In Chicago, March of 2016, the Accreditation Council of Graduate Medical Education (ACGME) convened a congress on Duty Hours and the Resident Training Environment. Many organizations were asked to submit formal position papers and offer testimony at the congress. To address this request, neurosurgery convened a writing group under the direction of the Society of Neurological Surgeons (SNS) and organized through the Washington Office of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS). The writing group had representatives from the AANS, the AANS/CNS Washington Committee (WC), the American Board of Neurological Surgery (ABNS), the CNS and the SNS. Working together, we created a single document for all of neurosurgery that expressed a unified position on this important topic. At the ACGME Congress, we had one spokesperson to present testimony, but representatives from each of the neurosurgical organizations noted above were in attendance throughout the meeting. The organization, unity of purpose and commitment of organized neurosurgery did not go unnoticed by the ACGME and the other attendees. This is one small example of what we have designated as One Neurosurgery – the AANS, ABNS, the ACGME Residency Review Committee (RRC), the CNS, the SNS and the WC working together to advance the specialty of neurosurgery. We think it is important that the members of all of our organizations are aware of what One Neurosurgery has accomplished.
Subspecialty Accreditation and Certification in Neurosurgery
The issue of how to recognize subspecialty expertise in neurosurgery has vexed our specialty for many years. The SNS Committee on Advanced Subspecialty Training (CAST) has created a process by which eight subspecialty fellowships, whether enfolded or post-residency, are accredited. We are now working closely with the ACGME to gather and share information about our fellowship programs to make sure they are of the highest quality. Working closely with the ABNS, CAST has also developed a process to award subspecialty certificates in neuroendovascular surgery and neurocritical care to those who meet the training and performance requirements. The process for accreditation and certification in neuroendovascular surgery has been accepted by endovascular specialists in neurology and radiology, as well as neurosurgery. A key feature of the process is that all neuroendovascular surgery fellowship programs must occur at a facility with an ACGME-accredited neurosurgery training program.
In regard to neurocritical care, the SNS/AANS Neurocritical Care Task Force has garnered recognition by the Leapfrog Group of the CAST process for certification in neurocritical care. Before these efforts, only the United Council of Neurologic Subspecialties was recognized by Leapfrog as a means of becoming certified in neurocritical care. These accomplishments of One Neurosurgery, in regard to subspecialty training and recognition, are profoundly important for the future of our specialty.
The One Neurosurgery Portal
The concept of linking the SNS Matrix curriculum for neurosurgery with the examinations of the ABNS and creating a single internet portal to access neurosurgical educational materials was first proposed at the winter meeting of the ABNS in 2011, with representatives of the AANS, CNS, RRC and SNS in attendance. One month later, the AANS Executive Committee met and recommended that this project be carried out under the oversight of the SNS, with participation of the other organizations. Over the last five years, a great deal of effort, led by the SNS but involving all of our organizations, has gone into creating the One Neurosurgery Portal. This site is now under construction. Under the direction of the SNS, with financial and technical support from the AANS and CNS, organizational support from the ABNS and content support from all organizations, the site will go live in 2016. The One Neurosurgery Portal will allow neurosurgical residents to link their ACGME Milestones to the SNS Matrix Curriculum and the extensive educational resources of the AANS and CNS, using a standard taxonomy. The Neurosurgical Dossier will allow each neurosurgeon to document and track his or her progress throughout his or her career through a user name and password protected site linked to a unique identifier supplied by the ABNS. This complex project has required all of our organizations to put the good of our specialty above the good of any individual organization. We believe it will be of great value for all of neurosurgery.
The One Neurosurgery Summit
For many years, the SNS has convened meetings of the leadership of the AANS, ABNS, CNS, RRC and the WC. Initially, these summit meetings were held once a year in conjunction with the AANS Annual Scientific Meeting, then twice a year, also in conjunction with the CNS annual meeting. Starting in 2014, the SNS began hosting a separate, all day retreat, the One Neurosurgery Summit, to discuss the issues of importance to our national neurosurgical organizations and to forge a single agenda for our specialty. This meeting brings together the leaders of the AANS, ABNS, CNS, RRC, SNS and WC for in depth discussions on any issue that the various organizations think is important. We do more than share information about our various organizations at this meeting – we commit to a strategic plan for all of neurosurgery. In effect, this One Neurosurgery Summit meeting serves as the executive committee meeting for organized neurosurgery in the U.S.
Although neurosurgery is a small specialty, it is blessed with many organizations that bring unique perspectives, talents and resources to the table. The effective collaboration of these organizations is essential in making sure that neurosurgery continues to lead American medicine in patient care, education, research and public service. One Neurosurgery – the seamless collaboration of the AANS, ABNS, CNS, RRC, SNS and the WC to advance the specialty of neurosurgery – is the key to our continued success.
Robert E. Harbaugh, MD, FAANS, President, SNS
Frederick A. Boop, MD, FAANS, President, AANS
Christopher I. Shaffrey, MD, FAANS, Chair, ABNS
Russel R. Lonser, MD, FAANS, President, CNS
Kim J. Burchiel, MD, FAANS, Chair, ACGME Residency Review Committee for Neurosurgery
Shelly D. Timmons, MD, PhD, FAANS, Chair, AANS/CNS Washington Committee
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