Response to: neurosurgical procedures performed during residency in Europe—preliminary numbers and time trends

Stienen, Martin N.; Bártek, Jiří; Czabanka, Marcus; Freyschlag, Christian F.; Kolias, Angelos G.; Krieg, Sandro M.; Moojen, Wouter A.; Renovanz, Mirjam; Samprón, Nicolás; Adib, Sasan Darius; Schubert, Gerrit Alexander; Demetriades, Andreas K.; Ringel, Florian; Regli, Luca; Schaller, Karl; Meling, Torstein R.

doi:10.1007/s00701-019-04048-3

Cited by 4 publications

(7 citation statements)

References 7 publications

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“…However, the prior results had also been criticized by some for potentially being too high and not representative [5,19]. The final survey results, contained in this article, were thus anticipated [5,8,19]. Here, the larger dataset serves as validation for the previous interim report.…”

Section: Discussionmentioning

confidence: 77%

“…The preliminary report of this survey [20] had already provoked some discussion about the training conditions for neurosurgeons in Europe, as an alarming decline in OR exposure was evident from the reported numbers [8]. However, the prior results had also been criticized by some for potentially being too high and not representative [5,19]. The final survey results, contained in this article, were thus anticipated [5,8,19].…”

Section: Discussionmentioning

confidence: 86%

“…In a previous issue of Acta Neurochirurgica, we were given the opportunity to present some preliminary data from an EANS survey that aimed to determine the number of operative procedures conducted during neurosurgery residency in Europe [20]. As similar articles about the training conditions in Europe before [16][17][18], also this article stimulated some debate [5,8,19]. Some years back already, we had surveyed residents in training and asked them to indicate the average number of certain surgical procedures performed per month [16].…”

Section: Introductionmentioning

confidence: 99%

“…Albeit interesting, it remained unclear how representative the results were, since residents across all stages of training had been included. Therefore, to substantiate the prior work, we had now chosen a different approach, where we collected residency case logs from neurosurgeons who had already completed their training [16,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Procedures performed during neurosurgery residency in Europe

Meling

Al-Amin²,

Al-Mahfoudh³

et al. 2020

Acta Neurochir

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Background In a previous article (10.1007/s00701-019-03888-3), preliminary results of a survey, aiming to shed light on the number of surgical procedures performed and assisted during neurosurgery residency in Europe were reported. We here present the final results and extend the analyses. Methods Board-certified neurosurgeons of European Association of Neurosurgical Societies (EANS) member countries were asked to review their residency case logs and participate in a 31-question electronic survey (SurveyMonkey Inc., San Mateo, CA). The responses received between April 25, 2018, and April 25, 2020, were considered. We excluded responses that were incomplete, from non-EANS member countries, or from respondents that have not yet completed their residency. Results Of 430 responses, 168 were considered for analysis after checking in- and exclusion criteria. Survey responders had a mean age of 42.7 ± 8.8 years, and 88.8% were male. Responses mainly came from surgeons employed at university/teaching hospitals (85.1%) in Germany (22.0%), France (12.5%), the United Kingdom (UK; 8.3%), Switzerland (7.7%), and Greece (7.1%). Most responders graduated in the years between 2011 and 2019 (57.7%). Thirty-eight responders (22.6%) graduated before and 130 responders (77.4%) after the European WTD 2003/88/EC came into effect. The mean number of surgical procedures performed independently, supervised or assisted throughout residency was 540 (95% CI 424–657), 482 (95% CI 398–568), and 579 (95% CI 441–717), respectively. Detailed numbers for cranial, spinal, adult, and pediatric subgroups are presented in the article. There was an annual decrease of about 33 cases in total caseload between 1976 and 2019 (coeff. − 33, 95% CI − 62 to − 4, p = 0.025). Variables associated with lesser total caseload during residency were training abroad (1210 vs. 1747, p = 0.083) and female sex by trend (947 vs. 1671, p = 0.111), whereas case numbers were comparable across the EANS countries (p = 0.443). Conclusion The final results of this survey largely confirm the previously reported numbers. They provide an opportunity for current trainees to compare their own case logs with. Again, we confirm a significant decline in surgical exposure during training between 1976 and 2019. In addition, the current analysis reveals that female sex and training abroad may be variables associated with lesser case numbers during residency.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Procedures performed during neurosurgery residency in Europe

Meling

Al-Amin²,

Al-Mahfoudh³

et al. 2020

Acta Neurochir

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“…Although training the future generation of neurosurgeons is an important task, recent regulations on working hour restrictions in medical practice may affect the quality of neurosurgical training. 2) To address such challenges, several neurosurgical societies have launched nationwide neurosurgical registries. In the United States (US), the American Association of Neurological Surgeons launched the National Neurosurgery Quality and Outcomes Database (N2QOD) in 2012, a nationwide prospective longitudinal registry.…”

Section: Introductionmentioning

confidence: 99%

The Japan Neurosurgical Database: Overview and Results of the First-year Survey

Iihara

Tominaga

Saito

et al. 2020

Neurol. Med. Chir.(Tokyo)

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The Japan Neurosurgical Database (JND) is a prospective observational study registry established in 2017 by the Japan Neurosurgical Society (JNS) to visualize real-world clinical practice, promote science, and improve the quality of care and neurosurgery board certification in Japan. We summarize JND's aims and methods, and describes the 2018 survey results. The JND registered in-hospital patients' clinical data mainly from JNS training institutions in 2018. Caseload, patient demographics, and in-hospital outcomes of the overall cohort and a neurosurgical subgroup were examined according to major classifications of main diagnosis. Neurosurgical caseload per neurosurgeon in training in core hospitals in 2018 was calculated as an indicator of neurosurgical training. Of 523,283 cases (male 55.3%) registered from 1360 participating institutions, the neurosurgical subgroup comprised of 33.9%. Among the major classifications, cerebrovascular diseases comprised the largest proportion overall and in the neurosurgical subgroup (53.1%, 41.0%, respectively), followed by neurotrauma (19.1%, 25.5%), and brain tumor (10.4%, 12.8%). Functional neurosurgery (6.4%, 3.7%), spinal and peripheral nerve disorders (5.1%, 10.1%), hydrocephalus/developmental anomalies (2.9%, 5.3%), and encephalitis/infection/ inflammatory and miscellaneous diseases (2.9%, 1.6%) comprised smaller proportions. Most patients were aged 70-79 years in the overall cohort and neurosurgical subgroup (27.8%, 29.4%). Neurotrauma and cerebrovascular diseases in the neurosurgical subgroup comprised a higher and lower proportion, respectively, than in the overall cohort in elderly patients (e.g. 80 years, 46.9% vs. 33.5%, 26.8% vs. 54.4%). The 2018 median neurosurgical caseload per neurosurgeon in training was 80.7 (25-75th percentile 51.5-117.5). These initial results from 2018 reveal unique aspects of neurosurgical practice in Japan.

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Surgical experience of neurosurgical residents in Europe: an alarming trend

Jakola

Skoglund

2019

Acta Neurochir

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Response to: neurosurgical procedures performed during residency in Europe—preliminary numbers and time trends

Cited by 4 publications

References 7 publications

Procedures performed during neurosurgery residency in Europe

Procedures performed during neurosurgery residency in Europe

The Japan Neurosurgical Database: Overview and Results of the First-year Survey

Surgical experience of neurosurgical residents in Europe: an alarming trend

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