Summary of the recommendations for advanced training in neuroanaesthesia that have been agreed by a Working Party on Training in Neuroanaesthesia of the Neuroanaesthesia Society of Great Britain and Ireland: All specialist neuroanaesthetists should have a minimum of six months training in neuroanaesthesia in addition to their basic training. During their training, all anaesthetists intending to sub-specialise in neuroanaesthesia and/or neuro-intensive care should be closely involved in the anaesthetic management of a minimum of:
- 20 patients for immediate management of head injury or intracranial haematoma in the neurosurgical unit which includes receiving or resuscitation of patients, imaging, operating theatre and intensive care management.
- 10 patients for shunt procedures (experience can be gained during a paediatric attachment).
- 20 patients for major spinal surgery, including unstable cervical spine, thoracic spinal surgery, spinal instrumentation and spinal tumour (some experience in anaesthesia for spinal surgery can be obtained during an orthopaedic surgery attachment).
- 5 patients for carotid endarterectomy (experience in this area can be obtained during vascular attachment).
- 25 patients for intracranial surgery other than evacuation of intracranial haematoma, which should include intracranial vascular surgery and anaesthesia for transphenoidal hypophysectomy.
- 5 patients for posterior fossa surgery
- 5 patients for stereotactic surgery/image guidance
- 15 patients for neuroradiological imaging, including experience in anaesthesia and sedation for interventional neuroradiology and MRI
There should be experience of anaesthesia for the whole range of the usual neurosurgical case-mix and the different positions used during neurosurgical procedures. Neurosurgical and neuroanaesthetic practice make experience in another centre desirable, either as a formal exchange or study leave. In addition, all neuroanaesthetists should have experience of at least one month in neuro-intensive care. Those wishing to have sessions in neuro-intensive care should have an attachment of at least three months to neuro-intensive care as part of their general ITU training and should have satisfied the requirements for advanced training in neuroanaesthesia. It is accepted that to rectify deficiencies in experience some training may need to take place after appointment to, and ideally before, taking up a consultant post. This could be in the unit in which the consultant is working or another centre. At the end of the period of advanced training the trainee should be able to demonstrate:
- Logbook confirmation that minimum targets have been achieved
- Demonstration that the trainee has carried out audit, CEPD, presentations and/or publications
- Demonstration that the trainee has been involved in teaching junior trainees
- Ten short case studies detailing intensive care management of patients with neurological disease for those wishing to have sessions in neuro-intensive care.
Cardiff
At Cardiff there is the opportunity be a research associate in neuroanaesthesia. These posts are for 6 months extendable to a year. Trainees time will be split between clinical work and research. In addition to neuroanaesthesia there are opportunities to gain experience in major spinal surgery including scoliosis surgery and in interventional neuroradiology. In accordance with the recommendations of the College CCT manual trainees wishing to do advanced training in neuroanaesthesia are encouraged to spend time in another neurosurgical centre either in the UK or abroad in order to gain experience of different neurosurgical techniques and neuroanaesthetic practices Research duties will be arranged under the close supervision of Prof. Judith Hall. Research will be based on aspects of neuroanaesthesia, either at basic science level or clinical neuroanaesthesia.
