325 Maintenance of Certification and the Aging Neurosurgeon.

INTRODUCTION: Assuring clinical competence in the aging neurosurgeon is of paramount importance for patient safety. The American College of Surgeons and the American Medical Association have both developed position statements on the aging surgeon. Cognition, technical dexterity, and physical status vary greatly among individuals. Determining how educational methods can optimally be delivered to senior neurosurgeons, and understanding neurosurgeon perceptions, will help create the most appropriate resources. We present the first wide-scale survey of neurosurgeons to evaluate perceptions of Maintenance of Certification (MOC) and testing of the aging neurosurgeon.

METHODS: We developed a validated, online, confidential survey and administered it to 4899 neurosurgeons (2435 American Board of Neurological Surgery (ABNS) Diplomates participating in MOC, 1440 Diplomates certified prior to 1999 (grandfathered), and 1024 retired Diplomates). We received 1247 responses overall (25% response rate).

RESULTS: Most respondents (65%) were aged 50 and older. Overall, the majority of respondents (62%) believed that the aging neurosurgeon (defined as 65 years of age and older) should undergo additional testing, including cognitive assessment or a review of cases, in addition to a standard MOC examination. Sixty-seven percent of respondents believed there should be no absolute age cutoff at which neurosurgical practice is forced to end. If asked to select an age at which neurosurgical practice should cease, 29% recommended 70 years of age. Forty-two percent of respondents believed that MOC should be tailored to accommodate the aging neurosurgeon. The majority of respondents (59%) believed that MOC should consist of a review of individual case logs and patient outcomes for the aging neurosurgeon.

CONCLUSION: Appropriately assessing the aging neurosurgeon is important to protect patient safety and also maximize the capacity of an aging neurosurgical workforce. This first of its kind comprehensive survey of neurosurgeon diplomates of the ABNS provides important information as to what evaluation mechanisms can be created to fairly evaluate aging neurosurgeons.