for practice. In response to Resolution V-2007F of the Council of State Neurosurgical Societies, a survey was developed for neurosurgeons who applied for oral examination, Part II of the American Board of Neurological Surgery boards, in 2002 through 2007 (N = 800). The survey was constructed in "survey monkey" format and sent to 775 of 800 (97%) neurosurgeons for whom e-mail addresses were available. The response rate was 30% (233/775). Most neurosurgeons were board certified (n = 226, 97%). General neurosurgical training was judged as adequate by a large majority (n = 188, 80%). Sixty-percent chose to pursue at least 1 additional year of fellowship training (n = 138, 60%). Surgical skills training was acceptable, but 6 skill-technique areas were reported to be inadequate (endovascular techniques, neurosurgical treatment of pain, stereotactic radiosurgery, epilepsy surgery, cranial base surgery, and stereotactic neurosurgery). Respondents also noted inadequate education in contract negotiation, practice evaluation, and management. The study suggests that neurosurgeons believed that they were well trained in their surgical skills except for some areas of subspecialization. However, there is a significant need for improvement of resident training in the areas of socioeconomic and medicolegal education. Continued evaluation of the efficacy of neurosurgical education is important.