Introduction: Surgical education in general, and neurosurgical training in particular, has only recently and slowly began evolving from the century-old Halstedian model. We explore the history of neurosurgical training, from the pre-Halstedian era, to Halsted, the Flexner Report, Cushing, Dandy, and the latter part of the 20th century, to current paradigms in neurosurgical training, and discuss possible trends in the future of surgical education with special reference to modern paradigms in education theory.
Methods: We performed an exhaustive search of the Ovid MEDLINE and Pubmed databases, as well as the historical literature in the German and English languages on the subject of surgical education with particular reference to neurosurgical training. We furthermore researched the state of neurosurgical training today in North America and Europe, and investigated the use of modern education theory in current neurosurgical training programmes, as well as simulation-based curricula.
Results: The history of neurosurgical training is a rich one, and is intertwined and inseparable from the history of neurosurgery as a whole. Even in the early eras of Cushing and Dandy, conflicting educational philosophies existed that resulted in heterogeneous neurosurgical programmes. National and supranational neurosurgical societies have tried with varying degrees of success to unify neurosurgical training in their respective jurisdictions.
Conclusions: In order to understand and improve the state of neurosurgical training today, it is important to recognize the rich history and evolution of neurosurgical education. We present the history of neurosurgical training, it's current state, and possible future trends in tune with modern education theory.
Patient Care: Understanding the history and the current status of neurosurgical training can help improve neurosurgical curricula and train future surgeons in a more efficient manner, helping doctors become more competent, thereby improving patient care.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) recount the history of surgical training, 2) learn about the current state of training in the USA and Europe, and 3) recognize possible future trends in neurosurgical training including surgical simulation.