Neuro-anaesthesia training in Pakistan: Evaluating the need for a dedicated fellowship program.

BACKGROUND & OBJECTIVE: Anaesthesia for neurosurgery has advanced with the passage of time. However, nation-wide training standards linked to general residency has certain limitations. It's important to have dedicated neuro-anaesthesia fellowship program, basis of which should be the three pillars of neuro-anaesthesiology. The objective of this survey was to assess the need of neuro-anaesthesia fellowship based on opinions of practicing anaesthesiologists and neurosurgeons of Pakistan.

METHODS

After getting ethical approval and consent, data related to this cross sectional survey was collected using online questionnaire at the Aga Khan University, Pakistan. The form was circulated through social media to individuals and relevant groups. The survey link remained active for a duration of one month, from November 3rd, 2023, to December 3rd, 2023.

RESULTS

Total 282 forms were received, out of which 63 were incomplete while 219 were analyzed. 80.2% respondents were anaesthesiologists and 19.8% neurosurgeons. A significant finding was utilization of non-neuro-anaesthesiologist based clinical care for majority of surgical cases. Gaps in training during residency years were also identified. Survey participants also agreed that neurosurgical case setup is complex, which mandates the need of specialized knowledge and skills. Overall, 87% of participants favored the need of neuro-anaesthesia fellowship training. In general, 45.2% anaesthesiologist wished to pursue a further fellowship in neuro-anaesthesia, and 65% believed that one-year duration to be adequate. Only 7.0% of physicians proposed that there is no need of additional fellowship training.

CONCLUSION

The need of neuro-anaesthesia fellowship program is well established based on findings of this survey. This was linked to training gaps as a part of general residency curriculum. Dedicated fellowship program is required for improving patient safety and better outcomes.