Abstract
Successful clipping surgery for cerebral aneurysms requires us to have a theory and an image, as well as experience and surgical skills. An expert neurosurgeon for cerebral aneurysms must possess these 3 factors. An efficient training system is necessary to train neurosurgeons to become expert at clipping surgery. Trainees can obtain a part of theory and image, which are necessary for clipping surgery, from textbooks, papers, and videotapes without on-the-job training. However, they must participate in a substantial number of clipping surgeries, maybe around 100, as the operator or assistant to brush up their theory and images as well as to develop the required surgical skills. The experience of 50 operations as the main operator followed by 50 operations teaching junior surgeons may be sufficient as a first step in becoming an expert clipping surgeon. More successors can be trained by this roof-tile system than in a one-on-one training system. However, this training system is not always open for all junior neurosurgeons.
