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Resident Curriculum Guidelines for Neurosurgery

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This curriculum was created in an effort to detail the body of knowledge which should be attained by an individual completing residency training in Neurological Surgery. The specific structure of resident education in Neurological Surgery is defined by the American Board of Neurological Surgery and each program is periodically examined by the Residency Review. It is not the intent of this curriculum to direct or influence these two entities in any way. The curriculum is meant to serve as a template to be utilized by individual Neurosurgery Residency Program Directors and residents as they see fit. In many respects, this compehensive and specific curriculum delineates the "ideal" and therefore complete compliance to the curriculum will be difficult or impossible to achieve for most if not all programs. Nevertheless, it represents a goal toward which to strive.

This document will assist program directors, faculty, and residents in structuring an adequate postgraduate experience in Neurological Surgery. It should serve to create an organizational structure of academic, clinical, and technical criteria for the training of residents in Neurological Surgery. The curriculum should prompt established training programs to examine their educational experience and assist new programs in designing a comprehensive educational experience. The goal is to improve patient care by assuring residents completing training have achieved the highest possible level of competency in Neurological Surgery.

Although each portion of the curriculum has been examined by a number of recognized experts and leading educators in Neurological Surgery, it is recognized that an absolute consensus concerning the definition of essential knowledge for the practice of Neurological Surgery has not, and will not, be achieved. Despite this inevitable shortcoming, wide distribution of this resource to program directors, faculty, and residents will allow for each program to maximize its strengths and address its weaknesses and promote constructive dialogue amongst all involved parties.

It is noted that there is redundancy in the curriculum. This has arisen because many areas of neurosurgery overlap. The curriculum structure is based on performance. This will hopefully facilitate self-directed resident study. It also will impart some objectivity to periodic resident evaluations. The curriculum is constructed in such a manner that the educational experience is divided into three levels - Junior, Middle, and Senior. The resident should display competency in each level before progressing to the next. Those individuals who do not stay on track will be promptly identified in an objective manner, thereby enabling more timely remedial attention or dismissal. Furthermore, it will force each program to examine its faculty and the structure of the basic and clinical training to assure an optimal educational experience. The curriculum does not define how information is imparted, only the body of knowledge which must be mastered. It is up to each program to determine whether achievement of the goals will be accomplished through conferences, required readings, scheduled lectures or workshops, etc.

Adequate supervision of the resident performance is critical to assure proper care of the patient and learning of the resident. It is recognized, however, that a great deal of learning also takes place without supervision. Programs should be structured to allow residents to act independently at various tasks commensurate with their skills and the specific medical situation.

Although the assessment of resident, faculty, and program performance is extremely important, the curriculum does not include specific outcomes measures. Presently, resident evaluation is performed in a non-uniform manner by the faculty and directors of each individual program. Hopefully there will be homogeneous evaluation of the knowledge and performance for each level of residency in the future.

Finally, it should be recognized that a great number individuals have provided input and reviewed this work. Many of these persons are not listed as authors but without their assistance the completion of this curriculum would not be possible.