Socioeconomic issues and education of neurologic surgery residents in the United States.

BACKGROUND

The goals of this project were to ascertain the extent to which socioeconomic issues are being formally addressed within neurologic training programs in the United States and to determine the perception of chief neurosurgery residents and program directors regarding training and preparation as it relates to these issues.

METHODS

The chief neurosurgery residents and program directors for the 1995 academic year were identified and mailed a survey with questions regarding the formal training of socioeconomic issues within their programs.

RESULTS

Residents indicated that 95% did not believe their residency program provided adequate training in socioeconomic issues; 97% and 95% respectively, did not feel adequately prepared to deal with the business aspects of a medical practice or to deal with insurance companies and the managed care environment; and 87% did not think they were adequately prepared to deal with a lawsuit. Moreover, from 25%-87% did not know the meaning of terms such as capitation, RVUs, PPOs, or IPAs. The program directors indicated that 58% of the programs did not formally deal with socioeconomic issues.

CONCLUSIONS

This survey indicates that socioeconomic issues are not currently being properly addressed in a large proportion of neurosurgical residency programs. An overwhelming majority of the residents did not feel they are adequately prepared to deal with those nonmedical-surgical aspects of the practice of neurosurgery. This perception was corroborated by the response of the program directors. There appears to be a significant deficiency in the training of neurosurgical residents with regard to socioeconomic issues in the United States.