How many residents shall we train--the situation in Germany

The situation of training neurosurgeons in Germany is reviewed taking into consideration the current figures of finished residencies, the development in the number of training neurosurgical units in Germany, and the personnel and structure of a neurosurgery unit allowed to train. The jurisdiction for specialist training as well as typical problems encountered in training residents are being discussed. In 1992; 130,364 patients, equivalent to 0.94% of all patients in Germany were treated in 4.792 dedicated neurosurgical beds. A total of 644 working neurosurgeons were registered. Between 1986 and 1993, 349 residents qualified as neurosurgeons, an average of 43.5 per year. 57% of neurosurgical units employ non-trainee junior doctors, 13% have no residents, and 62% of departments trained less than one resident per year on average. Only 57% of units finish residency training always on time and only 79% of major units have full training permission. The figures provided in this article do not substantiate the assumption that we have trained too many specialists in the past. The problems which some residency programmes encounter however do suggest that it could be wise not to continue to train specialists at the same rate as in the past.