Limoges Natalie, D'Agostino Erin, Gelinne Aaron, Maher Cormac O, Scott R Michael, Grant Gerald, Krieger Mark D, Limbrick David D, White Michael, Durham Susan
1Division of Neurological Surgery, University of Vermont Medical Center, Burlington, Vermont.
2Department of Neurological Surgery, University of North Carolina, Chapel Hill, North Carolina.
J Neurosurg Pediatr. 2020 Mar 20;26(1):6-12. doi: 10.3171/2020.1.PEDS19662. Print 2020 Jul 1.
Pediatric neurosurgery is a core component of neurosurgical residency training. Pediatric case minimums are established by the Neurosurgery Residency Review Committee of the Accreditation Council for Graduate Medical Education (ACGME). Case minimums, by themselves, allow for great variability in training between programs. There are no prior data on how the residency programs meet these requirements. The authors' objective was to gather information on pediatric neurosurgical education among the ACGME-accredited neurosurgery training programs in order to shape further pediatric neurosurgical educational efforts.
A 25-question survey about pediatric neurosurgical education was created by the Education Committee of the Section on Pediatric Neurological Surgery of the American Association of Neurological Surgeons/Congress of Neurological Surgeons and distributed to program directors of all 111 ACGME-accredited neurosurgery training programs.
The response rate was 77% (86/111). In 55% of programs the residents are rotated to a responder-designated "freestanding" children's hospital, and 39% of programs rotate residents to a children's hospital within a larger adult hospital or a general hospital. There are 4 or fewer pediatric neurosurgical faculty in 91% of programs. In 12% of programs less than 100 cases are performed per year, and in 45% more than 500 are performed. In 31% of responding neurosurgery residency programs there is also a pediatric neurosurgery fellowship program supported by the same sponsoring institution. Seventy-seven percent of programs have at least one specific pediatric neurosurgery rotation, with 71% of those rotations occurring during postgraduate year 3 and 50% occurring during postgraduate year 4. The duration of pediatric rotation varies from no specific rotation to more than 1 year, with 48% of residents spending 4-6 months on a pediatric rotation and 12% spending 7-11 months. Last, 17% of programs send their residents to external sites sponsoring other residency programs for their pediatric rotation.
There is great variety between neurosurgery training programs with regard to resident education in pediatric neurosurgery. This study's data will serve as a baseline for future studies, and the authors hope the findings will guide further efforts in pediatric neurosurgical education in residency training programs.
小儿神经外科是神经外科住院医师培训的核心组成部分。研究生医学教育认证委员会（ACGME）的神经外科住院医师评审委员会规定了小儿病例的最低数量。仅病例最低数量本身就使得各培训项目之间的培训差异很大。此前没有关于住院医师培训项目如何满足这些要求的数据。作者的目的是收集ACGME认证的神经外科培训项目中有关小儿神经外科教育的信息，以便进一步推动小儿神经外科教育工作。
美国神经外科医师协会/神经外科医师大会小儿神经外科学分会教育委员会编制了一份关于小儿神经外科教育的25个问题的调查问卷，并分发给所有111个ACGME认证的神经外科培训项目的项目主任。
回复率为77%（86/111）。在55%的项目中，住院医师会轮转至由应答者指定的“独立”儿童医院，39%的项目会将住院医师轮转至大型成人医院或综合医院内的儿童医院。91%的项目中，小儿神经外科教员人数为4人或更少。12%的项目每年开展的病例数少于100例，45%的项目每年开展的病例数超过500例。在31%做出回应的神经外科住院医师培训项目中，还有由同一主办机构支持的小儿神经外科 fellowship项目。77%的项目至少有一个特定的小儿神经外科轮转，其中71%的轮转发生在研究生第3年，50%发生在研究生第4年。小儿轮转的时长从无特定轮转至超过1年不等，48%的住院医师在小儿轮转上花费4 - 6个月，12%花费7 - 11个月。最后，17%的项目会将其住院医师送到赞助其他住院医师培训项目的外部机构进行小儿轮转。
神经外科培训项目在小儿神经外科住院医师教育方面存在很大差异。本研究的数据将作为未来研究的基线，作者希望这些发现能指导住院医师培训项目在小儿神经外科教育方面的进一步努力。
