Neurosurgical resident training in Czech Republic

David Netuka, Martin N. Stienen, Florian Ringel, Jens Gempt, Andreas K. Demetriades, Karl Schaller


Introduction: Resident training is essential to be able and 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 being from Czech Republic and the outcomes (e.g. satisfaction, working time).

Results: Of n=532 responses, 22 were from Czech trainees (4.14%). In 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 tended to be higher than in other Europe (OR 3.22, 0.72-14.39, p=0.125). 100% of Czech trainees vs. 88.7% of trainees from other Europe performed a surgical procedure as primary surgeon within the first year of training (Pearson Chi2 2.28, p=0.131). They were about 4 times as likely to begin with 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 in 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. 72% of Czech trainees adhere to the weekly limit of 48h as requested from the European Working Time Directive 2003/88/EC, and this is better than international comparison (OR 0.26, 0.09-0.75, p=0.013).

Conclusion: Most theoretical and practical aspects of neurosurgical training are rated similar by Czech trainees when compared to the situation of trainees from other European countries. They adhere better to the 48h-week as requested by the European WTD 2003/88/EC.

Klíčová slova

Resident education; surgical education; Neurosurgery; European working time directive; future perspective; training conditions; satisfaction rate; craniotomy; spine surgery; working time; surgical training; Czech Republic

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Cesk Slov Neurol N 2017; 80/113