Update on Neuroanesthesiology Fellowship Accreditation

Establishment of the International Council on Perioperative Neuroscience Training (ICPNT)

By Lara Ferrario, MD

Lara Ferrario, MD

In April 2017, SNACC hosted a meeting of international neuroanesthesiology fellowship program directors and division chiefs in Washington DC. One major topic discussed was whether neuroanesthesiology fellowship programs should receive accreditation by a governing body to ensure quality training.

During this meeting, the North American neuroanesthesia community felt very strongly against obtaining accreditation from the American College of Graduate Medical Education (ACGME) for neuroanesthesia fellowship. Unlike the course that other subspecialties in anesthesiology had taken, the majority of neuroanesthesia directors were in favor of exploring an alternative accreditation venue. The prominent advantage of an ACGME accreditation is the fact that it appeals to the residents trained in US anesthesia programs, therefore, potentially increasing the number of applicants for the fellowship and placing it at a competitive level with the other ACGME accredited anesthesia fellowships. Nevertheless, some important concerns were raised.

All division directors agreed that the biggest issues associated with an ACGME accreditation could be summarized in the following three points:

1. An ACGME accredited fellowship constitutes a significant financial burden for the institutions,
2. Accreditation by ACGME is limited to American anesthesia programs, and most importantly,
3. ACGME accreditation may put significant limitations on research and other center-specific activities available to fellows during training.

Thus, the decision was made to develop an accreditation body for neuroanesthesia fellowship training programs, independent of ACGME.  The accreditation process would be equally valued and accepted by all institutions and universally recognized. In other words, the international values of the Society for Neuroscience in Anesthesiology and Critical Care (SNACC) should be reflected in the criteria for neuroanesthesia fellowship training and in the accreditation process.

To start the development of an accreditation body for the Neuroanesthesia Fellowship Training programs, Dr. Andrew Kofke compiled a task force of neuroanesthesia directors: Drs. Rafi Avitsian, Lara Ferrario, Deepak Sharma, Alana Flexman, Michael Nathanson (UK), Ricard Valero (Spain), Chanannait Paisansathan and Jeff Pasternak. This group was charged with the assignment of creating an accreditation body and drafting a neuroanesthesia subspecialty curriculum. Since the program directors meeting in April 2017, members of this task force collaborated to draft a charter, the fellowship program guidelines, and an application for programs accreditation.

On January 20, 2018 members of the task force met at SNACC headquarters in Richmond, Virginia to finalize a draft for the structure of an accreditation body. The group decided on the following formal name: the International Council for Perioperative Neuroscience Training (ICPNT).

The ICPNT will consist of a Chair and Secretary/Treasurer, both appointed by the SNACC Executive Committee, along with members appointed by the Chair of the ICPNT. This accreditation council with its own mission statement and vision would also allow for accreditation of future subspecialties of neuroanesthesia such as neuromonitoring and neurocritical care.

The process of establishing the academic goals and the clinical curriculum for neuroanesthesiology fellowship training is currently being developed. Some of the criteria taken into consideration are consistent with the view that the standards should be set to meet the national, as well as, the international environments. This would ensure that neuroanesthesia programs produce high quality fellows. There is still a lot of work left to do and the ICPNT will work to ensure a strong future for the field of neuroanesthesia.

Watch for more information in the future and consider attending the next Program Director and Division Chair meeting in Chicago at the Sheraton Grand on Saturday, April 28 from 4-6 pm in the Mississippi Room. Attendance is free of charge. You can register to attend at https://www.surveymonkey.com/r/M7ZQ2NX.