Abstract
Purpose of ReviewThis review illustrates the evolution and progress with standardization of fellowship education in neuroanesthesiology. It provides a structured discussion around the need for curricula and framework which individual training programs in neuroanesthesiology can use to meet defined educational standards thus meeting criteria for accreditation.Recent FindingsNeuroanesthesiology training has traditionally been heterogenous around the world but international efforts from the community of neuroanesthesiology have culminated in the development of an international council for perioperative training in neuroscience in anesthesiology(ICPNT). This serves not only as an accrediting body but also creates a platform through their neuroanesthesia program relations committee for collaboration and engagement between various training programs internationally, increasing the educational standards of the individual programs and collectively increasing the overall level of standards for neuroanesthesia training. Standardized curriculum and competency-based assessments and milestones would help with narrowing the focus to quality education in neuroanesthesiology.SummaryStructured training around the three pillars of neuroanesthesiology with concomitant accreditation is expected to lead to higher education standards with better patient care. The SNACC created milestones for neuroanesthesiology training during residency and the ICPNT can now use this as a foundation for fellowship training. Having a council to accredit and standardize will likely become indispensable in creating a set path for training in neuroanesthesiology. Additionally, the flexibility built in due to the international nature would allow modified and variable pathways depending upon individual capabilities and interests. The path forward will include widespread adoption of standardization supporting the overarching goal of excellent patient outcomes around the world.
Highlights
With increasing numbers of complex and specialized neurosurgical and neuroradiological procedures being conducted, current training and education in neuroanesthesiology should adapt to create a specialist with expertise in team based care in perioperative neurosciences providing excellent patient outcomes
There are 10 sub-specialty fellowships under the umbrella of anesthesiology accredited by American College of Graduate Medical Education (ACGME): Pediatrics, Critical Care, Pain, Obstetric, Cardiac, Regional, Neurocritical care, Palliative care and hospice, Addiction Medicine and Clinical Informatics
While some fellowships are independent and can be done any time after residency, some are enfolded into the residency which means the trainee does the specialized training during the time of residency. These international differences in neuroanesthesia training culture arise due to different types of funding available to support the fellowship; while in some departments, fellows are funded by the GME (Graduate Medical Education) program of the hospital, in other departments they function as junior faculty eliminating the need for dependence on government funding
Summary
With increasing numbers of complex and specialized neurosurgical and neuroradiological procedures being conducted, current training and education in neuroanesthesiology should adapt to create a specialist with expertise in team based care in perioperative neurosciences providing excellent patient outcomes. As a neuroanesthesiologist and perioperative neuroscience expert, the well trained neuroanesthesiologist. Extended author information available on the last page of the article should be a leader capable of orchestrating the perioperative environment to optimize care and support innovations. Standardization of neuroanesthesia education and proper training will lay the foundation for acquisition of neuroanesthesiology specific clinical skills, afford a knowledge base required to optimize the central nervous system pathophysiology and support appropriate use of available peri-operative brain monitoring technologies. The challenge is to implement educational strategies that will enhance the quality of care offered in the realm of perioperative neurosciences. This review will focus on available literature regarding: 1. Subspecialty training in anesthesiology and evolving status of neuroanesthesiology training
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