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William E. Gordon, William M. Mangham, L. Madison Michael II and Paul Klimo Jr.

study of 4 resident orthopedic on-call services at 4 tertiary academic medical centers found that 9142 wRVUs could be generated collectively over a 90-day period by these on-call orthopedic services from consultations and performing procedures. 10 Our study suggests that the value of services provided by on-call neurosurgery residents is quite significant and far exceeds the cost of training with respect to GME funding. Limitations of the Study This study resulted from a single neurosurgical resident quantifying his on-call experience, and as such the data are

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review the current status of the physician workforce shortage, GME funding issues, including HR 1852-The Children's Hospital GME Support Re-authorization Act of 2011, offer an assessment of the current pediatric neurosurgery workforce and will discuss the implications of infolded pediatric neurosurgery fellowship training vs postresidency training as it currently exists. J Neurosurg Pediatr Journal of Neurosurgery: Pediatrics PED

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Kiarash Shahlaie and Griffith R. Harsh IV

clinical activity that can help guide discussions on graduate medical education (GME) funding. This study is the first of its kind in neurosurgery and provides valuable insights into the potential financial value of resident clinical activity. Although neurosurgery residents perform a variety of clinical tasks with potential financial value, overnight on-call shifts are unique because they represent a 12-hour period during which trainees provide the majority of direct patient care in a predominantly unsupervised or indirectly supervised structure. These shifts have

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H. Hunt Batjer and Vin Shen Ban

, graduate medical education (GME) funding was embedded also in that legislation. Language included “the public good” and “enhanced level of care” as justification for that provision. Over the years much of this GME funding enabled us to care for indigent patients. While medicine at large holds the social contract, neurosurgery is in a very unique and privileged position in that contract because of the critical organ systems that we treat. Neurosurgeons are committed to the patient safety and quality movements. We foam in, and foam out. We support timeouts, checklists

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Paul C. McCormick

ability to train the next generation of neurosurgeons is impaired by work-hour limitations and reductions in GME funding. Practice viability is under constant challenge from rising costs, regulatory burdens, and declining reimbursements. Patient access to neurosurgical care is threatened by flawed noncoverage determinations, an inefficient FDA system, and unauthorized organizations defining standards of practice, in neurosurgery's domain. So, just as the science and practice of neurosurgery have expanded, so too has our profession. We've evolved into a multifaceted

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,000 wRVUs annually. This results in potential reimbursements of $1,873,724 annually from activities performed while on-call. Conclusion Neurosurgery residents at our institution produce enough theoretical economic value exclusively from on-call activities to far exceed the cost of their education. This information could be used to more precisely estimate the true overall cost of neurosurgical training and determining future GME funding. 285: Safety and Costs Analysis of Early Hospital Discharge after Brain Tumor Surgery: A Pilot Study Alexandra Santos (Sao Paulo, Brazil