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Brian Wiltz

Neuroanatomy Exam Info.

A detailed knowledge of neuroanatomy is a requirement for becoming an excellent neurosurgeon.  In an effort to promote knowledge of neuroanatomy, the ABNS has decided to create a curriculum and a neuroanatomy examination.  The curriculum will be provided to the new PGY1 residents at the start of residency. The Neuroanatomy Exam will then be given a year later in July of the PGY2 year. This neuroanatomy exam will supplement the ABNS Primary Exam which is generally taken later on in residency. The neuroanatomy exam will be different from the ABNS primary exam. The test can only be failed if it is not completed. The test will consist of 100 “mostly fill in the blank” neuroanatomy questions.  The first time the resident takes this exam, the percent correct will be reported to the resident, as well as to their residency program director.  The resident will learn which questions they answered incorrectly.  After a “lock out” period of 1 week to allow for study of the questions missed, the resident will log back into the exam at a time of their choosing and answer questions similar to, but not identical, to the questions they got wrong the first time.   After the second test, the resident will again be informed which questions they answered incorrectly, be locked out for a week, and then be expected to log back in to answer the incorrect questions again.  The resident will have up to a total of 4 attempts to get every question correct. The Program…

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Change to how ABNS recognizes enfolded fellowships; effective July 2021

The ABNS believes that the culmination of neurosurgery residency training is chief residency (PG-6 or 7), during which the resident evolves during that 12-month experience into an independent and safe neurosurgeon (Milestones 4).  Fellowship is advanced clinical training (Milestones 5) in which subspecialty expertise is developed based on the experiential platform of residency training commencing as a PG-1 resident through chief residency. Commencing on July 1, 2021, the ABNS will only recognize enfolded fellowships completed in the PG-7 year after chief residency in the PG-6 year, two exceptions apply.  See below: Enfolded fellowships in neurocritical care may be taken prior to the trainee’s chief resident year CNS endovascular training requires an initial training experience in the performance of angiography. This training period may occur prior to the chief resident year.  The second year of CNS endovascular interventional training, as of July 1, 2021, must occur after the chief resident year, thus PG-7 For avoidance of doubt, the ABNS does not require fellowships (enfolded or otherwise) as a requirement for initial ABNS certification. A fellowship may be required for neurosurgeons who wish to achieve an ABMS “Focused Practice Designation” in certain areas of neurological surgery practice.

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“The new MOC/CC test is a VAST improvement over what it was previously!  A major high-five to whoever realized that at this point in our careers, one does not need to necessarily calculate the acid gap in an ICU patient nor remember every esoteric muscular dystrophy to take good care of patients.  If you have not had a chance to look it over, it is now based on Level 1 evidence data and recent randomized clinical studies.  Please extend my thanks to whoever had the good sense to finally fix this!!! CLICK HERE TO READ FULL DETAILS

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Patients want peace of mind when it comes to their care. Being board certified means physicians are skilled, knowledgeable and experts in their specialty. It also means they’ve met a higher standard. To learn more about board certification, view this new Certification Matters video or visit www.CertificationMatters.org

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Neurosurgery Residency prepares Neurosurgeons for spine surgery

Currently, there are several paths to become a spine surgeon in North America. The most common paths are: 1) an orthopedic residency followed by a spine fellowship OR 2) a neurological surgery residency Post graduate neurosurgical spine fellowships do exist and are useful and important for those surgeons pursuing an academic career or those seeking subspecialized training in a particular aspect of spinal surgery. A dedicated spine fellowship also allows post graduate neurosurgeons exposure to different clinical philosophies and approach management to spinal disorders. There has been some confusion regarding the role of fellowships for neurosurgeons interested in spine and a perception that some sort of added credential is required for hospital privileges or community acceptance of the neurosurgeon’s expertise.  This is despite the fact that in 1995, the Council of Spine Societies (AAOS, AANS, NASS and others) issued a statement regarding the fact that residency trained neurosurgeons are spine specialists upon completion of their residency.  Here are some facts, drawn from the 2016-2017 ACGME case requirements and case logs that may help put this issue to rest. The Orthopaedic Residency Review Committee requires that orthopedic residents be exposed to 15 spine cases during their residency.  In reality, the average orthopedic resident participates throughout residency in 79 spine cases with 8 of these cases involving spinal instrumentation.  In contrast, the Neurosurgical Residency Review Committee requires that neurosurgical residents be exposed to 240 spine cases.  In reality, the average neurosurgery resident is a senior or lead surgeon on 411 spine cases…

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American College of Surgeons: Committee on Trauma decision on MOC, CME requirements

Neurological Surgeons participating in the American Board of Neurological Surgery  MOC satisfy the American College of Surgeons COT continuing educational requirements necessary to participate in Level 1 Trauma Center coverage.  No additional trauma related CME are required.  The ABNS considers trauma and emergency neurological practice and principles part of every  diplomates “core knowledge”.  The ABNS will use their MOC/continuous certification process to update and educate our diplomates on these emergency neurological surgery principles as new evidence based data evolves.

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Diagnostic Cerebral Angiography considered “major” procedure

As of Spring 2018 the ABNS Directors, after soliciting advice from several stakeholders, decided to include diagnostic cerebral angiography as a “major” procedure.  As a result, these will be included as part of the required major case total for primary certification.   If you enter diagnostic cerebral angiogram data into POST, please note the following:  Patient demographic data and medical history data are entered, as with any case In the diagnostic section, if the cerebral angiogram yielded a positive result, choose the appropriate pathology(ies) identified  from the pull down menu. If the diagnostic angiogram yielded a negative or equivocal result, choose the most appropriate “other” category and write your suspected diagnosis in the text box provided. For example: CT scan with hemorrhage suggested possible aneurysmal SAH. One could choose in the procedure category: Cranial-Vascular-Hemorrhage (Y)- SAH- Other Hemorrhagic vascular pathology (text-Suspected Aneurysmal SAH) In the procedure section, diagnostic angiogram  is available in the cranial and spine major categories. Please choose the appropriate option  Under imaging and testing,  please list any studies that were performed prior to the diagnostic cerebral angiogram and were relevant to your decision to perform that procedure (e.g., head CT with findings suspicious for vascular pathology) In the image upload section, please provide select images from the diagnostic angiogram along with any select images from studies that may have influenced your decision to perform the procedure (e.g., CT with SAH and suggestion of PCOM aneurysm) Non-surgical management and Surgical outcomes data are entered as with any other case,…

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RFP: Joint Credential In Pediatric Neurological Surgery

In order to maintain a recognized focused practice in Pediatric Neurological Surgery all ABPNS Diplomates are required to participate in the annual continuous certification (CC) program hosted by the ABNS (see detailed scenario below). When the General & Emergency Principles of Neurosurgery Cognitive Learning Tool plus the Pediatric Principles of Neurosurgery Cognitive Learning module are completed then both the pediatric neurological surgery core principles and general neurological core principles satisfy the requirement for: ABNS/ABPNS CC certification ABNS/ABPNS CC  Focused Practice  in Pediatric Neurological Surgery dual credential Commencing on July 1, 2017, physicians who wish to obtain both (a) an initial certification in general neurological surgery issued by the ABNS; and (b) an additional initial certification in pediatric neurological surgery, which certification shall be issued jointly by the ABNS and the ABPNS (except in cases where the physician received residency training in Canada), must meet the following requirements: Process for Additional Certification in Pediatric Neurological Surgery All ABPNS certificates are time-limited.  
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