title: Preparedness of neurosurgery graduates for neuroendovascular fellowship: a national survey of fellowship programs.
abstract: OBJECTIVE
  Endovascular interventions have become an essential part of a neurosurgeon's practice. Whether endovascular procedures have been effectively integrated into residency curricula, however, remains uncertain. The purpose of this study was to assess the preparedness of US neurosurgery graduate trainees for neuroendovascular fellowship.
  
  
  METHODS
  A multidomain, global assessment survey was sent to all directors/faculty of neuroendovascular fellowship programs involved in training of US neurosurgery graduates. Surveyees were asked to assess trainees as they entered fellowship.
  
  
  RESULTS
  The response rate was 78% (25/32). Of respondent program directors, 38% reported that new fellows did not know the history and imaging of the patient and 50% were unable to formulate an appropriate treatment plan. As many as 79% of fellows were unfamiliar with endovascular devices and 75% were unfamiliar with angiographic equipment. Furthermore, 58% of fellows were unable to perform femoral access, 54% were unable to perform femoral closure, 79% were unable to catheterize a major vessel, 86% were unable to perform a 4-vessel angiogram, and 100% were unable to catheterize an aneurysm. Additionally, program directors reported that over 50% of fellows could not recognize neurovascular anatomy and 54% could not recognize/classify vascular abnormalities. There was an overall agreement that fellows demonstrated professionalism and interest in research and had good communication/clinical skills.
  
  
  CONCLUSIONS
  The results of this study suggest potential gaps in the training of neurosurgery residents with regard to endovascular neurosurgery. In an era of minimally invasive therapies, changes in residency curricula may be needed to keep pace with the ever-changing field of neurosurgery.
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Philip
authors.initials: P
authors.lastname: Manasseh
authors.affiliation: Department of Neurosurgery, University of Iowa, Iowa City, Iowa; and.
authors.forename: David
authors.initials: D
authors.lastname: Hasan
authors.affiliation: Department of Neurosurgery, Yale and New Haven Hospital, New Haven, Connecticut.
authors.forename: Ketan R
authors.initials: KR
authors.lastname: Bulsara
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Kevin
authors.initials: K
authors.lastname: Lawson
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenwasser
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania;
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
mesh_terms: D002404:Catheterization; D002533:Cerebral Angiography; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004503:Education, Medical, Graduate; D057510:Endovascular Procedures / Q000193:education*; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency; D002532:Intracranial Aneurysm / Q000601:surgery; D009493:Neurosurgery / Q000193:education*; D019635:Neurosurgical Procedures / Q000193:education; D024382:Professional Role; D011795:Surveys and Questionnaires; D014481:United States
keywords: AVM = arteriovenous malformation; endovascular; fellowship; interventional neurosurgery; neurosurgery; residency; training