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    Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

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    Author
    Drummond, KJ; Hunn, BHM; McAlpine, HE; Davies, MA; Gull, S
    Date
    2020-03-01
    Source Title
    Neurosurgical Focus
    Publisher
    AMER ASSOC NEUROLOGICAL SURGEONS
    University of Melbourne Author/s
    Drummond, Katharine; McAlpine, Heidi; Jones, Jordan; Hunn, Benjamin
    Affiliation
    Surgery (RMH)
    Florey Department of Neuroscience and Mental Health

    Business & Economics
    Metadata
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    Document Type
    Journal Article
    Citations
    Drummond, K. J., Hunn, B. H. M., McAlpine, H. E., Davies, M. A. & Gull, S. (2020). Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?. NEUROSURGICAL FOCUS, 48 (3), https://doi.org/10.3171/2019.12.FOCUS19870.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254177
    DOI
    10.3171/2019.12.FOCUS19870
    Open Access URL
    http://doi.org/10.3171/2019.12.FOCUS19870
    Abstract
    OBJECTIVE: Neurosurgical training poses particular challenges in Australia and New Zealand, given the large landmass, small population, and widely separated, often small, neurosurgical units. Such factors have necessitated a move away from autonomous, single-institution-based training to the selection of trainees by a centralized binational process. The success of this system is based on rigorous standardized evaluation of candidates' academic achievements, anatomical knowledge, references, and interview performance. Similarly, the accreditation of hospitals to train successful candidates has been standardized. The authors review the evolution of trainee selection and the accreditation of training posts in Australia and New Zealand. METHODS: The records of the Neurosurgical Society of Australasia Surgical Education and Training Board were reviewed for documents pertaining to the selection of neurosurgical trainees and the accreditation of training posts. Application records and referee scores from 2014 to the present were reviewed to encompass process changes, in particular the change from written referee reports to standardized interviews of referees. Surgical logbook case numbers for 23 trainees completing training in 2016, 2017, and 2018 were collated and presented in an aggregated, de-identified form as a measure of adherence to accreditation standards. Written evaluations of the training experience were also sought from two trainees reflecting on the selection process, the quality of training posts, and training limitations. RESULTS: While a time-consuming process, the method of obtaining referee reports by interview has resulted in a wider spread of scores, more able to separate high- and low-scoring applicants than other components of the selection process. Review of the training post accreditation records for the last 2 years showed that adherence to standards has resulted in loss of accreditation for one unit and shortened periods of review for units with more minor deficiencies. Two applications for accreditation have been denied. Examination of caseload data showed that trainees more than fulfill minimum requirements in accredited training posts, confirming the robust nature of this aspect of unit accreditation. CONCLUSIONS: A key factor determining the success of neurosurgical training in Australia and New Zealand has been a willingness to evolve selection and other processes to overcome challenges as they become apparent. According to available analyses, the revised referee process and strict accreditation standards appear effective. The benefits and challenges of the current training system are discussed in the context of a paucity of international literature.

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    • Minerva Elements Records [45689]
    • Business & Economics Collected Works - Research Publications [89]
    • Florey Department of Neuroscience and Mental Health - Research Publications [1052]
    • Surgery (RMH) - Research Publications [264]
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