Resident Education in Switzerland—Preliminary Results of a Multinational EANS Survey

Introduction: Neurosurgical education at present is handled differently across the European countries and the introduction of the European Working time directive has substantial impact on the future of the neurosurgical specialty. Methods: A survey was addressed to all European neurosurgical residents that are members of the EANS, including 45 from Switzerland. Participants were invited to state their opinion regarding the current situation of theoretical and practical neurosurgical education as well as regarding their working time. Data were collected in an online database and subsequently analyzed using Graph Pad Prism 5.0c. Results: A total of 318 responses were analyzed, and 32 from Swiss residents (71.1%; 69% male, 59% in first–third year of training, 44% university hospital) were compared with 286 from other Europe. Residents from Switzerland generally rated their theoretical education better (clinical lectures: OR 2.07, 95% CI 0.97–4.46; p = 0.064; anatomical lectures: OR 2.19, 95% CI 1.04–4.60; p = 0.042;, journal club: OR 4.21, 95% CI 1.82–9.69; p < 0.001; multidisciplinary meetings/tumor board: OR 14.46, 95% CI 1.94–107.67; p < 0.001), ward rounds (p = 0.219), radiology meetings (OR 8.19, 95% CI 1.91–34.98; p < 0.001)). Practical aspects of the training were rated similar (operative exposure: p > 0.99; simulator training: p = 0.405; microsurgical training: p = 0.269; cadaveric training: p = 0.268; decision making: p > 0.99). Swiss residents begin significantly later with own craniotomies (71.9 vs. 40.5% after third year; p = 0.005), while the practical training of burr holes (p = 0.958), lumbar (p = 0.524), and cervical spine surgeries (p = 0.365) begins similar. Swiss residents perform less peripheral nerve surgeries (p = 0.013); the number of burr holes (p = 0.453), spinal (p = 0.995), and cranial surgeries (p = 0.380) is similar. A total of 71.8% of Swiss residents work 51 to 70 hours/week (p = 0.014). Swiss residents are more likely to spend < 25% of their daily working time in the operation room (OR 2.87, 95% CI 1.29–6.4; p = 0.009); the percentage of administrative work is similar (p > 0.99). The satisfaction concerning amount of working time was similar with 13.8% of Swiss residents estimating their working time as too much. A total of 27.6% of Swiss residents indicated to receive an insufficient clinical education (p > 0.99), and 58.6% were worried about their future career chances (p = 0.540). Conclusion: These results will help to evaluate the resident education and improve aspects of the future Swiss training programs.