Neurosurgical procedures performed during residency in Europe-preliminary numbers and time trends.
Caseload
Europe
Neurosurgery
Residency
Training program
Working hour restriction
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
20
01
2019
accepted:
20
03
2019
pubmed:
31
3
2019
medline:
13
3
2020
entrez:
31
3
2019
Statut:
ppublish
Résumé
Differences in the postgraduate training programs of neurosurgical residents are suspected throughout Europe. The influence of working hour restrictions by the European Working Time Directive (WTD) 2003/88/EC on the number of surgical procedures remains unclear. We designed a survey to collect information on the number of surgical procedures, performed by European neurosurgical trainees during residency. This article reports preliminary data. An electronic survey was distributed among the European Association of Neurosurgical Societies (EANS) member countries by national delegates of the training committee, as well as by members of the Young Neurosurgeons' committee. The EANS mailing list of individual members was also used for distribution. All responses received between 04/2018 and 12/2018 were considered. From n = 180 responses received, 42 were omitted as responders were still in residency and for 58 relevant information was missing. The final sample was n = 80, with a mean responder's age of 43.0 years (SD 8.6) and 88.8% being male. Responses came from 16 European countries; board certification was received between the years of 1976-2018. The numbers of surgical procedures performed independently were 511 (mean, 95% confidence interval (CI) 413-610), supervised were 514 (95%CI 360-668) and assisted were 752 (95%CI 485-1019) throughout residency. More detailed numbers for specific procedure types are reported in the article. Independently performed cranial procedures outnumbered spinal procedures (p < 0.006), and adult procedures outnumbered pediatric procedures (p < 0.001). There was a strong decrease in caseload between 1976 and 2018, with trainees performing on average 65 cases less throughout residency for each calendar year increase in board certification (95% CI - 116 to - 15, p = 0.012). Trainees graduating residency before introduction of the European WTD 2003/88/EC participated in more procedures than those graduating afterwards (mean 2797 vs. 1418, p = 0.005). The preliminary analysis of the first 80 responses now provides a first reference frame for caseload that can be used by current and future European residents to critically compare their own operative numbers to. There was a strong decline in surgical cases over time, and trainees graduating after introduction of the European WTD 2003/88/EC had less surgical exposure. The survey remains open, and we invite further European neurosurgeons to provide their data in order to get even more robust estimates.
Sections du résumé
BACKGROUND
Differences in the postgraduate training programs of neurosurgical residents are suspected throughout Europe. The influence of working hour restrictions by the European Working Time Directive (WTD) 2003/88/EC on the number of surgical procedures remains unclear. We designed a survey to collect information on the number of surgical procedures, performed by European neurosurgical trainees during residency. This article reports preliminary data.
METHODS
An electronic survey was distributed among the European Association of Neurosurgical Societies (EANS) member countries by national delegates of the training committee, as well as by members of the Young Neurosurgeons' committee. The EANS mailing list of individual members was also used for distribution. All responses received between 04/2018 and 12/2018 were considered.
RESULTS
From n = 180 responses received, 42 were omitted as responders were still in residency and for 58 relevant information was missing. The final sample was n = 80, with a mean responder's age of 43.0 years (SD 8.6) and 88.8% being male. Responses came from 16 European countries; board certification was received between the years of 1976-2018. The numbers of surgical procedures performed independently were 511 (mean, 95% confidence interval (CI) 413-610), supervised were 514 (95%CI 360-668) and assisted were 752 (95%CI 485-1019) throughout residency. More detailed numbers for specific procedure types are reported in the article. Independently performed cranial procedures outnumbered spinal procedures (p < 0.006), and adult procedures outnumbered pediatric procedures (p < 0.001). There was a strong decrease in caseload between 1976 and 2018, with trainees performing on average 65 cases less throughout residency for each calendar year increase in board certification (95% CI - 116 to - 15, p = 0.012). Trainees graduating residency before introduction of the European WTD 2003/88/EC participated in more procedures than those graduating afterwards (mean 2797 vs. 1418, p = 0.005).
CONCLUSIONS
The preliminary analysis of the first 80 responses now provides a first reference frame for caseload that can be used by current and future European residents to critically compare their own operative numbers to. There was a strong decline in surgical cases over time, and trainees graduating after introduction of the European WTD 2003/88/EC had less surgical exposure. The survey remains open, and we invite further European neurosurgeons to provide their data in order to get even more robust estimates.
Identifiants
pubmed: 30927157
doi: 10.1007/s00701-019-03888-3
pii: 10.1007/s00701-019-03888-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
843-853Investigateurs
Sasan D Adib
(SD)
Amro Al-Habib
(A)
Rafid Al-Mahfoudh
(R)
Ridvan Alimehmeti
(R)
Aymeric Amelot
(A)
Lisa Arvidsson
(L)
Nurali Ashirov
(N)
Toomas Asser
(T)
Kaspar Auslands
(K)
Cecilia I A Avellan
(CIA)
Jiri Bartek
(J)
Jacques Beaurain
(J)
Luka Berilazic
(L)
Roman Bosnjak
(R)
Pierre Bourdillon
(P)
Oliver Bozinov
(O)
Anna Martina Brunner
(AM)
Bilginer Burcak
(B)
Alexandre Carpentier
(A)
Antonio Cerejo
(A)
Hans Clusmann
(H)
Dominik Cordier
(D)
Marcus Czebanka
(M)
Suparna Das
(S)
Andreas Demetriades
(A)
Sandra F Dias
(SF)
Francesco DiMeco
(F)
Djula Djilvesi
(D)
Johnny Duerinck
(J)
Chloé Dumot
(C)
Pierre-Jacques Finiels
(PJ)
Nikolaos Foroglou
(N)
Christian F Freyschlag
(CF)
Arnab Ghosh
(A)
Dimitrios Giakoumettis
(D)
Nathalie Gilis
(N)
Jagos Golubovic
(J)
Stefan J Grau
(SJ)
Nils Hecht
(N)
Markus Holling
(M)
Bogdan Iliescu
(B)
Marcel Ivanov
(M)
Timothee Jacquesson
(T)
Dariusz Jakolski
(D)
Ibrahim Jalloh
(I)
Assylbek Kaliyev
(A)
Almuth F Kessler
(AF)
Jean-Charles Kleiber
(JC)
Angelos Kolias
(A)
Nikolay Konovalov
(N)
Karl F Kothbauer
(KF)
Vojin Kovacevic
(V)
Nenad Krajcinovic
(N)
Sandro M Krieg
(SM)
Aki Laakso
(A)
Christophe Lapras
(C)
Aaron Lawson McLean
(AL)
Caroline Le Guerinel
(C)
Milan Lepic
(M)
Dominique Liguoro
(D)
Johan Ljungqvist
(J)
William B Lo
(WB)
Ivan Macuga
(I)
Martin Majovsky
(M)
Yerbol Makhambetov
(Y)
Francesco Marchi
(F)
Torstein R Meling
(TR)
Anthony Melot
(A)
Antonio Meola
(A)
Patrick Mertens
(P)
Stephen Metcalfe
(S)
Svein Harald Moerkve
(SH)
Wouter Moojen
(W)
Arsim Morina
(A)
Mohammad Jawad Naushahi
(MJ)
Laszio Novak
(L)
Aitimbetov Nurzhan
(A)
Ibrahim Omerhodzic
(I)
Johan Pallud
(J)
Vakis Papanastassiou
(V)
Vladimir Papic
(V)
Michael Payer
(M)
Jenny Pettersson Segerlind
(JP)
Jussi P Posti
(JP)
Francois Proust
(F)
Lukas Rasulic
(L)
Luca Regli
(L)
Michael Reinert
(M)
Mirjam Renovanz
(M)
Florian Ringel
(F)
Jaako Rinne
(J)
Pierre-Hugues Roche
(PH)
Saulius Rocka
(S)
Roman Rotermund
(R)
Scott A Rutherford
(SA)
Tönu Rätsep
(T)
Ilkka M Saarenpää
(IM)
Marko Samardzic
(M)
Nicolas Sampron
(N)
Ulrika Sandvik
(U)
Michel Schneider
(M)
Gerrit Schubert
(G)
Saurabh Sinha
(S)
Jane Skjoeth-Rasmussen
(J)
Volodymyr Smolanka
(V)
Martin Smrcka
(M)
Ole Solheim
(O)
Sergey Spektor
(S)
Martin N Stienen
(MN)
Mario Teo
(M)
Claudius Thomé
(C)
Simon Thomson
(S)
Magnus Tisell
(M)
Cristina P Torres Diaz
(CP)
Dirk Van Roost
(D)
Henk van Santbrink
(H)
Nicolay Velinov
(N)
Aleksic Vuk
(A)
Miroslav Vukic
(M)
James Walkden
(J)
Christopher Wendel
(C)
Commentaires et corrections
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