Introduction: The American Board of Neurological Surgery (ABNS) is the body awarding certification of competency in neurological surgery in the USA. While it does not define practice privilege, recognition is necessitated by many institutions. Application was open to residents entering Canadian programs prior to 1997; however has since been only available to Accreditation Council for Graduate Medical Education (ACGME) recognized programs, excluding Canadian schools. This study asks whether this change has affected education and employment opportunities for graduating neurosurgeons.
Methods: All neurosurgical residency programs in Canada were invited to participate. Programs were asked to provide lists of graduates from 2012 to 1984. Graduates were sorted by year of graduation into pre or post 2003 (ie. 6 years after 1997) and further training and employment information, if not provided, was gathered from public domain resources.
Results: 50% of programs participated in this study for 220 graduating residents. There was no difference in proportion of American fellowships obtained relative to graduation date. The proportion of American consultant positions declined from 36.4% to 28% after 2003. This difference was statistically significant. Overall proportions of residents obtaining any fellowship or consultancy position did not change.
Conclusions: Changes in ABNS eligibility did not obviously affect the proportion of American fellowships while consultancy positions did decrease. The aetiology may be multifactorial, including coinciding evolving economics and hiring trends. Overall proportions of residents finding employment or fellowships were not affected. Future study may delineate the other factors that influence migration and assist future residency planning.
Patient Care: By recognizing the effect of changing board eligibility, American employers and educators will also be able to gain a better appreciation for the changing demographics of potential applicants. Canadian neurosurgery residency programs may also better plan for future work force requirements. In doing so, funding may be more appropriately divested towards other aspects of patient care.
Learning Objectives: At the end of the session, participants should be able to 1) identify trends that have occurred over time in Canadian neurosurgical post graduate training and employment; 2) discuss the potential impact that ABNS eligibility changes has had on Canadian graduates seeking employment or further education in the USA; 3) comment on the implications that changing qualifications for board eligibility may have on individuals seeking employment or education in the USA.