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.”


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.


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.


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.