title: Neurosurgical Education in a Changing Healthcare and Regulatory Environment: A Consensus Statement from 6 Programs.
abstract: The purpose of neurosurgical education is to teach the clinical knowledge and surgical skills necessary to become a neurosurgeon. Another goal is to inculcate the principles of the scientific method. However, increasing expectations about attending involvement during surgery, duty hour requirements, and new curricular mandates have put programs under stress to ensure adequate training, in less time, in an environment of limited resident independence. More recently, the Accreditation Council for Graduate Medical Education has developed a new tracking process based on "milestones" or defined educational outcomes. At the same time, our healthcare system is undergoing a rapid socioeconomic transition in organization and payment models, which traditionally has not been a focus of formal teaching. A 2008 survey conducted by the Council of State Neurosurgical Societies found that graduating residents felt inadequately prepared in areas like contract negotiation, practice evaluation, and management.
authors.affiliation: Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, Texas.
authors.forename: Dong H
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Ralph G
authors.initials: RG
authors.lastname: Dacey
authors.affiliation: Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Zipfel
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Mitchel S
authors.initials: MS
authors.lastname: Berger
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Michael
authors.initials: M
authors.lastname: McDermott
authors.affiliation: Department of Neurosurgery, Indiana University, Indianapolis, Indiana.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Barbaro
authors.affiliation: Department of Neurosurgery, Indiana University, Indianapolis, Indiana.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Shapiro
authors.affiliation: Department of Neurosurgery, Columbia University, New York, New York.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Solomon
authors.affiliation: Department of Neurosurgery, Pennsylvania State University, Hershey, Pennsylvania.
authors.forename: Robert
authors.initials: R
authors.lastname: Harbaugh
authors.affiliation: Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, Texas.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Day
mesh_terms: D032921:Consensus; D004503:Education, Medical, Graduate / Q000379:methods / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D000069471:Neurosurgeons / Q000193:education; D009493:Neurosurgery / Q000193:education*; D058996:Quality Improvement / Q000592:standards*
keywords: Neurosurgery residency; Neurosurgical education; Neurosurgical milestones