Neurosurgery (2015)

Overview Key Topics Professional/Leadership Skills Initial Intermediate Final Special Interest Training

Key Topics

To be eligible for the award of a CCT in Neurosurgery or to be considered for a Certificate of Eligibility for Specialist Registration trainees and applicants will be competent in all aspects of the clinical management of patients presenting with the essential neurosurgical conditions.

Trainees and applicants must be competent to undertake the full range of emergency and urgent operative procedures specified in the final training stage of the schedule of essential operative competencies. They must demonstrate sufficient operative experience to be able to undertake these procedures without supervision and to manage operative difficulties and complications (Competence level 4).

It is expected that trainees will be able to show evidence that competence in the management of trauma is being maintained (ATLS certificate or equivalent from August 2012).

Essential Neurosurgical Conditions

Cranial trauma
Spontaneous intracranial haemorrhage
Hydrocephalus
Intracranial tumours
CNS infections
Spinal trauma
Benign intradural tumours
Malignant spinal cord compression
Degenerative spinal disorders
Emergency paediatric care

Schedule of Essential Operative Competences

	Initial	Intermediate	Final
Surgical approaches Burr hole Craniotomy - convexity Craniotomy - pterional Craniotomy - midline supratentorial Craniotomy - midline posterior fossa Transsphenoidal approach Lateral posterior fossa Lumbar fenestration Laminectomy	3 2 1 1 2 1 1 2 2	4 3 3 3 3 2 2 4 3	4 4 4 4 4 4 4 4 4
General procedures Insertion of lumbar drain Tapping/draining of CSF reservoir Application of skull traction Image guidance/stereotaxy set up	3 3 2 2	4 4 4 4	4 4 4 4
Management of cranial trauma Insertion of intracranial (ICP) monitor Burr hole evacuation of CSDH Elevation of depressed skull fracture Craniotomy for traumatic haematoma (ICH)	3 3 2 2	4 4 4 3	4 4 4 4
Management of spontaneous intracranial haemorrhage Craniotomy for spontaneous intracerebral haematoma (ICH supratentorial) Craniotomy for spontaneous intracerebellar haematoma (ICH infratentorial)	1 1	3 3	4 4
Management of hydrocephalus Insertion of ventricular drain/access device Insertion of VP shunt Revision of VP shunt	3 2 1	4 3 2	4 4 4
Management of intracranial tumours Supratentorial tumour biopsy Craniotomy for supratentorial intrinsic tumour/metastasis Craniotomy for posterior fossa intrinsic tumour/metastasis Craniotomy for convexity meningioma	2 1 1 1	3 3 2 3	4 4 4 4
Management of intradural spinal tumours Excision of intradural extramedullary tumour	1	2	4
Management of degenerative spinal disorders Lumbar microdiscectomy Anterior cervical discectomy	1 1	3 3	4 4
Emergency paediatric care Insertion of EVD Evacuation of intracranial haematoma (ICH)	1 1	2 2	4 4