David Netuka, Martin Nikolaus Stienen, Florian Ringel, Jens Gempt, Andreas K Demetriades, Karl Schaller
Neurosurgical resident training in Czech Republic
Číslo: 1/2018
Periodikum: Česká a slovenská neurologie a neurochirurgie
ISBN: 1210-7859
DOI: 10.14735/amcsnn201866
Klíčová slova: resident education – surgical education – neurosurgery – European Working Time Directive – future perspective – training conditions – satisfaction rate – craniotomy – spine surgery – working time – Czech Republic
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Resident training is essential to be able to offer high-quality medical care. Neurosurgical training in its traditional form is currently challenged by law-enforced working hour restrictions and general re-structuring within Europe. We aimed to evaluate the current situation of resident training in the Czech Republic.
Methods:
An electronic survey was sent to European neurosurgical trainees between 06/ 2014 and 03/ 2015. The responses of Czech trainees were compared to those of trainees from other European countries. Logistic regression analysis was used to assess the effect size of the relationship between a trainee from the Czech Republic and the outcomes (e. g. satisfaction, working time).
Results:
Of n = 532 responses, 22 were from Czech trainees (4.14%). In a multivariate analysis, Czech trainees were as likely as non-Czech European trainees to be satisfied with clinical lectures given at their teaching facility (OR 1.84; 95% CI 0.77– 4.43; p = 0.170). The satisfaction rate with hands-on operating room exposure was nonsignificantly higher than in other European countries (OR 3.22; 0.72– 14.39; p = 0.125). Approximately 100% of Czech trainees vs. 88.7% of trainees from other European countries performed a surgical procedure as the primary surgeon within the first year of training (Pearson Chi2 test 2.28; p = 0.131). They were about 4-times as likely to begin with their own cranial cases within 36 months of training (OR 3.69; 1.04– 13.07; p = 0.042). Czech trainees were 52-times as likely to perform on average ≥ 4 peripheral nerve interventions per month (OR 52.05; 11.46– 236.31; p < 0.001), but less likely to operate ≥ 10 burr hole trepanations (OR 0.13; 0.02– 0.97; p = 0.047) and the exposure was balanced regarding craniotomies and spine procedures. About 72% of Czech trainees adhered to the weekly limit of 48 h as requested from the European Working Time Directive 2003/ 88/ EC, and this was better than the international comparison (OR 0.26; 0.09– 0.75; p = 0.013).
Conclusion:
Most theoretical and practical aspects of neurosurgical training are rated similarly by Czech trainees when compared to the situation of trainees from other European countries. They adhered better to the 48 h week as requested by the European WTD 2003/ 88/ EC.