The First ICPNT Retreat Summary Report

Chanhung Lee, MD, PhD
Member, ICPNT Executive Committee & Neuroanesthesia Program Relations Committee

W. Andrew Kofke, MD, MBA, FCCM, FNCS

Dr. Lee
Chanhung Lee, MD, PhD
Dr. Kofke
W. Andrew Kofke, MD, MBA, FCCM, FNCS

In 2019, the International Council for Perioperative Neuroscience Training (ICPNT) was established to develop a SNACC-based international neuroanesthesiology fellowship accreditation service. During the COVID pandemic in 2020, ICPNT did not pause for a moment. It continued to implement the regular application and accreditation for all programs after three rounds of invited pilot program reviews and accreditation to strengthen the program requirements, governing procedures, and applications review process. To this date, there are a total of 22 accredited programs, with eight programs having applications in process. May of 2021 marks the second anniversary of the first three pilot fellowship programs accredited by ICPNT: National Hospital of Neurology and Neurosurgery at University College of London (UK), Northwestern University (USA), and University of Washington (USA).

To assist with review and continued development, the first retreat for ICPNT was held virtually on April 10, 2021. The plan was to build collaborations, explore future opportunities to improve the accreditation process, and train our future educators and leaders in perioperative neuroscience. The virtual retreat participants included nearly 30 fellowship program directors, mostly from accredited programs and some having applications in process. They represented worldwide institutions across international time zones from Asia, Europe, and South America, to North America.  Here are some of the highlights:

  • Opening and Welcome. Dr. Andrew Kofke, Chair of the ICPNT Executive Council, gave the introduction and welcomed all participants. He followed with an ICPNT report, summarizing the progress made, updates on the ongoing revision of the application process to establish a user-friendly platform, webinars on a variety of neuroscience topics organized by the Neuroanesthesia Program Relations (NPR) Committee, and the research abstracts submitted to anesthesiology conferences reflecting on our continuous effort to establish a novel international education network. He encouraged the attendees to provide feedback and suggestions for future directions to help ICPNT’s quality improvement.
  • Speech from Guest of Honor. We had the honor and privilege to invite Dr. Adrian Gelb, a long-time member of SNACC since 1981, a Past President of SNACC, and the current President of the World Federation of Societies of Anaesthesiologists (WFSA). Dr. Gelb complimented the global vision of the ICPNT efforts and discussed potential opportunities for ICPNT to collaborate with WFSA with allied goals and missions in education, such as developing tutorials, sharing education web links, and establishing fellowships for low-income countries.
  • Reviews from the First Three Pilot Programs. One important agenda item for the retreat was the reviews from the three pilot programs in the first accreditation cycle, facilitated by Dr. Lara Ferrario, Secretary of ICPNT. The Program Directors, Dr. Valpuri Luoma from University College London, Dr. John Bebawy from Northwestern University, and Dr. Deepak Sharma from the University of Washington, presented their experience with ICPNT accreditation and how it had helped shape their fellowships. The three programs appreciated the benefits of ICPNT accreditation in the following main areas: first, in recruitment, noting the popularity of accreditation to the applicants; secondly, in the building of the curriculum structure because of the required 80% focused time on neuroanesthesia, required blocks of subspecialty rotations, and dedicated time for scholarly activity; thirdly, in strengthening the education and teaching opportunities through international engagement with other programs, and by joining the monthly NPR webinars to learn various topics and experiences from expert neuroanesthesiologists around the world. Other benefits included the leverage to negotiate recognition and administrative support of the fellowship from the department and the institution.
  • Virtual Reception. This meet-and-greet session consisted of introductions from program directors of themselves and the strengths of their programs and institutions. The extraordinary efforts and support from our colleagues in Europe and Asia were sincerely appreciated, even though the time of the virtual retreat was chosen to cover most of the time zones in between the ICPNT programs to facilitate participation, Dr. Valpuri Luoma from the United Kingdom, Dr. Karsten Bulow from Denmark, and Dr. Ricard Valero from Spain stayed up in the late evening hours of their local time. Dr. Nan Lin joined the retreat at 3:00 AM her local time in Beijing, China, and presented her fellowship program and the modern Tiantan Hospital, a specialized Neurosurgical hospital with an impressive 14,000 neurosurgery cases per year.
  • Education Survey. Dr. Colleen Naglee presented the survey results on behalf of the NPR Committee. The response was collected from directors of 25 fellowship programs, including 18 accredited and seven non-accredited. Most respondents were happy with monthly ICPNT rounds (NPR webinars) and willing to participate in future presentations, liked educational contents mirrored from SNACC, and were interested in sharing a didactic blueprint with all program directors monthly. Nineteen of 25 supported an away rotation at an outside institution with interests mostly in pediatric experience and other complex neurosurgical cases. Twenty-one of 25 were interested in participating in neuroanesthesia boot camp. Other suggestions included regular meetings for program directors to exchange experience and ideas, share educational, clinical, and research resources, and encourage the involvement of fellows in ICPNT activities.
  • Discussions and Feedback. This session was designated to engage the program directors in discussions on feedback and suggestions for future ICPNT initiatives, moderated by Drs. Andrew Kofke and Shobana Rajan, Chair of the NPR Committee. Dr. Kofke confirmed that the ICPNT Logo could be requested during the certification of fellows graduating from accredited programs. The comments from the participants encompassed the following areas, with some resonating with the results from the Education Survey: to provide shared resources for teaching didactics for fellows; to increase the involvement of fellows in ICPNT committees; to develop platforms to encourage communications and support among fellows; to develop tools for assessment of fellow competency.

Overall, the retreat provided good evidence of acceptance and enthusiasm for the ICPNT impact throughout the world. Progress is still needed, and further quality improvement in ICPNT is anticipated through future retreats such as we herein report.

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