RESUMEN

OBJECTIVE: Recently there has been an increase in pediatric neurosurgical fellowship graduates. It is important to understand the current pediatric neurosurgical workforce to help with prospective strategic workforce planning. The authors sought to determine 1) the geographic distribution and regional retention after training and 2) academic and leadership metrics by geographic location, era of training, and gender for practicing pediatric neurosurgeons in the United States. METHODS: Current practicing pediatric neurosurgeons were identified through American Board of Pediatric Neurological Surgery (ABPNS) certification status and the American Association of Neurological Surgeons directory. NIH RePORTER, Web of Science, and departmental and hospital networking websites were used to collect data on demographics, training, leadership, NIH involvement, and academic metrics. RESULTS: A total of 298 ABPNS-certified pediatric neurosurgeons were identified as currently practicing in the United States. Of these pediatric neurosurgeons, 26.2% were women, 74.5% were academic, and 11.7% have received current or past NIH funding. There were significant differences in the concentration of pediatric neurosurgeons per general population based on region. A total of 117 (39.3%) pediatric neurosurgeons held leadership positions; 4 (1.3%) served as neurosurgery department chairs, 67 (22.5%) served as chief of pediatric neurosurgery (9 of whom were women), 12 (4.0%) served as residency program directors, and 32 (10.7%) served as pediatric fellowship directors. Women were more likely to currently practice in the same region in which they trained for medical school (p = 0.050), have a lower academic rank (p = 0.004), and have a lower h-index (p < 0.001). Pediatric neurosurgeons practicing in the Northeast were more likely to have completed residency (p = 0.022) and medical school (p = 0.002) in the same region as their current practice. CONCLUSIONS: There are differences in the concentration of pediatric neurosurgeons based on region. In pediatric neurosurgery, women hold fewer leadership positions, have lower academic ranks, and are less academically impactful as measured by the h-index. As the demand for pediatric neurosurgeons evolves, thoughtful monitoring of the distribution and composition of the neurosurgical workforce can help ensure equitable access to care across the country.

RESUMEN

Ranked lists are a highly praised method of assessment in America. Whether it's a list of the top national sports teams, the best restaurants in New York City, or as in this case, the strongest educational institutions, we look to rankings to scrutinize, evaluate, and compare. Unfortunately, not all rankings offer insightful and valuable information. Many use metrics that fall short of an accurate representation of the desired outcome. The U.S. News & World Report (USNWR), one of the most widely regarded rankings of educational institutions, has recently been under the spotlight as several major medical schools have removed themselves from candidate lists. The current USNWR Medical School's rankings are regarded as having a narrow perspective in that the metrics perpetuate a less diverse medical community and fail to recognize worthy institutions that choose to champion a well-rounded student experience. The authors, along with the many others, fear this may deliver a skewed vision of what the USNWR tries to measure: the excellence of a medical education.

Asunto(s)

RESUMEN

OBJECTIVE: Twitter (X) is increasingly utilized by medical residency programs to boost engagement and potentially enhance ranking. This study aims to evaluate the role of Twitter (X) in neurosurgery residency programs, assessing their online activity, followership, and content to identify current practices and potential improvements. METHODS: We identified 97/123 neurosurgery residency programs in the United States with Twitter accounts. Active accounts, posting in 2022 and 2023, were matched with the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Tweets from January 2022 through June 2023 were categorized as original or retweets and further subcategorized based on content. Descriptive and correlation analyses were conducted. RESULTS: Twitter (X) accounts were found for 78.8% of accredited neurosurgery programs (n = 97/123), with 68.3% active as of July 2023 (n = 84/123). All active accounts amassed 167,068 followers. Among 5612 tweets identified, 2764 were original content, and 2848 were retweets. Tweets primarily focused on resident or program information (64.3%), research publications (32.0%), and conference participation (9.4%). Only 12.3% (n = 341) of original tweets contained public medical information. A significant correlation (r = 0.493, P < 0.001) was observed between Twitter (X) following and program ranking. CONCLUSIONS: The majority of US neurosurgery residency programs actively use Twitter (X), primarily to showcase academic achievements and aid in recruitment. The correlation between Twitter following and program ranking suggests that online engagement reflects program visibility and impact, underscoring the importance of social media in program outreach and strategic management for maximizing program benefits.

RESUMEN

INTRODUCTION: Pediatric Neurosurgery as a subspeciality started to emerge during the late 1950s, with only a few dedicated pediatric neurosurgeons in the Western world. Over the last few decades, the awareness that children require subspecialized care by dedicated pediatric neurosurgeons and an interdisciplinary team has been growing worldwide, leading to an increase in pediatric neurosurgeons. Several studies have shown that subspecialized care for pediatric patients improves outcomes and is cost-effective. This survey aims to assess the current setting of pediatric neurosurgery and training of neurosurgical residents in pediatric neurosurgery in Switzerland. METHODS: We conducted an online survey by sending e-mail invitations in 2021 to all neurosurgical residents in Switzerland. The survey included questions regarding the participants' demographics, current workplace structures, the care of specific pediatric neurosurgical pathologies, and participants' opinions of the Swiss training program for pediatric neurosurgery and possible improvement. We defined at the beginning of the survey that a pediatric neurosurgeon is a board-certified neurosurgeon with at least one year of dedicated pediatric neurosurgical fellowship training abroad. RESULTS: We received a total of 25 responses from residents, of which 20 (80%) were male. Twenty-two participants (88%) worked in one of seven major hospitals in Switzerland at the time of the survey, and four (16%) were interested in pursuing a fellowship in pediatric neurosurgery. Seven (35%) and five residents (25%) feel comfortable taking care on the ward of a craniosynostosis and hydrocephalus patient younger than 6 months, respectively. Twelve residents (60%) feel comfortable taking care of a pediatric brain tumor patient. The majority (n = 22, 88%) of all residents agree that a fellowship-trained pediatric neurosurgeon should treat children, while two (8%) residents state that any neurosurgeon with an interest in pediatric neurosurgery should be able to treat children. All residents (n = 25, 100%) agree that pediatric neurosurgery training and care in Switzerland needs to be improved. CONCLUSION: Pediatric neurosurgery training in Switzerland is rather heterogeneous and not very well structured, with varying frequencies of children-specific neurosurgical pathologies. Most residents agreed that a subspecialized pediatric neurosurgeon should oversee the care of children in neurosurgery, while all agree that pediatric neurosurgical training and care should be improved in Switzerland.

Asunto(s)

RESUMEN

Neurosurgery at Baylor Scott & White Memorial Hospital in Temple, Texas began as a division in the Department of Surgery many decades ago. The hospital has long served as the flagship tertiary referral center for the Baylor Scott & White healthcare system, which merged in 2013 with Baylor University Medical Center, a hospital system based in Dallas. It is now the largest non-profit hospital system as well as the most awarded hospital system by the US News and World Report within the state of Texas. The Department of Neurosurgery was established at Baylor Scott & White Memorial Hospital in the 2006-2007 academic year. Between then and 2014, four neurosurgeons served as department chair or interim chair: Dr. Robert Buchanan, Dr. Gerhard Friehs, Dr. Ibrahim El Nihum, and Dr. David Garrett Jr. In 2014, Dr. Jason Huang was appointed chairman after a national search and established the neurosurgery residency program in 2015. The department has undergone tremendous growth under the leadership of Dr. Huang, and the residency program is a priority of the department. Surgical excellence is honed at primarily three campuses: Baylor Scott & White Memorial Hospital, Baylor Scott & White McLane Children's Medical Center, and Baylor Scott & White Medical Center - Hillcrest. In this editorial, we provide a brief history of the institution, a recent history of the neurosurgical presence at Baylor Scott & White Memorial Hospital in Temple, Texas, and briefly describe the program's future directions under the continued leadership of Dr. Jason Huang.

RESUMEN

OBJECTIVE: The number of women graduating from United States medical schools has reached parity with that of men. However, persistent inequalities and barriers have slowed the pace toward equity in application and representation in neurosurgery residency despite initiatives to increase female representation. The objective of the present study was to assess the advancement of gender parity within neurosurgery residency programs. Additionally, the study aimed to analyze the pipeline dynamics by investigating the effects of attrition on women in neurosurgery, as well as exploring the patterns of female applications to neurosurgery residency programs versus other surgical specialties. METHODS: Data on the number of active female neurosurgery residents and female applicants to neurosurgery were collected from the Accreditation Council for Graduate Medical Education Data Resource Book from 2007 to 2021 and Electronic Residency Application Service from 2014 to 2022. Linear regression analysis was used to predict the percent of active female residents based on academic year (AY). A Pearson chi-square test was used to determine the odds of a female applying to neurosurgery. RESULTS: The percent of active female residents in neurosurgery increased from 11.0% in 2007 to 21.8% in 2021. Bivariate linear regression analysis using AY as a predictor of the percent of active females showed a statistically significant correlation. On average, the percent of active female residents increased by 0.65% per year. If trends persist, parity for females in neurosurgery will not be reached until 2069. Linear regression analysis of the overall rate of attrition in neurosurgery as a predictor of the percent of active female residents revealed that for every 1% increase in the rate of attrition, the percent of active female residents decreased by 2.91% (p = 0.001). The percent of female applicants to neurosurgery increased from 19.6% in 2014 to 29.8% in 2022 (p = 0.009), yet the odds of a female applying to neurosurgery remain low. CONCLUSIONS: Neurosurgery continues to struggle with the recruitment of female medical students even as parity has been reached for female medical school matriculants. Greater effort is needed to recruit and retain female applicants to neurosurgery, including increased transparency in match and attrition metrics.

Asunto(s)

RESUMEN

INTRODUCTION: This survey was conducted to explore the perceptions of undergraduate (UG) medical students regarding enrolling in a neurosurgical training program. The purpose was to understand' expectations, reasons, apprehensions, and variables influencing students' decisions to pursue a career in neurosurgery. The results shed light on students' perceptions and can help educational institutions and training programs draw in and encourage aspiring neurosurgeons. METHODS: A 35-point online questionnaire was created using Google Forms (Google LLC) after content and face validation and circulated using social media platforms among various public medical colleges across India. Responses were collected over a period of 3 months, from February 2023 to April 2023. A 5-point Likert scale was used to collect the responses wherever applicable. RESULTS: A total of 1042 respondents from 47 medical colleges completed the survey. The majority of the students were not exposed to neurosurgery during their UG program, but despite this, 60.1% (n = 627) were willing to consider it as their career option. Around 91.4% of the respondents perceived neurosurgery to be a challenging but prestigious specialty that has a long learning curve and the worst work-life balance when compared with other specialties. The majority of the respondents (strongly disagree = 24.3%, n = 253; disagree = 31.7%, n = 330) did not view neurosurgery as a male-dominated specialty. Most students preferred a 6-year training program over a 3-year program (P = 0.001) if their medical college had such a course. CONCLUSIONS: Our study reveals that although a majority of the UG students would like to join neurosurgery residency, there are significant barriers in the form of less exposure, negative perceptions, and apprehensions toward the branch. Enhancing medical students' awareness about neurosurgery necessitates the integration of hands-on workshops, simulation-based training, didactic lectures, and neurosurgery rotations into the UG curriculum.

Asunto(s)

RESUMEN

Background Passing the American Board of Neurological Surgeons (ABNS) Primary Exam is required for residents in training. Both the program directors and residents are given keywords of the exam afterward in the hope to help program directors determine their relative strengths and weakness. We have organized and tabulated these keywords for neurosurgery residents' benefit. Methodology We collected and analyzed ABNS Primary Exam keywords (2015-2023) in each of the exam's main categories for trends and recurrences. We examined the overall passing rates among first-time credit test takers. The frequency of each subcategory was calculated as a percentage within its corresponding category. Recurrent keywords were grouped together with their corresponding years and categorized as once, twice, or thrice and greater occurrences; the last category was considered to be high-yield keywords. Results The number of questions in Neurosciences and Neurology has decreased over the years while Neurosurgery and Critical Care questions have increased. Similarly, there are fewer keyword repeats in Neurosciences and Neurology. The most repeated keywords are in Neuroimaging. The most common keywords are presented and listed along with the years of occurrences. Overall, the passing rate among first-time credit test takers is over 90%. Conclusions Neurosurgery residents can consider the common keywords as a guide in preparation for the ABNS Primary Exam.

RESUMEN

OBJECTIVE: The United States Medical Licensing Examination (USMLE) Step 1 recently transitioned to a pass/fail outcome, renewing interest in how programs select neurosurgical residents. This study investigates the association between match status and key academic metrics over time. METHODS: Data are from the National Resident Matching Program from 2009 to 2022 for matched and unmatched US allopathic (MD) seniors. Investigated metrics included the mean number of contiguous ranks; mean number of distinct specialties ranked; mean USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores; mean number of abstracts, presentations, and publications; mean number of research, work, and volunteer experiences; Alpha Omega Alpha status; attendance at a top 40 NIH-funded institution; PhD degree; and other degree. Multiple linear regression without an interaction term was used to evaluate how these have varied between the two groups during the study period and whether there is a difference between unmatched and matched MD seniors applying for a neurosurgical residency. Multiple linear regression with an interaction term was then used to test whether the difference in variables between the two groups changed over time. RESULTS: Regardless of match status, MD senior neurosurgical residency applicants exhibited an increase in USMLE Step 1 and 2 scores; average research experiences; abstracts, presentations, and publications; and work and volunteer experiences (p < 0.001). The percentage of applicants from a top 40 NIH-funded school decreased (p = 0.018), and the percentage who held an additional degree increased (p = 0.007). Between groups, there were significant differences in all categories except work experiences and other degree obtained. Over time, the difference between USMLE Step 2 scores between matched and unmatched seniors diminished (p = 0.027); in contrast, the difference in abstracts, presentations, and publications between the two groups increased over time (p < 0.001). CONCLUSIONS: From 2009 to 2022, neurosurgical residency applicants grew in their achievements across many metrics. In the advent of Step 1 becoming pass/fail, this study suggests that Step 2 is not viewed by programs as an adequate replacement. However, the Step 1 grading transition may serve as an opportunity for other factors to be considered that may better predict success in neurosurgical residency.

Asunto(s)

RESUMEN

BACKGROUND/OBJECTIVE: Education is at the core of neurosurgical residency, but little research in to the cost of neurosurgical education exists. This study aimed to quantify costs of resident education in an academic neurosurgery program using traditional teaching methods and the Surgical Autonomy Program (SAP), a structured training program. METHODS: SAP assesses autonomy by categorizing cases into zones of proximal development (opening, exposure, key section, and closing). All first-time, 1-level to 4-level anterior cervical discectomy and fusion (ACDF) cases between March 2014 and March 2022 from 1 attending surgeon were divided into 3 groups: independent cases, cases with traditional resident teaching, and cases with SAP teaching. Surgical times for all cases were collected and compared within levels of surgery between groups. RESULTS: The study found 2140 ACDF cases, with 1758 independent, 223 with traditional teaching, and 159 with SAP. For 1-level to 4-level ACDFs, teaching took longer than it did with independent cases, with SAP teaching adding additional time. A 1-level ACDF performed with a resident (100.1 ± 24.3 minutes) took about as long as a 3-level ACDF performed independently (97.1 ± 8.9 minutes). The average time for 2-level cases was 72.0 ± 18.2 minutes independently, 121.7 ± 33.7 minutes traditional, and 143.4 ± 34.9 minutes SAP, with significant differences among all groups. CONCLUSIONS: Teaching takes significant time compared with operating independently. There is also a financial cost to educating residents, because operating room time is expensive. Because attending neurosurgeons lose time to perform more surgeries when teaching residents, there is a need to acknowledge surgeons who devote time to training the next generation of neurosurgeons.

Asunto(s)

RESUMEN

Background Neurosurgery residency became one of the most competitive specialties in the medical field worldwide, which is increasing with time in contrast to the limited positions. Therefore, the requirements for the program have increased. There are different criteria for each program, which are determined by specific factors. It has become increasingly important for medical students to be aware of the factors that affect their acceptance into the program. There was a lack of data regarding the factors that contribute to the selection of neurosurgery residents in Oman Methods A questionnaire composed of 14 questions was conducted, using the SurveyMonkey Web site, among neurosurgeons in Oman which was distributed to the five hospitals that have neurosurgery departments in Oman. SPSS software was used in the analysis of the collected data. Results Forty-four participants responded to the survey. Ninety-five percent of them answered all the questions. Out of all participants, only two were female participants. Standardized international exam scores, such as the United State Medical Licensing Examination and Medical Council of Canada Qualifying Examination, ranked as the most important factor with a percentage of 44, followed by interview performance with a percentage of 33. While the least important factor was the age of applicants, which 46% of the participants ranked 8. Conclusion Most of the participants agreed that standardized exams are the most important factor in the selection of neurosurgery residents followed by interview performance, although there was no significant statistical difference between the two.

RESUMEN

OBJECTIVE: Increasing centralization of high-level neurosurgical practice at academic centers has increased the need for academic neurosurgeons. The lack of systematic metrics-based analyses among neurosurgery trainees and the recent pass/fail U.S. Medical Licensing Examination system necessitates a multiparametric approach to assess academic success among trainees. METHODS: We conducted a comprehensive analysis of the University of Miami residency program using 2 data sets, one containing applicants' pre-residency metrics and a second containing trainees' intra-residency metrics. Intra-residency metrics were subjectively and anonymously assessed by faculty. Univariate and multivariate logistic regression analyses were performed to determine differences among academic and non-academic neurosurgeons and identify predictors of academic careers. RESULTS: Academic neurosurgeons had a significantly higher median Step 1 percentile relative to non-academic neurosurgeons (P = 0.015), and medical school ranking had no significant impact on career (P > 0.05). Among intra-residency metrics, academic neurosurgeons demonstrated higher mean rating of leadership skills (mean difference [MD] 0.46, P = 0.0011), technical skill (MD 0.42, P = 0.006), and other intra-residency metrics. Higher administrative and leadership skills were significantly associated with increased likelihood of pursuing an academic career (odds ratio [OR] 9.03, 95% CI [2.296 to 49.88], P = 0.0044). Clinical judgment and clinical knowledge were strongly associated with pursuit of an academic career (OR 9.33 and OR 9.32, respectively, with P = 0.0060 and P = 0.0010, respectively). CONCLUSIONS: Pre-residency metrics had little predictive value in determining academic careers. Furthermore, medical school ranking does not play a significant role in determining a career in academic neurosurgery. Intra-residency judgment appears to play a significant role in career placement, as academic neurosurgeons were rated consistently higher than their non-academic peers in multiple key parameters by their attending physicians.

Asunto(s)

RESUMEN

OBJECTIVE: Standardized letters of recommendation (SLORs) were introduced during the 2020-2021 neurosurgery residency application cycle, but suffered from poor interrater reliability and grade inflation. Changes were made to the SLOR template and utilization patterns in response to these shortcomings. The authors examined the second year of SLOR utilization. They hypothesized that grade inflation and interrater reliability would be improved from the first iteration. They also hypothesized that increased numbers of letters by single writers would correlate with broader rating distributions. METHODS: This cross-sectional study analyzed all SLORs submitted to a single neurosurgery residency program over the 2021-2022 cycle. Data from 7 competency domains and the overall rating were recorded and stratified by academic category of the letter writer. Interrater reliability was evaluated using Krippendorff's alpha. The frequency of letters written was evaluated using the Kruskal-Wallis H test. RESULTS: Ninety percent of SLORs rated applicants among the top 25%, but there was a significant decrease in the usage of the top 1% and top 2%-5% ratings. Interrater reliability was poor across all competencies. Writers who completed 1 SLOR rated applicants higher and had a narrower range than those who completed multiple SLORs. CONCLUSIONS: Changes in the format and subsequent utilization patterns of SLORs have slightly decreased grade inflation; however, interrater reliability remains poor. The most wide-ranging evaluators submitted the highest number of SLORs, suggesting that future evaluation and usage of SLORs should emphasize letter-writer characteristics and numbers of SLORs written. Overall, SLORs have been well and broadly accepted with subtle improvements in the second year of utilization.

Asunto(s)

RESUMEN

OBJECTIVE: Since the Accreditation Council for Graduate Medical Education (ACGME) implemented duty-hour restrictions in 2003, many residency programs have adopted a night float system to comply with time constraints. However, some surgical subspecialities have been concerned that use of a night float system deprives residents of operative experience. In this study, the authors describe their training program's transition to a night float system and its impact on resident operative experience. METHODS: The authors conducted a single-program study of resident surgical case volume before and after implementing the night float system at 3 of their 5 hospitals from 2014 to 2020. The authors obtained surgical case numbers from the ACGME case log database. RESULTS: Junior residents received a concentrated educational experience, whereas senior residents saw a significant decrease from 112 calls/year to 17. Logged cases significantly increased after implementation of the night float system (8846 vs 10,547, p = 0.04), whereas cases at non-night float hospitals remained the same. This increase was concurrent with an increase in hospital cases. This difference was mainly driven by senior resident cases (p = 0.010), as junior and chief residents did not show significant differences in logged cases (p > 0.40). Lead resident cases increased significantly after implementation of the night float system (6852 vs 8860, p = 0.04). When normalized for increased hospital cases, resident case increases were not statistically significant. CONCLUSIONS: Transitioning to a night float call system at the authors' institution increased overall resident operative cases, particularly for lead resident surgeons. Based on the results of this study, the authors recommend the use of a night float call system to consolidate night calls, which increases junior resident-level educational opportunities and senior resident cases.

Asunto(s)

RESUMEN

OBJECTIVE: Applicants rely heavily on virtual information in the form of neurosurgery residency websites (NRWs) to better understand a program's culture, faculty, and opportunities. There is a paucity of information regarding the value of NRW on applicant decision making. The advent of the supplemental ERAS application and continuation of virtual interviews may increase the propensity of which applicants use NRW. The objective of our study was to distribute a survey to further understand applicants' perceptions and opinions of NRW, as well as provide future direction for NRW optimization. METHODS: The current study is a single-institution, retrospective survey design. A survey was designed via Qualtrics software to evaluate applicant demographics, resident education, resident recruitment, and future directions. The survey includes the most frequently used variables on NRW. The survey was distributed to neurosurgery applicants who received an interview at the University of Alabama at Birmingham. Data were analyzed using Microsoft Excel. RESULTS: Among the 293 applicants who received a link to the survey, 87/293 (29.7%) completed it. Respondents elected that useful website variables were "resident rotation schedules and hospital locations," "faculty listings and biographies," and "neurosurgery residency websites served as a first impression of a neurosurgery residency program." More than half of the respondents agreed that their rank list would not be the same without an NRW. The most strongly received statement for future directions was "Neurosurgery residency programs will benefit from renovating their residency website." CONCLUSIONS: Our data suggest NRWs play a vital role in resident recruitment and decision making. Residency programs will benefit from this data and may use it to restructure their virtual recruitment tools and discover innovative virtual recruitment strategies. Our team elucidated the most important variables found on NRWs and proposed future directions for their improvement and the virtual application and recruitment process.

Asunto(s)

RESUMEN

Background: The authors investigated perceived discrepancies between the neurosurgical research productivity of international medical graduates (IMGs) and US medical graduates (USMGs) through the perspective of program directors (PDs) and successfully matched IMGs. Methods: Responses to 2 separate surveys on neurosurgical applicant research productivity in 115 neurosurgical programs and their PDs were analyzed. Neurosurgical research participation was analyzed using an IMG survey of residents who matched into neurosurgical residency within the previous 8 years. Productivity of IMGs conducting dedicated research at the study institution was also analyzed. Results: Thirty-two of 115 (28%) PDs responded to the first research productivity survey and 43 (37%) to the second IMG research survey. PDs expected neurosurgery residency applicants to spend a median of 12-24 months on research (Q1-Q3: 0-12 to 12-24; minimum time: 0-24; maximum time: 0-48) and publish a median of 5 articles (Q1-Q3: 2-5 to 5-10; minimum number: 0-10; maximum number: 4-20). Among 43 PDs, 34 (79%) ranked "research institution or associated personnel" as the most important factor when evaluating IMGs' research. Forty-two of 79 (53%) IMGs responding to the IMG-directed survey reported a median of 30 months (Q1-Q3: 18-48; range: 4-72) of neurosurgical research and 12 published articles (Q1-Q3: 6-24; range: 1-80) before beginning neurosurgical residency. Twenty-two PDs (69%) believed IMGs complete more research than USMGs before residency. Of 20 IMGs conducting dedicated neuroscience/neurosurgery research at the study institution, 16 of 18 who applied matched or entered a US neurosurgical training program; 2 applied and entered a US neurosurgical clinical fellowship. Conclusion: The research work of IMGs compared to USMGs who apply to neurosurgery residency exceeds PDs' expectations regarding scientific output and research time. Many PDs perceive IMG research productivity before residency application as superior to USMGs. Although IMGs comprise a small percentage of trainees, they are responsible for a significant amount of US-published neurosurgical literature. Preresidency IMG research periods may be improved with dedicated mentoring and advising beginning before the research period, during the period, and within a neurosurgery research department, providing a formal structure such as a research fellowship or graduate program for IMGs aspiring to train in the US.

RESUMEN

Neurosurgery residents spend a significant amount of their time teaching patients, families, students, residents, and other health professionals. To help ensure competence in their residents' teaching abilities, many specialties have established formal residents-as-teachers (RAT) curricula; however, such formalized curricula are often lacking in neurosurgery programs. The authors' goal was to develop and implement a formal RAT curriculum, designed with neurosurgery residents' other responsibilities in mind, to improve residents' formal and informal teaching abilities. Here, the authors report on the design of a formalized teaching curriculum tailored for the needs of neurosurgical residents, with a focus on deliberate practice and minimal time needed for preparation. The curriculum, designed using Kern's 6 steps of curriculum design as a framework, comprises 5 lecture series spread over 3 years, repeated twice through a resident's training, with each lecture series outlined with its respective topics and objectives. Opportunities for observed teaching as well as informal and formal evaluation will be provided to residents. The program will be evaluated on a yearly basis using direct and anonymized resident feedback on the RAT curriculum. Measures of program success will also include pre- and postprogram medical student and peer evaluation of residents. These data will be used for continual improvement of the curriculum as it is implemented. Successes and shortcomings of this program will be disseminated by publication, presentations, and placement on the authors' department website and social media. This paper may serve as a foundation for other neurosurgical programs to develop RAT curricula for greater enhancement of resident teaching abilities.

Asunto(s)

RESUMEN

Neurosurgical procedures have relied on the use of various intraoperative equipment since its advent. These include an operative microscope, ultrasound, and loupes with a headlight. The necessity of these pieces of equipment makes them vital in the training of residents as well. A national survey utilizing a Likert scale to determine how often loupes, microscopes, and ultrasound were used for various neurosurgeries was created. This was then compared to a single program's responses, and it identified that the practice parameters of residents closely modeled those behaviors portrayed by their attending mentors. It appears that the higher frequency of use by residents when compared to faculty and neurosurgeons nationwide highlights the importance of this equipment in training neurosurgical residents.  As such, they should be available to residents from the onset of training to promote the highest quality of learning. Faculty should encourage the use of this equipment by leading by example, and residents, in turn, should use all the available equipment as often as possible to maximize the quality of their training. Modulating the use of learning technologies can be accomplished if it is a nationally accepted practice, discussed in an academic setting with the residents, and modeled by the faculty.

RESUMEN

BACKGROUND: The number of neurosurgeons in the Philippines is less than ideal for its population, so there is a need to recruit and train more. This study aimed to determine medical students' perception of neurosurgery and their likelihood of pursuing a career in this specialty. METHODS: A cross-sectional survey was conducted of medical students in the Philippines to assess their perceptions and likelihood of pursuing a career in neurosurgery. Data obtained were analyzed using descriptive statistics and a χ2 test with a significance level of 0.05. RESULTS: A total of 627 medical students completed the survey, with a response rate of 72.4%. The mean age was 23.8 years, and almost half (49.1%) were women. They had mostly negative perceptions of neurosurgery, and only 18.7% were likely to pursue a career in this specialty. Reasons included poor work-life balance, poor understanding of neuroscience and neurosurgery, and the self-perceived lack of manual dexterity. The most common sources of their perceptions included lectures, movies, and neurosurgery residents and consultants whom they met in hospital. Previous exposure to neurosurgery lectures or rotations, going back to their hometown to work, and having a physician parent were associated with a higher likelihood of pursuing neurosurgery. CONCLUSIONS: Our study showed that medical students' perceptions of neurosurgery were generally negative and that only 18.7% were likely to pursue it as a career. Major changes would have to be made to improve students' perceptions to attract more students to the field and increase the neurosurgical workforce.

Asunto(s)

RESUMEN

Objectives: Since the onset of the COVID-19 pandemic many large institutions have turned towards virtual education. Neurosurgery in our institute, recognizing its benefits, readily embraced the virtual learning experience using Zoom Inc (San Jose, California) beginning on May 21, 2020. The result of this form of educational experience may not be apparent readily. Hence, nearing the end of one year of monthly Zoom meetings, an effort was undertaken to assess the feasibility and the barriers of effective virtual teaching learning activity in neurosurgery among the participants. Methods: The participants consisted of neurosurgeons and trainees from department of neurosurgery Tribhuvan University Teaching Hospital in Nepal, neurosurgeons based in Seattle, United States of America and neurosurgeons based in Sweden, who have been regularly attending the monthly virtual education organized by Dr. Wohns. At the end of one-year experience of monthly Zoom teaching and learning activities between the participants a questionnaire comprising objective questions related to their experience of virtual education in neurosurgery was distributed to the participants and answers were collected and analyzed. Results: A total of 18 persons out of 25 responded to the questionnaire. Majority of participants responded favorably to virtual education. A few responders faced disturbance in internet connectivity affecting the quality of video and sound during the presentations. None of the participants faced inconvenience due to time difference. Most responders preferred to continue virtual education even after the pandemic. Conclusions: Overall most participants responded favorably to virtual education which has helped them increase their participation and hence broaden their knowledge in the field. Most participants look forward to continuing this form of education even in future. Thus, this form of education may be incorporated at least in part in the future of neurosurgical training.