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neurosurgery_resident

Neurosurgery Resident

A resident physician or resident or resident medical officer is a person who has received the title of “physician” (usually a D.O., M.D. or MBBS, MBChB, BMed) or in some circumstances, another health sciences terminal degree (such as psychology or dentistry) who practices medicine usually in a hospital or clinic.

Its a stage of Graduate Medical Education.

The definition of Residency varies worldwide by country and structure of the medical industry.

In the US, it is classically associated with physicians (D.O. or M.D.), the training programs of pharmacists, physical therapists, physician assistants, veterinarians, podiatrists, medical physicists, optometrists, and dentists may also involve a period of training referred to as a residency.

see Neurosurgery residency matching program.

Neurosurgical training

Working Time directive

Competencies

see Neurosurgery Resident Competencies.


The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who had undergone neurosurgical procedures between 2006 and 2012. The operating surgeon(s), whether an attending only or attending plus resident, was assessed for his or her influence on morbidity and mortality. Multivariate logistic regression, was used to estimate odds ratios for 30-day postoperative morbidity and mortality outcomes for the attending-only compared with the attending plus resident cohorts (attending group and attending+resident group, respectively).

The study population consisted of 16,098 patients who had undergone elective or emergent neurosurgical procedures. The mean patient age was 56.8 ± 15.0 years, and 49.8% of patients were women. Overall, 15.8% of all patients had at least one postoperative complication. The attending+resident group demonstrated a complication rate of 20.12%, while patients with an attending-only surgeon had a statistically significantly lower complication rate at 11.70% (p < 0.001). In the total population, 263 patients (1.63%) died within 30 days of surgery. Stratified by operating surgeon status, 162 patients (2.07%) in the attending+resident group died versus 101 (1.22%) in the attending group, which was statistically significant (p < 0.001). Regression analyses compared patients who had resident participation to those with only attending surgeons, the referent group. Following adjustment for preoperative patient characteristics and comorbidities, multivariate regression analysis demonstrated that patients with resident participation in their surgery had the same odds of 30-day morbidity (OR = 1.05, 95% CI 0.94-1.17) and mortality (OR = 0.92, 95% CI 0.66-1.28) as their attending only counterparts.

Cases with resident participation had higher rates of mortality and morbidity; however, these cases also involved patients with more comorbidities initially. On multivariate analysis, resident participation was not an independent risk factor for postoperative 30-day morbidity or mortality following elective or emergent neurosurgical procedures 1).


Current selection methods for neurosurgical residents fail to include objective measurements of bimanual psychomotor performance. Advancements in computer-based simulation provide opportunities to assess cognitive and psychomotor skills in surgically naive populations during complex simulated neurosurgical tasks in risk-free environments.

Neurosurgical resident publication productivity

Neurosurgical resident publication productivity during training years has been linked with academic positions and future promotions to professorship and chairmanship 2).

1)
Bydon M, Abt NB, De la Garza-Ramos R, Macki M, Witham TF, Gokaslan ZL, Bydon A, Huang J. Impact of resident participation on morbidity and mortality in neurosurgical procedures: an analysis of 16,098 patients. J Neurosurg. 2015 Apr;122(4):955-61. doi: 10.3171/2014.11.JNS14890. Epub 2015 Jan 9. PubMed PMID: 25574567.
2)
Crowley RW, Asthagiri AR, Starke RM, et al. In-training factors predictive of choosing and sustaining a productive academic career path in neurological surgery. Neurosurgery. 2012;70(4):1024-1032.
neurosurgery_resident.txt · Last modified: 2019/05/07 16:54 by administrador