NEUROSURGICAL RESIDENCY PROGRAM: APPRAISAL AFTER 25 YEARS Professor Walid Maani Jordan University Hospital and Medical School

HISTORICAL BACKGROUND In 1975 Jordan had: 2 full time neurosurgeons 1 part time neurosurgeon In 1975 Jordan had one neurosurgical facility In 1975 Jordan had no neurosurgical private sector

HISTORICAL BACKGROUND In 2008 Jordan has: 47 full time neurosurgeons 25 neurosurgeons in training locally 10 training abroad In 2008 Jordan has 5 neurosurgical facilities in the public sector In 2008 Jordan has a thriving neurosurgical private sector

HISTORICAL BACKGROUND Before 1974, Jordanians traveled to Lebanon and Egypt for a PID Some surgeries were performed by one neurosurgeon who came to Amman twice a month In 2008, hardly any Jordanian travels abroad for neurosurgical management In 2008, 100.000 Arab patients came to Jordan for medical treatment

HISTORICAL BACKGROUND By 1978 there were: One American trained neurosurgeon Three British trained neurosurgeons One German trained neurosurgeon

HISTORICAL BACKGROUND By 1978 there were: One CT (EMI) 30 neurosurgical beds 2 neurosurgical public facilities

HISTORICAL BACKGROUND By 2008 there were: 100 CT machines 30 MRI machines 2 PET scanners 2 PET-CT scanners 120 neurosurgical beds in public facilities 100 neurosurgical beds in private facilities 5 neurosurgical public facilities

HISTORICAL BACKGROUND Before 1984 there was no training in neurosurgical practice in Jordan.

THE FIRST NEUROSURGICAL TRAINING PROGRAM Introduced in 1984 at the University of Jordan Managed by the School Of Graduate Studies Carried out at the Jordan University Hospital Ends by award of the M.Sc. in Neurosurgery

THE PROGRAM Requirements A Batchelor degree of Medicine from a recognized university An average (GPA) of 75% Must have completed one year internship Must pass a special written examination in the four major branches of medicine Must satisfy a committee through an interview

THE PROGRAM Format A 6 years program (PGY1- PGY6) Must pass each year with an average of 70% Must pass the final year with a cumulative average of 75% Trainees leave the program if they score <70% in any year If a trainee scores <75% cumulative average in the final year he is on probation for one more year

THE PROGRAM Structure The first year (PGY1) is spent in general surgery The second year (PGY2) is spent in allied neurological sciences: Adult neurology Pediatric neurology Neuro - pathology Neuro - radiology Neuro - ophthalmology Neuro - intensive care

THE PROGRAM Structure The third to the fifth years (PGY3-PGY5) are clinical neurosurgery The sixth year (PGY6) is spent as Chief Resident

THE PROGRAM Evaluation Formal written examination Oral examination* Clinical examination* Long cases Short cases *The clinical and oral examinations are conducted by local and external examiners

THE PROGRAM Activities Daily morning reports Once every week: Inter-departmental meeting Basic neuroscience seminar (3PGY) Special topic seminar (4PGY) Once every two weeks: Journal club (5PGY) Mortality morbidity meeting (6PGY)

THE PROGRAM Activities Daily morning round Closing evening round Rounds are attended by all residents and conducted by the Senior Resident.

THE PROGRAM Residents’ Duties Admission of patients and care of patients Emergency room on call Out-patient department Intensive care unit supervision Minor surgeries Major surgeries