Attempts to increase the Number of Cases and Perform Safe and Reliable Surgery —Current status and the perspective of a senior resident working at a small–scale hospital—

Abstract

  After two years of neurosurgical training at a university hospital, the author works as a senior resident at a secondary emergency medical facility with 99 beds. Our department primarily treats emergent patients. The total number of emergency cases transported by ambulance is 90.1 patients/month and walk‒in arrivals is 79.1 patients/month after the author’s assignment. Of 389 hospitalized patients, conservative treatment was selected in 322 cases (82.8%), craniotomy was performed in 13 cases (3.3%), endovascular treatment in 18 cases (4.6%), burr hole surgery, in 27 cases (6.9%) and other treatments in 9 cases (2.3%). The rate of surgical intervention before and after the assignment of the author increased from 3.7% of all emergency patients to 4.4%, reaching 5.9% in the latter period after assignment. In addition, 72% of surgeries were performed for emergency patients. We believe that the active acceptance of emergency cases is important in order to increase the number of surgeries. At a small‒scale hospital, even young neurosurgeons can provide consistent medical care from the initial diagnosis of emergency patients to surgery and perioperative management. We believe that working at both large‒ and small‒scale hospitals is effective for young neurosurgeons to master safe and reliable neurosurgical care.