1Department of Neurological Surgery, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; and.
2Department of Neurological Surgery, Rush Medical College, Chicago, Illinois.
Neurosurg Focus. 2020 Mar 1;48(3):E6. doi: 10.3171/2019.12.FOCUS19827.
Postgraduate training in medicine has been under scrutiny in the last 10 years, with a focus on improving residents' education. The aim of this study was to quantify trends in neurosurgery residency (NSR) training and education over the last 10 years.
The authors assessed Accreditation Council for Graduate Medical Education (ACGME), National Resident Matching Program, and American Board of Neurological Surgeons records and searched PubMed to collate 2009-2019 data. Analyzed trends included residents' demographic data, programs' characteristics, graduation and attrition rates, match data, resident case logs, and qualitative educational curriculum changes.
Significant increases in residents' demographic data (p < 0.05) included the number of female residents (from 12.7% to 17.6%) and the absolute number of residents (from 1112 to 1462). Age (mean 28.8 years), ethnicity, and number of residents per program (mean 13 residents per program) were unchanged. There were 16 new ACGME NSR programs, with currently 115 programs nationwide. The number of applicants per year (324 applicants per year) and the matching rate (mean 64%) remained stable. The mean attrition rate of 2.6% (range 2%-4%) was higher than the mean 2.1% ACGME attrition rate, a rate that decreased from 3% in 2009 to 1.6% in 2019. Education curriculum changes aimed at the standardization of training across the US included residents' boot camp (2009), the Milestones project (2012), and mandatory 7-year training initiated in 2013. An increase in endovascular, functional, trauma, and spine resident caseload was noted. The number of yearly publications about US NSR education has significantly increased (p < 0.05).
NSR education has received greater attention over the last decade in the US. Standardization of training has been implemented. A steady number of students remain interested in neurosurgery, with an increased number of women entering the field. Attention to wellness, in addition to high-quality education, should be further assessed as a factor to improve the overall NSR training and retention rate.
在过去的 10 年中，医学研究生培训一直受到关注，重点是提高住院医师的教育水平。本研究的目的是量化过去 10 年神经外科住院医师培训和教育的趋势。
作者评估了研究生医学教育认证委员会（ACGME）、全国住院医师匹配项目和美国神经病学外科委员会的记录，并在 PubMed 上搜索以整理 2009-2019 年的数据。分析的趋势包括住院医师的人口统计学数据、项目特征、毕业和流失率、匹配数据、住院医师病例记录和定性教育课程变化。
住院医师人口统计学数据（p<0.05）显著增加，包括女性住院医师的数量（从 12.7%增加到 17.6%）和住院医师的绝对数量（从 1112 人增加到 1462 人）。年龄（平均 28.8 岁）、种族和每个项目的住院医师人数（平均每个项目 13 名住院医师）保持不变。新增了 16 个新的 ACGME NSR 项目，全国目前共有 115 个项目。每年的申请人人数（每年 324 名申请人）和匹配率（平均 64%）保持稳定。2.6%（范围 2%-4%）的平均流失率高于平均 2.1%的 ACGME 流失率，该比率从 2009 年的 3%下降到 2019 年的 1.6%。旨在实现美国培训标准化的教育课程变化包括住院医师训练营（2009 年）、里程碑项目（2012 年）和 2013 年开始的强制性 7 年培训。注意到血管内、功能、创伤和脊柱住院医师病例量增加。关于美国 NSR 教育的年度出版物数量显著增加（p<0.05）。
在过去的十年中，美国对 NSR 教育的关注度有所提高。培训的标准化已经实施。仍然有相当数量的学生对神经外科感兴趣，越来越多的女性进入该领域。除了高质量的教育外，还应该进一步评估关注健康作为提高整体 NSR 培训和保留率的一个因素。
