1Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and.
2Department of Neurosurgery, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
J Neurosurg. 2023 Aug 4;140(2):570-575. doi: 10.3171/2023.5.JNS222861. Print 2024 Feb 1.
Neurological surgery residency remains one of the most competitive and longest specialties in terms of training in medicine. The Accreditation Council for Graduate Medical Education uses residents' case volume throughout residency as one of its measures for the quality of surgical training. The objective was to study the variability of residency case volume among US training programs and to analyze the factors that potentially influence that case volume.
In line with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines, an online survey regarding department size, case volume, number of residents per year, number of dedicated research years, presence of fellows, and resident case volume by the time of graduation was created using Google Forms and distributed to all neurosurgery residency program directors and coordinators in the US.
A total of 97 of the 115 programs (84.3%) responded to the survey. Fifteen programs were excluded due to missing data or incomplete resident cohort at the time of the survey, and a total of 82 programs were included in the analysis. The average number of cases performed by residents as lead or senior surgeons by the time of graduation ranged from 900 to 2250 (median 1600 cases). The resident case volume did not have a significant correlation with the program case volume, number of operating attending neurosurgeons, number of residents, number of research years, or presence of fellows. The only factor that impacted the resident case volume was the number of cases performed per faculty.
The number of cases performed by residents throughout residency varied significantly between programs. Although other factors play important roles in the quality of training, including autonomy, variation, and complexity of cases, the resident case volume is one of the only measurable factors. This study sheds some light on the factors that potentially influence neurosurgical resident case volume.
神经外科住院医师培训是医学培训中竞争最激烈、时间最长的专业之一。研究生医学教育认证委员会（Accreditation Council for Graduate Medical Education）将住院医师在住院期间的病例量作为外科培训质量的衡量标准之一。本研究旨在研究美国培训项目之间住院医师病例量的差异，并分析潜在影响病例量的因素。
根据互联网电子调查结果报告清单（Checklist for Reporting Results of Internet E-Surveys，CHERRIES）指南，使用 Google 表单创建了一份关于科室规模、病例量、每年住院医师人数、专职研究年限、研究员存在情况以及住院医师毕业时病例量的在线调查，并分发给美国所有神经外科住院医师培训项目主任和协调员。
共有 115 个项目中的 97 个（84.3%）对调查做出了回应。由于数据缺失或调查时住院医师 cohort 不完整，有 15 个项目被排除在外，共有 82 个项目纳入分析。住院医师作为主导或高级外科医生毕业时完成的病例数平均为 900 至 2250 例（中位数为 1600 例）。住院医师的病例量与项目病例量、手术神经外科医生人数、住院医师人数、研究年限或研究员的存在均无显著相关性。唯一影响住院医师病例量的因素是每位教员完成的病例数。
住院医师在整个住院医师培训期间完成的病例量在项目之间差异显著。尽管其他因素（包括手术自主性、病例多样性和复杂性）在培训质量中起着重要作用，但住院医师的病例量是唯一可衡量的因素之一。本研究揭示了潜在影响神经外科住院医师病例量的因素。
