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Neurosurgical Resident Training in Germany
Martin N Stienen1, Jens Gempt2, Oliver P Gautschi1
1Service de Neurochirurgie, Hôpitaux Universitaires de Genève, Genève, Switzerland.
Summary
Neurosurgical training in Germany shows mixed results compared to Europe. While German residents gain early lumbar spine experience, they lag in cervical spine and craniotomy procedures, with longer working hours spent on administration rather than surgery.
Area of Science:
- Neurosurgery
- Medical Education
- Surgical Training
Background:
- High-quality neurosurgical training is essential for patient care.
- European Working Time Directive impacts resident training hours.
- Current neurosurgical resident training status in Germany requires evaluation.
Purpose of the Study:
- To evaluate the current status of neurosurgical resident training in Germany.
- To compare German trainees' experiences with those in other European countries.
- To identify areas of superiority and inferiority in German neurosurgical training.
Main Methods:
- An electronic survey was distributed to European neurosurgical trainees (June 2014 - March 2015).
- Responses from German trainees were compared to non-German trainees.
- Logistic regression analysis assessed the impact of being a German trainee on training outcomes.
Main Results:
- German trainees reported lower satisfaction with clinical lectures (OR: 0.29) but similar satisfaction with operating room exposure.
- German trainees were more likely to perform lumbar spine interventions early (OR: 2.27) but less likely to perform cervical spine procedures (OR: 0.38) and craniotomies (OR: 0.49) within specified training periods.
- German trainees exceeded the 48-hour work week limit (25.6% adherence), worked longer hours (>50 hours/week, OR: 2.13), and spent less time in surgery (OR: 0.26) and more on administrative tasks (OR: 1.83).
Conclusions:
- Neurosurgical training in Germany presents a mixed picture, with some aspects superior and others inferior to European standards.
- Training deficiencies include less exposure to complex spinal and cranial procedures and increased administrative workload.
- The findings necessitate a critical review of German neurosurgical training facilities and practices.
