Tso Michael K, Dakson Ayoub, Ahmed Syed Uzair, Bigder Mark, Elliott Cameron, Guha Daipayan, Iorio-Morin Christian, Kameda-Smith Michelle, Lavergne Pascal, Makarenko Serge, Taccone Michael S, Wang Bill, Winkler-Schwartz Alexander, Sankar Tejas, Christie Sean D
1Division of Neurosurgery,University of Calgary,Calgary,AB.
2Division of Neurosurgery,Dalhousie University,Halifax,NS.
Can J Neurol Sci. 2017 Jul;44(4):415-419. doi: 10.1017/cjn.2017.30. Epub 2017 Mar 21.
Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative.
Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons.
Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures.
This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.
背景 目前，文献中缺乏关于加拿大神经外科住院医师培训项目手术病例数量的可靠数据。我们的目标是利用由学员主导的加拿大神经外科研究协作组，提供加拿大神经外科培训手术情况的简要概述。
收集了2014年1月1日至2014年12月31日期间每个神经外科住院医师培训项目的匿名管理手术数据。手术大致分为颅脑、脊柱、周围神经和其他手术。记录了一些预先指定的亚专业手术。我们将住院医师病例指数定义为该项目手术总数与神经外科住院医师总数的比率。住院医师人数包括加拿大医学毕业生和国际医学毕业生，包括在神经外科服务、不在服务岗位、因研究或其他个人原因休假的住院医师。
总体而言，每个神经外科住院医师培训项目平均有1845例手术病例。颅脑、脊柱、周围神经和其他手术的平均数量分别为725例、466例、48例和193例。全国范围内颅脑、脊柱、周围神经和总手术的平均住院医师病例指数分别为90、58、5和196。特定亚专业手术的住院医师病例指数存在一些差异，一些培训项目不进行颈动脉内膜切除术或内镜经蝶窦手术。
本研究展示了加拿大神经外科住院医师培训项目中神经外科培训的广度。随着皇家内科医师和外科医师学院住院医师培训向以能力为设计的课程过渡，这些结果可能有助于为神经外科培训的实施提供参考。
