The evolution of the Neurosurgery Residency System in North America. Part II: From the 1970s to the present

In this second part of the article on the Residency System in North America we analyse the impact of the changes in the management and financing of healthcare on the evolution of training. The restriction of financial resources introduced by the third-party payer system and duty hour regulations ultimately deterioraterd the quality of training and the conduct of research by residents. The potential strategies to sustain and improve the Residency System at the end of the first quarter of the 21st century are commented.