1344. The clinical experience of a junior resident in pediatric neurosurgery and introduction of the Resident Experience Score

Authors: William Edward Gordon, MD; Paul Klimo, MD, MPH (Memphis, TN)

Introduction:  Pediatric neurosurgical operative and non-operative experience per program or PGY level is not available from the ACGME.  The objective of our study was to quantify the pediatric neurosurgery workload and educational experience of a junior resident while “on-call.”


Methods:

A single resident’s on-call log from July 1 2014 to June 30 2016 was reviewed, corresponding to the resident’s PGY2 and 3 levels. For each patient encounter (ie, consult or admission), information pertaining to the patient’s demographics, disease or reason for consult, date/time/location of consult, and need for any neurosurgical intervention within the first 24 hours was collected. Information was obtained on how ACPNF-accredited programs provide pediatric experience to their residents. A novel Resident Experience Score (RES) was calculated per program.

Results:

In total, the junior resident was asked to evaluate 267 pediatric patients over a 2-year period. The majority of patients were male (64%) with a mean age of 7.6 years (range, 0-20 years) and had traumatic diagnoses (51%). The busiest and slowest months were July and January/November, respectively. Neurosurgical intervention performed within the first 24 hours of consultation occurred in 50 (18.7%) patients: 42 (15.7%) major operations, 3 (1.1%) external ventricular drains, and 5 (1.9%) intracranial pressure monitors. Programs were ranked according to the RES; the top 5 are University of Tennessee/St. Jude Children’s Research Hospital, Children’s Healthcare of Atlanta, Seattle Children’s Hospital, Doernbecher Children’s Hospital and Riley Children’s Hospital.

Conclusion:

This is the first study to quantify the pediatric neurosurgical educational experience of a typical neurosurgical junior resident while “on-call” for 2 consecutive years.