Proceedings from the Neuroanesthesia Fellowship Program Director and Division Chair Meeting

By Jeffrey J. Pasternak, MD
SNACC President
Lara Ferrario, MD
Secretary/Treasurer, ICPNT

George Mashour, MD, PhD
Jeffrey J. Pasternak, MD
Lara Ferrario, MD
Lara Ferrario, MD

Last year, SNACC hosted a meeting for neuroanesthesia fellowship program directors and division chairs. We decided to host a second meeting again this year at the Sheraton Grand Hotel in Chicago on April 28 concurrently with the Annual Meeting of the IARS.  

Dr. Shobana Rajan from the Cleveland Clinic was the first presenter. Dr. Rajan discussed some perceptions among trainees that might account for low interest in neuroanesthesia including a feeling that neuroanesthesia fellowship training does not provide a skill set, and concern among residents that neuroanesthesia is not an accredited fellowship. She also presented some of the activities that were undertaken by the SNACC Neuroanesthesia Education Special Interest Group including the results of a survey, creation of a brochure, and a trainee-specific session at the last SNACC meeting that awarded prizes. The Neuroanesthesia Education Special Interest Group has now become the Trainee Engagement Subcommittee co-chaired by Drs. Shobana Rajan and Angele Theard. Dr. Rajan invited everyone to check out the new tab for subcommittees under the education tab on the SNACC website. Future plans include increasing blog activities, a welcome reception for trainees, continuing the lunch session for trainees at the SNACC meeting, collaborating with ASA and SEA, and developing neuroanesthesia curriculum. Dr. Rajan suggested starting recruiting for neuroanesthesia earlier, focusing on medical students and interns.

W. Andrew Kofke, MD
Deepak Sharma, MBBS, MD, DM
W. Andrew Kofke, MD
W. Andrew Kofke, MD
Ravi Avitsian, MD
Rafi Avitsian, MD
Shobana Rajan, MD

Dr. Deepak Sharma is the chair of the 2018 SNACC Annual Meeting Planning Committee. He provided an update on the SNACC annual meeting including letting people know that a Nobel Laureate will be the keynote speaker, there is a special session on traumatic brain injury, and workshops that focus on airway management and education. He reminded people that, if they plan to attend the SNACC meeting, they must pay the registration fee for attendance on Friday only. They must pay an additional fee to attend any Thursday afternoon sessions or the Dinner Symposium on Thursday evening.

Drs. W. Andrew Kofke and Lara Ferrario provided an update on perioperative neuroscience fellowship accreditation. SNACC has decided to move forward with developing a means to accredit neuroanesthesia fellowship training programs. To accomplish this, the International Council on Perioperative Neuroscience Training (ICPNT) was born. The SNACC executive committee appointed Drs. Kofke and Ferrario as the chair and secretary/treasurer of the ICPNT, respectively.

The team summarized past activities and arrived at the decision that SNACC will develop an accreditation body for neuroanesthesia fellowships. There was discussion about the flexibility of the ICPNT to accommodate critical care or neuromonitoring in the future. The current plan is to move forward with just clinical neuroanesthesia with the option of accommodating other types of programs in the future, hence the name included ‘perioperative neuroscience’ and not ‘neuroanesthesia’. The ICPNT organizing committee developed a charter and mission and vision statements. The structure of the ICPNT is as follows: the chair and the secretary/treasurer are appointed by the SNACC executive committee. The members at large will be selected by the chair with no set numbers. Members must be SNACC members and will serve up to two successive three-year terms and should have current or past experience as the fellowship program director and membership in postgraduate educational activities. There was discussion about the importance of having international representation on the ICPNT board. This should be specifically stated in the charter. Also, being a fellowship director should not be a requirement to serve as an ICPNT member at large.

The team then reviewed the general responsibilities of the ICPNT including:

    • Developing curricula that has the flexibility to account for diversity among global programs.
    • Constructing training requirements.
    • Developing an application and a process for submitting applications.
    • Allowing accreditation in five year intervals.
    • Assigning application fees.
    • Establishing metrics for program directors to determine successful completion of a fellow.
    • Awarding certificates to candidates who complete an ICPNT accredited fellowship. However, it should be made clear that the ICPNT will accredit the fellowship, not the candidate. There was discussion about whether or not the ICPNT should provide certificates to candidates who complete an ICPNT accredited fellowship.

The group discussed some other key issues, such as the need to have provisions in the plan that allow fellows to work part-time as an attending and the possibility of credentialing core faculty. Credentialing also provides a space that helps improve the credibility of neuroanesthesia as a subspecialty.

The team anticipates possibly starting the accreditation process for the 2019-2020 academic year. However, there is significant work left to do including developing a business plan, marketing the ICPNT, and a possible pilot roll out. For anyone potentially interested in serving as a member of the ICPNT, you should contact Dr. Kofke here.

Update from May 18: The ICPNT writing subcommittee met in Cleveland, Ohio. The meeting was very productive. The charter and curriculum are now almost entirely finalized. Stay tuned for further updates. – Lara Ferrario, MD

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