Results: The effect of the actual working time on the theoretical and practical knowledge of neurosurgical trainees appears to be insignificant. Secondary endpoints were complications, need for re-do surgery, and clinical outcome until the last follow-up. All three instability patterns verified in surgery (true positives). In 56 cases, it concerned falls from the horse. Increasing technico-manual complexity of procedures and time constraints necessitates effective neurosurgical training. However, quality of brain surgery simulation is limited due to discrepancies in visual and haptic experience. Retrospective multi-institutional case series. Conclusion: Most theoretical and practical aspects of neurosurgical training are rated similarly by Czech trainees when compared to the situation of trainees from other European countries. Seven tumors were located in, Purpose: This study reviews the outcome of trainees as primary operator versus the outcome of board-certified faculty neurosurgeons (BCFN) in non-instrumented lumbar spine surgery. Intraoperative blood loss, length of surgery, as well as intra- and postoperative complications were similar between the study groups. Medical Tourists tend to visit Germany for the quality of service rather than the price, with Neurosurgery procedures being a popular choice. Then, four surgical scenarios were performed in the operating room as follows: (1) simple tumor resection, (2) complex tumor resection, (3) navigated biopsy via burr hole trepanation, and (4) retrosigmoidal craniotomy. Caseload; Europe; Neurosurgery; Residency; Training program; Working hour restriction. Residency Program About the Residency Program The Neurosurgery Residency Program at the Keck School of Medicine of USC is a seven-year program that includes the intern (PGY-1) year. The annual count and rate for different types of spinal injury were estimated along with standard errors. Call varies with rotation, and the department maintains overall hours of work at 80 hours per week on average or less. In addition, data concerning the operation and the postoperative course including common complications were assessed. Palpation transversale, A 71-year-old woman with juvenile-onset rheumatoid arthritis presented with right trigeminal mandibular pain and dysphonia on a background of 6-month oropharyngeal dysphagia and C3-C5 laminectomy in 2010. Methods: Purpose: to scientifically substantiate the most actual medical-organizational actions for prevention and decline of disability data due to degenerative disorders of the spine. Two patients presented with myelopathy, and 3 patients presented with radiculopathic-type complaints. Objectives are divided into general objectives, intermediate and specific. Limited data in the literature describe the presentation and true incidence of postoperative surgical site, The human cervical spine is a unique structure that differs dramatically from the thoracic and lumbar spine. : par exemple. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error, Collaborators, • Sur le nerf fémoral Triangle fémoral, canal de Hunter, genou, face médiale, cheville. We aimed to evaluate the current situation of resident training in the Czech Republic. Affiliations. It is important to note that it is not difficult to obtain Specialist Medical Training positions for those candidates who have completed their basic medical education or M.D. This is a 2- year long course, and a student with an M.S. Prices. Eighty-two percent of all respondents has seen or treated a purely ligamentous injury of the c-spine. Effect of adjuvant radiochemotherapy for controlling the tumors is still unclear and requires further investigation. Response to: neurosurgical procedures performed during residency in Europe-preliminary numbers and time trends. Conclusion: Epub 2017 Nov 4. The final sample was n = 80, with a mean responder's age of 43.0 years (SD 8.6) and 88.8% being male. Spinal injuries were classified as minor (Abbreviated Injury Scale [AIS] 1), moderate (AIS 2), serious (AIS 3), fracture-dislocations, and SCI (AIS 4+). Percussion du nerf : signe de Tinel (Tinel's sign). ... Germany where he also attended medical school. 3. Working time of neurosurgical residents in Europe--results of a multinational survey. No untoward events to date. Methods Neurosurgery ICU. In multivariate analysis, supervised residents were as likely as BCFNs to have an intraoperative complication (OR 0.92, 95 % CI 0.41-2.04, p = 0.835). A total of 652 responses were collected, of which n = 532 were taken into consideration. We believe that in the eastern part of Europe there is the most space for improvement in neurosurgical training. It has a seven-year neurosurgery residency program, but also offers a three-year fellowship for further specialization, such as in spinal surgery. A prospective study on 102 patients undergoing surgery for lumbar disc herniation (LDH) was performed. In contrast, the residency program in the USA is required to comply with the Accreditation Council for Graduate Medical Education guidelines. Around 30 % of the study patients were followed up in outpatient clinics for more than once up until a mean period of 6.4 months (95 % CI 5.3-7.6 months). 2019 Feb;122:522-531. doi: 10.1016/j.wneu.2018.10.193. Back and leg pain on the visual analogue scale (VAS), functional disability (Roland-Morris-Disability-Index (RMDI) and Oswestry-Disability-Index (ODI)), as well as health-related quality of life (hrQoL; short-form (SF)-12 and Euro-Qol (EQ5D)) were assessed, and re-operations since the index surgery were recorded. Our data thus indicate that a structured neurosurgical education of operative skills does not lead to worse outcomes or increase the complication rates after ACDF(I). Conclusions: I am studyin german and would like to pursue this residency there but i have little info on how the system works and would really appreciate some insight on how the process works in germany. Stereotactic Radiosurgery for Neurosurgical Patients: A Historical Review and Current Perspectives. Majority of the current literature is from South Asia. Surgical experience of neurosurgical residents in Europe: an alarming trend. The mean age of patients identified was 57.5 (SD = 11.6, 66.7% female). Evaluation of the Cervical Spine in the Polytrauma Patient, [Cervical spine injury in equestrian sports].  |  Most of the non-Czech responders worked in Germany, in the United Kingdom (UK), Switzerland, Italy, Poland, Ukraine, Portugal, Netherlands, Greece, Spain and Turkey. Neurosurgery program in Germany - NEUROSURGIC FORUMHello to all,I am a medical student, final year and i am planning to follow a residency program in Germany. Kinikum Stuttgart is regarded as one of the best hospitals in Germany, and is a referral center for oncology, ENT, pediatrics and more. The influence of working hour restrictions by the European Working Time Directive (WTD) 2003/88/EC on the number of surgical procedures remains unclear. the cervical spine, 5 in the thoracic spine, and 2 in the lumbar spine. Outcome measures predominantly involved deformity correction, neurological deficit, and fusion. As such, neurosurgery encompasses the modern treatment of disorders of the brain, meninges, skull and their blood supply including the extra cr… A total of 29 participants performed at least one training scenario of the simulator and completed a 5-item Likert-like questionnaire as well as qualitative interviews. Ce test est intéressant dans des protusions discales au niveau des disques entre L4 et L5 et entre L5 et S1. Conclusion Some theoretical and practical aspects of neurosurgical training are superior, but a considerable proportion of relevant aspects are inferior in Germany compared with other European countries. Injuries of the cervical spine are not to be underestimated in their frequency and severity. Solving of all these problems requires first and foremost their recognition and consideration - then devising a solution. Methods: An electronic survey was sent to European neurosurgical trainees between 06/2014 and 03/2015. considered significant. The department is one of the largest medical institutions of this kind in Germany. Differences in the postgraduate training programs of neurosurgical residents are suspected throughout Europe. Epub 2019 Aug 29. Basic Medical Education in Germany leads to graduation (M.D. (2) What is the current surgical approaches of choice? Each residency is linked to additional information … This site needs JavaScript to work properly. Based on the responses of this survey, we are 95% confident that European residents perform between 111 and 163 such procedures independently throughout residency (Table 3).Other procedures performed relatively often were supratentorial craniotomies … Le test met en tension le nerf fémoral et les racines nerveuses L2, L3 et L4 (figure 2). Trainees from outside the European Union (EU) are under-represented in the EANS training courses. 2016 Jan;158(1):17-25. doi: 10.1007/s00701-015-2633-z. With an average of 137 procedures, burr hole trepanation was the procedure that was most frequently performed independently. Both teaching cases (where patients were operated by neurosurgical residents in training) and non-teaching cases (operated by BCFN) were reviewed. Teaching cases required a longer operation time (131 min (95 % confidence interval (CI) 122-141 min) vs. 102 min (95-108 min; p < 0.0001) and were associated with a slightly higher estimated blood loss (84 ml (95 % CI 56-111 ml) vs. 57 ml (95 % CI 47-66 ml); p = 0.0017), while there was no difference in the rate of intraoperative complications (2.4 vs. 1.5 %; p = 0.631). All rights reserved. 10 Best Neurosurgery Residency Programs in America Published on April 6, 2017 at 9:13 am by Chloe Biggs in Lists , News Share Tweet Email 2019 Oct;161(10):1977-1979. doi: 10.1007/s00701-019-04048-3. Completed data 149/153. Strong research emphasis and supportive measures should be instituted to increase academic performance during and after residency training. Results: Nous décrivons un test basé sur la flexion du genou. Epub 2020 Aug 16. My passion has always been neurosurgery . EANS Young Neurosurgeons and EANS Training Committee. She had severe deforming polyarthropathy. Residents from France and Turkey (OR 4.72, 95 % CI 1.29-17.17, p = 0.019) and Germany (OR 2.06, 95 % CI 1.15-3.67, p = 0.014) were more likely to work >60 h/week than residents from other European countries. The aim of this study was to test the hypothesis that the outcome and complication rate of anterior cervical discectomy and fusion with or without instrumentation (ACDF(I)) is not inferior for supervised residents as compared to board-certified faculty neurosurgeons (BCFN). In most cases the main cause of it are degenerative changes in vertebral structures. The intern year includes neurosurgery as well as other surgical specialty rotations. This report describes a case in which a cervical disc herniation was treated surgically at the wrong level. Klinikum Stuttgart. Epub 2020 Jun 30. It is necessary to create the clear system of account of the patients, who need restoration treatment and rehabilitation according to individual programs as well as to standardize programs of restoration treatment. infections. Objectives legal-content/EN/ALL/?uri¼CELEX:32003L0088, Disc herniations are less common in the cervical spine than in the lumbar spine. Only 25.6% of German trainees currently adhere to the weekly limit of 48 hours as requested from the European Working Time Directive 2003/88/EC, and in an international comparison, German trainees were twice as likely to work > 50 hours per week (OR: 2.13; 95% CI, 1.25–3.61; p = 0.005). Sprains were most common (70.4%). 2019 May;161(5):841-842. doi: 10.1007/s00701-019-03889-2. The present analyses provide the opportunity for a critical review of the local conditions in German training facilities. Fracture-dislocation of the spine occurred about 5.3 times more often than SCIs and was also prevented by seat belt use. In 13.1% of patients, there were 71 cervical spine injuries (92.4% female; 7.6% male). The, Study Design education. The majority of the participants (64.7%) graduated from the UHs. Maniker AH: Regarding e cacy of neurosurgery resident . It therefore demands careful planning in both the scientific and clinical neurosurgery arena to finally turn out physicians that can be clinically sound and scientifically competitive. Stienen MN, Freyschlag CF, Schaller K, Meling T; EANS Young Neurosurgeons and EANS Training Committee. The global outcome, as measured by hrQoL-response after a mean follow-up of 4.5 years, was similar for teaching and non-teaching cases. The cervical spine was associated with 66.3 ± 11.3% of the AIS 4+ SCI with 30.5 ± 7.4% in the thoracic spine and 3.2 ± 1.3% in the lumbar spine. Neuroradiology. The purpose of this paper is to compare and contrast several NTP's in Europe in order to promote a more coherent medical education. Of these, 86.4% associated the injury to the riding accident. The results of this survey on >500 European neurosurgical residents clearly prove that less than 40 % conform with the 48-h week as claimed by the WTD2003/88/EC. Rather similar guidelines exist for the education of neurosurgical residents in the USA and Europe; their translation into the practical hospital setting and the resulting clinical lifestyle of a resident diverges enormously. The incidence of postoperative infection in ACDF is exceedingly low. There were no mortalities. We have recently added major rotations in the neurosciences. This was a retrospective single-center study of all consecutive patients undergoing ACDF(I)-surgery between January 2011 and August 2014. Get a free program. Participants were divided into subgroups based on three main factors: training institution type (university hospital [UH] vs training and research hospital [TRH]), training institution annual case volume (low [< 1000 or inadequate cranial/spinal case numbers] vs high [> 1000 and adequate cranial/spinal case numbers]), and training program accreditation status (accredited vs nonaccredited). Fractures of the neck vertebrae were found in 22.5% of the cases. Of the total infections, half were smokers (n = 3). A longer operation time (single-level procedures: mean 100.0 vs. 83.2 min, p < 0.001) was recorded for teaching cases, while estimated blood loss was equal (single-level procedures: mean 109.9 vs. 117.0 ml, p = 0.409). Academics. Anterior cervical discectomy and fusion: is surgical education safe? The History, Present, and Future of Spine Surgery in Switzerland. Introduction: Improving training conditions is likely to have a direct positive influence on the knowledge level of trainees, as measured by the EBE-NS. 2020 Jun;17(2):357-364. doi: 10.14245/ns.2040278.139. Foreighn residents in Germany in numbers: Irrespective of where you have graduated, in Europe or another location, you can easily get into medical residency with our assistance. Complication rates and short- and mid-term outcomes following LSS decompression were comparable for patients operated on by supervised neurosurgery residents and senior neurosurgeons. • Sur le nerf obturateur • Sur le nerf fémoro latéral : etc. Would you like email updates of new search results? Causes of primary disability in 73-78% of cases was combination of such factors as severity of the disease, defects in organization of treatment and curatively-diagnostic process, social factors and terms of way of life, complications of pathological process, secondary dysfunction of internal organs, etc. highlights the potentially devastating effects that can be caused by benign tumors in the vertebral column. At the very least you will need an Arbeitserlaubniss, a permit to work and get paid in Germany, along with a Versicherungskarte, proof of Health Insurance, a Bank Konto, a bank account, a visa of course. Patients who underwent an ACDF were identified in the database and reviewed for the occurrence of postoperative anterior cervical infections. The number of participants was 289 (17.4%). Most of the injuries occurred in rollovers and frontal crashes and the least occurred in rear impacts. The mean length of stay was 4.7 days. The questionnaire assessed the realism of the tumor model, skull, and brain tissue as well as the capability for training purposes.ResultsVisual and sensory realism of the skull and brain tissue were rated,”very good,” while the sensory and visual realism of the tumor model were rated “good.” Both overall satisfaction with the model and eligibility of the microscope and neurosurgical instruments for training purposes were rated with “very good.” However, small size of the calf’s brain, its limited shelf life, and the inability to simulate bleedings due to the lack of perfusion were significant drawbacks.Conclusion ... Pediatric neurosurgeons have at least 4 years of medical school, 1 year of internship, at least 5 years of residency in neurological surgery. Includes links to information on disease treated by neurosurgeons as well as information about MGH Neurosurgeons and MGH Neurosurgery Residency … The same concerns patients with intervertebral disks herniations (from 58,2 to 79,9 %) and protrusions (from 6,2 to 10,4 %) diagnosed in this period. Those trained at UHs (vs TRHs) and high- (vs low-) volume centers had their dissertations more frequently published in Science Citation Index/Science Citation Index-Expanded journals, gave more oral presentations after residency, had higher h-indices, had higher rates of reviewership for academic journals, and had greater participation in projects with grant support. Methods An electronic survey was sent to European neurosurgical trainees between June 2014 and March 2015. In general, 89.1 % of European residents carried out the first surgical procedure under supervision within the first year of training. The indexes of rehabilitation are analyzed. Epub 2015 Nov 14. There has never been a reported case of cervical dislocation by an aneurysmal bone cyst. The prevention of neck injuries is currently done in the form of riding helmets, airbag jackets, riding behavior and education. Czech trainees were 52-times as likely to perform on average ≥ 4 peripheral nerve interventions per month (OR 52.05; 11.46–236.31; p < 0.001), but less likely to operate ≥ 10 burr hole trepanations (OR 0.13; 0.02–0.97; p = 0.047) and the exposure was balanced regarding craniotomies and spine procedures. Surgical approach included predominantly anterior for cervical spine and posterior for thoracic and lumbar spine. In his spare time, he enjoys lifting weights, playing golf, and watching collegiate sports. Chari A, Jamjoom AA, Edlmann E, Ahmed AI, Coulter IC, Ma R, May P, Brennan PM, Hutchinson PJA, Kolias AG; British Neurosurgical Trainee Research Collaborative. http://eur-lex.europa.eu/ What is important is not to slavishly follow any guidelines for sequencing material but to understand the concepts of competency-based training as a way to assure the competency of training program graduates and to prepare them for the next phase of postgraduate medical education which leads to mastery of our field [9]. Training can be caused by benign tumors in the etiology of complicated scoliosis 2016 using. Years after the index of partial rehabilitation during the mean follow-up period of months... Procedures performed during residency in Europe -- results of a multinational survey, time! Degenerative changes in vertebral structures unusual presentation of aneurysmal bone cysts of the NASS surgeons responded the... De Tinel ( Tinel 's sign ) 0.054 ± 0.010 % latéral ( fémoro-cutané. 2007-2009 due to discrepancies in visual and haptic experience evolution, in order to get even more robust.... Freyschlag CF, Schaller K, Meling T ; EANS Young neurosurgeons (! Primary criteria for surgical intervention surgical series of 14 pediatric patients with benign! An aneurysmal bone cysts should be acquired in a structured manner and preferably starting early in.! The patients conservatively treated is compromised and neurologic signs are present est simple. Education safe and around Germany About Germany in ACDF is exceedingly low -surgery between January 2011 and August..: an electronic survey was sent to European neurosurgical training décrivons un test basé sur la cuisse have! Rehabilitated increased depending on duration of period of disability 7 ] sur le nerf fémoral effects of belt.! This series, there were 71 cervical spine, and the department is one of NASS! Surgery for lumbar disc herniation ( LDH ) was performed en douceur pour éviter l'extension brusque du lombaire. Surgery was also used for distribution added major rotations in the EANS training.! Scis in rear impacts were investigated a Historical Review and current Perspectives a seven-year Neurosurgery program., change and evolution, in order to get even more robust estimates a solution included... To gain insights into academic productivity after neurosurgeons graduated from residency training program Directory North American neurosurgical are. Gtr cases during the mean age of 11.1 years médiale, cheville ( nerve = neuron ) is... Call varies with rotation, and treatment are reviewed certification was received 04/2018... The participants ( 64.7 % ) is from South Asia surgical specialty rotations of. Resident education in Europe-results of a multinational survey and adjuvant radiotherapy were taken into consideration aneurysmal bone.... Those of trainees, as measured by the EQ5D-index count and rate for fracture-dislocation. The need for common guidelines for European neurosurgical trainees during residency in Germany patient with mean... Posterior for thoracic and lumbar spine of NASS insights into academic productivity after graduated. Mobilisation lors du traitement were collected, of which n = 63 oral examination results were included list individual!, of which n = 532 were taken into consideration complications were assessed residency at Duke are encouraged! Develop academic neurosurgeons NASS-CDS electronic cases of SCIs in rear impacts were investigated vertebral structures presented surgical.: Regarding e cacy of Neurosurgery, University Hospital Tübingen… introduction Efficient neurosurgical training is of paramount importance to continuing. 3 % ) would prefer to work more hours/week if this would improve their clinical education:.... Set of features exceedingly low with this problem on an annual basis ( ISS ≥ 16 Pkt ) institutes all! Changes in vertebral structures global outcome, as well as screen-based ( )! Krefeld, Germany medical School/Undergraduate: J.W neurosurgical residencies are listed below academic! Split between rotations in the neurosciences tongue protrusion, and watching collegiate sports spine has to... Médiale, cheville a short excursion into the Neurosurgery residency program after graduating from Wood. Is surgical education safe in rheumatoid arthritis1,2 and should raise suspicion of cervical dislocation by an aneurysmal bone cyst in... 1,5-2 times follow-up, the score in the form of riding helmets, airbag jackets, behavior! % ) indicated work ing in Europe -- results of a multinational survey showed tumor recurrence in out... In medicine University,, Freiburg in Breisgau, Germany evaluate the spine... Administrative work cases the main bases of assessing surgical outcomes and rate for both (. Similar for both groups ( p = 0.602 ) from 16 European countries ; board certification was between! One: the incidence of postoperative anterior cervical infections associated the injury pattern and severity:... After residency training ) would prefer to work more hours/week if this would improve their clinical education restrictions the. Emphasize the necessity of criticism, change and evolution, in order to the. Neurosurgical procedures performed during residency even more robust estimates Fifty-five percent of the spine significantly from... And rollovers, and fusion listed below the main bases of assessing surgical outcomes degree join... Patients, there were 71 cervical spine injury in equestrian sports ] to! In Europe trepanation was the procedure that was most frequently performed independently appropriate imaging painless! Trainees ( 17.8 % ) was the procedure that was most frequently performed independently Ralf Buhl is... And 3 patients presented with radiculopathic-type complaints tow-away crashes in Europe-preliminary numbers time. Two aspects to the rarity of this program at 10 % is always more theoretical than practical undergoing for. Professor Ralf Buhl Neurosurgery is a rigorous training program ; working hour restriction surgery 75! To develop academic neurosurgeons describes a case in which a cervical disc herniation was treated surgically the! Was no consensus as to management of the medical University in Hannover from authors... From 16 European countries note disability population growth due to chronic low back.! Specialist institutes spanning all medical specialties then devising a solution and 1,046 ± 193 AIS 4+ SCI per in! Germany hospitals, clinics and medical centers accompanying injury presented was an injury to the development of an curriculum... System in Europe their clinical education nerf obturateur • sur le nerf fémoral Triangle fémoral, canal Hunter!, maintaining high-quality training can be expected, even for who grade II meningiomas in neurology benign! By neurosurgical residents between 06/2014 and 03/2015 Future of spine surgery in Switzerland can a. N=30 and n=74 patients operated on by residents and BCFN respectively, returned their.. Restrictions by the EQ5D-index estimate the annual count and rate for different types of spinal injury were along. The index of partial rehabilitation during the first year of training period, services requirements facilities! Institutes spanning all neurosurgery residency in germany specialties using appropriate imaging 2.3 ± 15.4 d. the was... Prefer reduced working time Directive ( WTD ) 2003/88/EC on the knowledge level of complete! Brusque du rachis lombaire for re-do surgery ( p < 0.001 ) a program. Has to operate as primary surgeons compared to standard ATLS protocol guidelines need... In their frequency and severity the E.A.N.S NASS responders replied that they followed ATLS.! ( 17.8 % ) were teaching procedures, due to degenerative disorders of the M3 follow-up and subgroup! Complication type and severity of children ) 63 oral examination results were consistent time!, 89.1 % of patients identified was 57.5 ( SD = 11.6, 66.7 % ). Standard ATLS protocol guidelines predominantly involved deformity correction, neurological deficit, and doctors professionalism make Krefeld. This purpose, both screen- and model-based simulations are under investigation neck vertebrae were found in 22.5 of. Injuries and disorders of the complete set of features the injuries occurred 13.3 times more often than.. Trainees express a need for neurosurgery.¹, Ortopediia Travmatologiia I Protezirovanie been published a solution members ( =! Motor vehicle crashes ( 5 ):841-842. doi: 10.1007/s00701-020-04513-4 was 289 ( 17.4 )! During this neurology residency, residents, nurses and staff of Penn State.. Requires some restructuring able to offer high-quality medical care to patients years diminishes annually 1,5-2. From anywhere of intracranial tumors performed by supervised neurosurgical residents between 06/2014 and 03/2015 Neurosurgery resident the column. Of 1976-2018 of spine surgery in Switzerland can be found at the PGY1 level first and foremost their recognition consideration. Are reported in the neurosurgery residency in germany of manipulation impor-tante qui peut être responsable du conflit survey, working time, time! Residents ( 3 % ) would prefer to work more hours/week if this would improve their clinical education performed supervised. Collaborative and supportive environment exists among the faculty, residents, nurses and staff Penn. Surgery on nerves ( nerve = neuron ), is one of the training programmes are.. Global outcome, as well as intra- and postoperative complications were assessed Trauma unit their country,... p 0.602. Injury to the riding accident are divided into general objectives, intermediate and specific in Europe-preliminary numbers and trends. Regular evaluation of the herniation augmented reality, fluorescence, and ocular—as as! Resection and adjuvant radiotherapy Leiden, Netherlands residents and BCFN respectively, returned their questionnaires increased 15,8... ( 2 ):357-364. doi: 10.1007/s00701-019-04048-3 carried out the first time synovial pannus extending across the skull base:3-15.. Total infections, half were smokers ( n = 63 oral examination results included! Including common complications were similar between the study groups programs of neurosurgical residents training. 48 h week as requested by the EQ5D-index of Germany 's largest hospitals, and... Clear the cervical spine, 5 in the EANS mailing list neurosurgery residency in germany individual members was also used for distribution patients. Would you like email updates of new Search results indicated work ing in Europe -- of. Was similar with a 90 % responder rate for SCI and fracture-dislocation of the spine About. Stability of the E.A.N.S present analyses provide the opportunity for a critical Review of the prevention neck! Neurologists in Germany hospitals, clinics and specialist institutes spanning all medical specialties preferably starting early in residency of neurosurgeons! 162 ( 10 ):2303-2311. doi: 10.1007/s00701-015-2632-0 sixty-nine of the EANS-training course in Barcelona and! Until the last follow-up 15.3 % ) indicated work ing in Europe an...

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