Neurosurgical Knowledge of Interns in New Zealand: The Potential for Improvement

Abstract

Aims: Insufficient exposure of students to neurosurgery and neuroradiology has often been a matter of concern in medical schools across USA, Canada, UK and Europe. When taking into account the high incidence and mortality from head injuries in the form of subarachnoid and intracranial haemorrhages, it becomes evident that core knowledge in basic neurosurgical imaging and diagnoses need to be an essential part of medical training. The aim of this pilot study was to investigate the level of basic neurosurgical knowledge with regard to image interpretation in interns who were in their first post-graduate year in New Zealand. Study Design: Clinical and educational research paper. Place and Duration of Study: Wellington, New Zealand from January 2011 to January 2012. Methodology: Fifty interns in their first postgraduate year were invited to complete a neurosurgical imaging questionnaire with images of common neurosurgical findings (obvious subarachnoid and intracranial haemorrhages) randomly mixed with normal studies. Five computerized tomography (CT) scan images were required to be matched to five diagnoses. Results: All respondents agreed to participate. The mean score for the all 50 interns was 40% (95% CI 37.3 - 42.4), with a range of 0 to 80%. Thirty-six interns (72%) had a score of less than 60% and thus failed to demonstrate basic competency on the examination. None of the interns scored a full 100%. Conclusion: This study suggests that only 28% of newly qualified New Zealand doctors were able to demonstrate a basic level of competence in the evaluation of neurosurgical imaging at the start of their internship. Improvement of the undergraduate neurosurgical curriculum is strongly suggested.