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Jay Jagannathan, G. Edward Vates, Nader Pouratian, Jason P. Sheehan, James Patrie, M. Sean Grady and John A. Jane Sr.

residents before and after implementation of an 80-hour workweek at UVA Parameter 2002 2007 % Change from 2002 average reported hrs per wk 103 78 −28 required conference/academic hrs per wk 15 7 −47 time in op room per wk, including nights 64 41 −35 on-call time per wk, including nights 24 30 +20 Discussion The US graduate medical education system has set the standard for the world, with many physicians from abroad anxious to repeat their training here. The hallmark of this educational experience has

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Christopher Miller, Paige Lundy and Sarah Woodrow

to train at an early point in their career and develop the necessary knowledge base and skills to continue as a member of the international surgical workforce throughout their career. The individual at any given US training program most responsible for resident education is the program director. Therefore, a strong understanding of their opinions on exposure to LMIC environments is crucial to understand and expand this type of resident training. To do this, program directors at Accreditation Council for Graduate Medical Education (ACGME)–approved training sites

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Travis M. Dumont, Anand I. Rughani, Paul L. Penar, Michael A. Horgan, Bruce I. Tranmer and Ryan P. Jewell

national survey of the program directors and residents in neurosurgery training programs . Neurosurgery 56 : 398 – 403 , 2005 4 Gopaldas RR , Chu D , Dao TK , Huh J , LeMaire SA , Coselli JS , : Impact of ACGME work-hour restrictions on the outcomes of coronary artery bypass grafting in a cohort of 600,000 patients . J Surg Res 163 : 201 – 209 , 2010 5 Jagannathan J , Vates GE , Pouratian N , Sheehan JP , Patrie J , Grady MS , : Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on

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

W hen Medicare was established in 1965, it recognized that “a part of the net cost of such [educational] activities (including stipends of trainees, as well as compensation of teachers and other costs) should be borne to an appropriate extent by the hospital insurance program.” Thus, Medicare is the principal means for federal support to teaching hospitals through its direct graduate medical education (DGME) funding via direct and indirect payments. Medicare compensates teaching hospitals for a portion of their per-resident amount (PRA). 1 These payments are

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Nathan R. Selden, Zoher Ghogawala, Robert E. Harbaugh, Zachary N. Litvack, Matthew J. McGirt and Anthony L. Asher

care organizations and regulators. Milestones, Lifelong Learning The Accreditation Council for Graduate Medical Education (ACGME) is charged with oversight of medical and surgical residency and fellowship training programs in the US. In July 2002, the ACGME introduced the “Outcomes Project,” notable for the introduction of 6 core competencies: professionalism, communications and interpersonal skills, systems-based practice, practice-based learning and improvement, medical knowledge, and patient care. 1 The ACGME Outcomes Project envisioned the creation by

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Kurt A. Yaeger, Stephan A. Munich, Richard W. Byrne and Isabelle M. Germano

S ince residency training for neurological surgery in the US was formalized with the initiation of the Residency Review Committee (RRC) in 1953, educational paradigms and training philosophies have shifted substantially. 26 What began as an offshoot from the American College of Surgeons (ACS) has branched into a highly complex and specialized training system, with both internal and external regulation, from the American Board of Neurological Surgeons (ABNS) and Accreditation Council for Graduate Medical Education (ACGME), respectively. The beginning of the past

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Natalie Limoges, Erin D’Agostino, Aaron Gelinne, Cormac O. Maher, R. Michael Scott, Gerald Grant, Mark D. Krieger, David D. Limbrick Jr., Michael White and Susan Durham

neurosurgery during residency training. That being the case, the goal of the current study was to define pediatric neurosurgery exposure and education during neurosurgery residency across all Accreditation Council for Graduate Medical Education (ACGME) training programs. We hope this will address the current gap in the care of pediatric neurosurgery patients across the US, particularly in trauma, because adult neurosurgeons may not feel comfortable caring for pediatric patients. Methods A 25-question survey on pediatric neurosurgical education during residency was created by

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John A. Jane Jr., Larry D. Sulton and Edward R. Laws Jr.

perspectives from an initial experience. Neurosurgery 50: 1–10, 2002 17. Long DM : Competency-based residency training: the next advance in graduate medical education. Acad Med 75 : 1178 – 1183 , 2000 Long DM: Competency-based residency training: the next advance in graduate medical education. Acad Med 75: 1178–1183, 2000 18. Long DM : Competency based residency training: the next advance in graduate medical education. Acta Neurochir Suppl 78 : 153 – 158 , 2001 Long DM: Competency based residency

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Isaac Josh Abecassis, Rajeev D. Sen, Richard G. Ellenbogen and Laligam N. Sekhar

master the necessary skills is limited by appropriate Accreditation Council for Graduate Medical Education (ACGME) concerns about patient safety and resident well-being. Motivated by the further decrease in available training opportunities due to the unfortunate COVID-19 pandemic, 2 residents (I.J.A. and R.D.S.) sought ways to augment their microsurgical psychomotor skills by training at home while on a rotating “shelter at home” order. These residents, with guidance and direction from the senior authors (R.G.E. and L.N.S.), implemented a metered stepwise approach

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Robert W. Bina, G. Michael Lemole Jr. and Travis M. Dumont

W ithin neurosurgery, the national mandate of the 2003 duty hour restrictions (DHR) by the Accreditation Council for Graduate Medical Education (ACGME) has been controversial at best. Ensuring the proper education, training, socialization, and psychological well-being of residents while fulfilling our primary purpose of patient care has generated an 11-year debate. Many of the formal medical disciplines have studied the effects that DHR have had on resident education and have developed strategies to address the often conflicting needs of education and