scholarly journals C.05 Canadian neurosurgery operative landscape

Author(s):  
MK Tso ◽  
M Bigder ◽  
A Dakson ◽  
C Elliott ◽  
D Guha ◽  
...  

Background: The Canadian Neurosurgery Research Collaborative (CNRC) is a trainee-led multi-centre collaboration made up of representatives from 12 of 14 neurosurgical centres with residency programs. To demonstrate the potential of this collaborative network, we gathered administrative operative data from each centre in order to provide a snapshot of the operative landscape in Canadian neurosurgery. Methods: Residents from each training program provided adult neurosurgical operative data for the 2014 calendar year, including the number of surgeries in the subcategories cranial, spinal, and peripheral nerve. Because some residency programs have surgeries distributed among more than one hospital, we calculated mean case load per residency program and per hospital. Results: Interim results from 6 neurosurgery residency programs are presented (with data from other programs forthcoming). Overall, there were on average 2,352 operative cases per residency program (n=6) and 1,176 operative cases per adult hospital (n=12). Among 5 programs with more detailed operative data, the mean numbers of cranial, spinal, peripheral nerve, and miscellaneous surgeries per residency program were 757 (47%), 487 (30%), 47 (3%), and 319 (20%) respectively. Conclusions: We show as a proof-of-concept that a trainee-led nation-wide research collaborative can generate meaningful data in a Canadian context.

Author(s):  
Michael K. Tso ◽  
Ayoub Dakson ◽  
Syed Uzair Ahmed ◽  
Mark Bigder ◽  
Cameron Elliott ◽  
...  

AbstractBackground Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Methods: Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Results: Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. Conclusions: This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.


2020 ◽  
pp. 000348942093882
Author(s):  
Aatin K. Dhanda ◽  
Brittany Ward ◽  
Christopher J. Warren ◽  
Ben Birkenfeld ◽  
Kirolos Georges ◽  
...  

Objectives: Matching to an otolaryngology residency program is a competitive process for medical students, and research performed by students is considered as a factor for granting interviews by program directors. Because abstracts, presentations and publications are all reported in combination by the National Resident Matching Program’s “Charting Outcomes in the Match” (ChOM) and may be weighted differently by PDs, we specifically investigated the number of publications by past applicants accepted to top otolaryngology residency programs. Methods: The top 25 otolaryngology residency programs were identified using Doximity, sorting by reputation. Current residents were determined from the programs’ websites. Using PubMed, each resident’s number of publications, authorship status, and journal type were recorded. Results: A total of 24 programs were included in the final analysis and the average number of manuscripts was 2.76 ± 4.01. The mean number of publications in otolaryngology journals was 1.03 ± 1.91. Conclusions: The difference between the investigated average number of publications (2.76) and those published by ChOM (10.4) represent a discrepancy due to the lack of delineation between abstracts, presentations and publications. The reported numbers for research may lead medical students to pursue alternate measures to increase their own research. Some options, such as adding a research year are not universally accessible. A clearer and more detailed approach to reporting research statistics would be beneficial to both applicants and PDs for otolaryngology programs.


2020 ◽  
Vol 12 (02) ◽  
pp. e234-e238
Author(s):  
Isdin Oke ◽  
Steven D. Ness ◽  
Jean E. Ramsey ◽  
Nicole H. Siegel ◽  
Crandall E. Peeler

Abstract Introduction Residency programs receive an institutional keyword report following the annual Ophthalmic Knowledge Assessment Program (OKAP) examination containing the raw number of incorrectly answered questions. Programs would benefit from a method to compare relative performance between subspecialty sections. We propose a technique of normalizing the keyword report to determine relative subspecialty strengths and weaknesses in trainee performance. Methods We retrospectively reviewed our institutional keyword reports from 2017 to 2019. We normalized the percentage of correctly answered questions for each postgraduate year (PGY) level by dividing the percent of correctly answered questions for each subspecialty by the percent correct across all subsections for that PGY level. We repeated this calculation for each PGY level in each subsection for each calendar year of analysis. Results There was a statistically significant difference in mean performance between the subspecialty sections (p = 0.038). We found above average performance in the Uveitis and Ocular Inflammation section (95% confidence interval [CI]: 1.02–1.18) and high variability of performance in the Clinical Optics section (95% CI: 0.76–1.34). Discussion The OKAP institutional keyword reports are extremely valuable for residency program self-evaluation. Performance normalized for PGY level and test year can reveal insightful trends into the relative strengths and weaknesses of trainee knowledge and guide data-driven curriculum improvement.


2021 ◽  
Vol 13 (01) ◽  
pp. e88-e94
Author(s):  
Alyssa M. Kretz ◽  
Jennifer E. deSante-Bertkau ◽  
Michael V. Boland ◽  
Xinxing Guo ◽  
Megan E. Collins

Abstract Background While ethics and professionalism are important components of graduate medical education, there is limited data about how ethics and professionalism curricula are taught or assessed in ophthalmology residency programs. Objective This study aimed to determine how U.S. ophthalmology residency programs teach and assess ethics and professionalism and explore trainee preparedness in these areas. Methods Directors from accredited U.S. ophthalmology residency programs completed an online survey about components of programs' ethics and professionalism teaching curricula, strategies for assessing competence, and trainee preparedness in these areas. Results Directors from 55 of 116 programs (46%) responded. The most common ethics and professionalism topics taught were informed consent (38/49, 78%) and risk management and litigation (38/49, 78%), respectively; most programs assessed trainee competence via 360-degree global evaluation (36/48, 75%). While most (46/48, 95%) respondents reported that their trainees were well or very well prepared at the time of graduation, 15 of 48 (31%) had prohibited a trainee from graduating or required remediation prior to graduation due to unethical or unprofessional conduct. Nearly every program (37/48, 98%) thought that it was very important to dedicate curricular time to teaching ethics and professionalism. Overall, 16 of 48 respondents (33%) felt that the time spent teaching these topics was too little. Conclusion Ophthalmology residency program directors recognized the importance of an ethics and professionalism curriculum. However, there was marked variation in teaching and assessment methods. Additional work is necessary to identify optimal strategies for teaching and assessing competence in these areas. In addition, a substantial number of trainees were prohibited from graduating or required remediation due to ethics and professionalism issues, suggesting an impact of unethical and unprofessional behavior on resident attrition.


2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Richard M Elias ◽  
Karen M Fischer ◽  
Mustaqeem A Siddiqui ◽  
Trevor Coons ◽  
Cindy A Meyerhofer ◽  
...  

Previous studies show that patient complaints can identify gaps in quality of care, but it is difficult to identify trends without categorization. We conducted a review of complaints relating to admissions on hospital internal medicine (HIM) services over a 26-month period. Data were collected on person characteristics and key features of the complaint. The complaints were also categorized into a previously published taxonomy. Seventy-six unsolicited complaints were identified, (3.5 per 1000 hospital admissions). Complaints were more likely on resident services. The mean duration between encounter and complaint was 18 days, and it took an average of 12 days to resolve the complaint. Most patients (59%) had a complaint in the Relationship domain. Thirty-nine percent of complaints mentioned a specific clinician. When a clinician was mentioned, complaints regarding communication and humaneness predominated (68%). The results indicate that the efforts to reduce patient complaints in HIM should focus on the Relationships domain.


2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Facundo N. Diaz ◽  
Marina Ulla

Abstract Background Diagnostic radiology residency programs pursuits as main objectives of the development of diagnostic capabilities and written communication skills to answer clinicians’ questions of referring clinicians. There has been also an increasing focus on competencies, rather than just education inputs. Then, to show ongoing professional development is necessary for a system to assess and document resident’s competence in these areas. Therefore, we propose the implementation of an informatics tool to objectively assess resident’s progress in developing diagnostics and reporting skills. We expect to found decreased preliminary report-final report variability within the course of each year of the residency program. Results We analyzed 12,162 evaluations from 32 residents (8 residents per year in a 4-year residency program) in a 7-month period. 73.96% of these evaluations belong to 2nd-year residents. We chose two indicators to study the evolution of evaluations: the total of discrepancies over the total of preliminary reports (excluding score 0) and the total of likely to be clinically significant discrepancies (scores 2b, 3b, and 4b) over the total of preliminary reports (excluding score 0). With the analysis of these two indicators over the evaluations of 2nd-year residents, we found a slight decrease in the value of the first indicator and relative stable behavior of the second one. Conclusions This tool is useful for objective assessment of reporting skill of radiology residents. It can provide an opportunity for continuing medical education with case-based learning from those cases with clinically significant discrepancies between the preliminary and the final report.


2019 ◽  
Vol 11 (01) ◽  
pp. e1-e8
Author(s):  
Michael Solotke ◽  
Susan Forster ◽  
Jessica Chow ◽  
Jenesis Duran ◽  
Hasna Karim ◽  
...  

Purpose The aim of this article is to examine the association between industry payments to ophthalmologists and scholarly impact. Design Retrospective cross-sectional study. Methods All ophthalmology faculty at United States accredited ophthalmology residency programs were included in this study. The main exposure was industry payments to ophthalmologists in 2016, as reported in the Centers for Medicare and Medicaid Services Open Payments Database. The primary outcome was Hirsch index (H-index), a measure of scholarly impact. Results Among 1,653 academic ophthalmologists in our study, 1,225 (74%) received industry payments in 2016. We did not observe a difference between the mean H-index of ophthalmologists receiving any industry payments versus those not receiving any payments (p = 0.68). In analysis including only ophthalmologists who received industry payments, H-index differed significantly by payment amount: 12.6 for ophthalmologists receiving less than $100, 12.2 for those receiving $100 to 1,000, 18.8 for those receiving $1,000 to 10,000, 21.3 for those receiving $10,000 to 100,000, and 29.4 for those receiving greater than $100,000 (p < 0.001). Within each academic rank and gender, industry payments greater than $1,000 were associated with a higher H-index (p < 0.05). Conclusions Although our analysis cannot prove causality, we observed a significant association between industry payments and scholarly impact among academic ophthalmologists, even after adjusting for gender, academic rank, and subspecialty. Prospective studies should further evaluate this relationship.


2011 ◽  
Vol 3 (3) ◽  
pp. 414-416 ◽  
Author(s):  
Nathan H Boyd ◽  
Raul M Cruz

Abstract Background The objective of this study was to determine the extent of interest in international electives among prospective otolaryngology residents and to determine whether the availability of international electives affected students' interest in ranking a particular residency program. Methods A 3-part survey was given to all medical students enrolled in the 2008 otolaryngology match via the Electronic Residency Application Service. Part 1 elicited demographic information. Part 2 explored general interest in international rotations. Part 3 involved ranking several factors affecting students' choice of residency programs. This survey was developed at our institution, with no formal validation. Participation was anonymous and voluntary. Results A total of 307 students entered the otolaryngology match, and 55 surveys (18%) were completed. Twenty-five of 55 students (55%) had completed an international elective during or prior to medical school, and 51 of 55 respondents (93%) had a “strong” or “very strong” desire to participate in an international elective during residency; 48 of 55 students (87%) had a “strong” or “very strong” desire to participate in international surgical missions after residency. Future practice goals had no correlation with interest in international rotations, either during or after residency training. Respondents ranked 8 factors that had an impact on residency program selection in the following order of importance: operative experience, location, lifestyle, research opportunities, didactics, international electives, prestige of program, and salary. Conclusion Interest in international medicine among prospective otolaryngologists was high in this subset of respondents but did not appear to affect residency program selection.


Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011354
Author(s):  
Fábio A. Nascimento ◽  
Jay R. Gavvala

Objective:To better understand the EEG education provided to adult neurology residents by surveying program directors (PDs) of adult neurology residency programs in the US.Methods:An online survey focused on characteristics of neurology residency programs and their EEG teaching systems was distributed to the 161 adult neurology residency PDs listed in the ACGME website at the time of the study.Results:Forty-seven (29%) out of the 161 PDs completed the survey – most of the participating programs (89%) were academic. The mean number of 1-month EEG rotation(s) required to graduate was 1.7 (range 0-4, median 1.75). EEG rotations involved the inpatient and outpatient setting in 91% and 70% of programs, respectively. The average number of EEGs read during a typical EEG rotation varied from more than 40, in about one-third of programs, to 0-10, in about 14% of programs. There was significant variability in the requirements for successful completion of EEG rotations, and most PDs (64%) reported not utilizing objective measures to assess EEG milestones. The most commonly used educational methods were didactics throughout the year (95%) and EEG teaching during EEG rotations (93%). The most commonly reported barriers to EEG education were insufficient EEG exposure (32%) and ineffective didactics (11%); possible solutions are summarized in table 1.Conclusion:Our study identified a lack of consistency in teaching and evaluating residents during residency and presented EEG education barriers alongside possible solutions. We encourage PDs across the country to re-evaluate their EEG teaching systems in order to optimize EEG education.


Author(s):  
Ryan Mortman ◽  
Harold A. Frazier ◽  
Yolanda C. Haywood

ABSTRACT Background Increasing diversity in medicine is receiving more attention yet underrepresented in medicine (UiM) surgeons remain a small fraction of all surgeons. Whether surgical training programs attempt to attract UiM applicants to their programs, and therefore their specialties, through program website information is unclear. Objective To analyze the scope of diversity and inclusion (D&I) related information on US allopathic and osteopathic general surgery, integrated thoracic surgery, and integrated vascular surgery residency program websites. Methods Residency programs were identified through the Electronic Residency Application Service (ERAS) in July 2020. We searched surgical program websites and collected data on the presence or absence of variables labeled “diversity & inclusion” or “underrepresented in medicine.” Variables found on program websites as well as sites linked to the program website were included. We excluded programs identified in ERAS as fellowship training programs. Programs without webpages were also excluded. Results We identified 425 residency programs and excluded 22 from data analysis. Only 75 of the 403 included programs (18.6%) contained D&I-related information. The presence of individual variables was also low, ranging from 4.5% for opportunities related to early exposure to the specialty to 11.1% for a written or video statement of commitment to D&I. Conclusions In 2020, as recruitment and interviews moved entirely online, few US allopathic and osteopathic general surgery, integrated thoracic surgery, and integrated vascular surgery residency programs provided D&I-related information for residency applicants on their program websites.


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