A detailed knowledge of neuroanatomy is a requirement for becoming an excellent neurosurgeon. In an effort to promote knowledge of neuroanatomy, the ABNS has decided to create a curriculum and a neuroanatomy examination. The curriculum will be provided to the new PGY1 residents at the start of residency. The Neuroanatomy Exam will then be given a year later in July of the PGY2 year. This neuroanatomy exam will supplement the ABNS Primary Exam which is generally taken later on in residency.
The neuroanatomy exam will be different from the ABNS primary exam. The test can only be failed if it is not completed. The test will consist of 100 “mostly fill in the blank” neuroanatomy questions. The first time the resident takes this exam, the percent correct will be reported to the resident, as well as to their residency program director. The resident will learn which questions they answered incorrectly. After a “lock out” period of 1 week to allow for study of the questions missed, the resident will log back into the exam at a time of their choosing and answer questions similar to, but not identical, to the questions they got wrong the first time. After the second test, the resident will again be informed which questions they answered incorrectly, be locked out for a week, and then be expected to log back in to answer the incorrect questions again. The resident will have up to a total of 4 attempts to get every question correct. The Program Director will be notified of completion but not subsequent test scores or how many attempts the resident required for completion.
The curriculum for the PGY2 Neuroanatomy Exam consists of the following three sources:
- The Rhoton Top 100 Surgical Anatomy Images. https://www.aans.org/education/The-Rhoton-Collection or http://rhoton.ineurodb.org. This site is free and provided by the AANS. To view the site and the Rhoton top 100 images, the resident must create a LOGIN. Once logged in, click on “The top 100 anatomy images” in The Rhoton Top 100. Then click through the various images of the spine or Rhoton surgical anatomy dissection images. Any word or anatomic phrase in green to the right of the image is fair game for the exam. Residents are expected to master every one of the top 100 images in the Rhoton Collection.
- A smart phone webpage link has been created: http://rhoton.ineurodb.org/mobile. Once logged into this site, use the up arrow at the bottom of your smart phone screen to “add to your home screen”. Once the Rhoton icon is on your phone, click the link. Then hit the “Featured” tab and look through the collection. Click on the “…” at the top right and you can quickly see all the images in the collection and scroll through them.
- Neuroanatomy Text and Atlas. John H. Martin 4th McGraw Hill.
- Aids to the Examination of the Peripheral Nervous System 5th
The PGY2 Neuroanatomy Exam will consist of 100 questions and the source material for each question is as follows:
Questions 1 – 54: Rhoton top 100 – Rhoton surgical anatomy dissection images
Questions 55 – 60: Rhoton top 100 – spine or vertebral images
Questions 61 – 92: J Martin Neuroanatomy Text. There will be 2 questions from each of the 16 chapters
Questions 93-97: J Martin Neuroanatomy Text and Atlas. The questions will come from the following Atlas images:
- Atlas I: Images 1 through 7 (gyri, sulci, cranial nerves)
- Atlas II: Images 1 through 14, and images 20, 23, 26, and 28 (cross sections of spinal cord and brain)Question 98: Aid to the Examination of the Peripheral Nervous System 5th Ed Figure 3: Brachial Plexus
Question 99: Aid to the Examination of the Peripheral Nervous System 5th Ed Figure 56: Lumbar Plexus
Question 100: “Commonly Tested Movements” chart on the last page of the Aids to the Examination of the Peripheral Nervous System 5th Edition book
The ABNS believes that the culmination of neurosurgery residency training is chief residency (PG-6 or 7), during which the resident evolves during that 12-month experience into an independent and safe neurosurgeon (Milestones 4). Fellowship is advanced clinical training (Milestones 5) in which subspecialty expertise is developed based on the experiential platform of residency training commencing as a PG-1 resident through chief residency.
Commencing on July 1, 2021, the ABNS will only recognize enfolded fellowships completed in the PG-7 year after chief residency in the PG-6 year, two exceptions apply. See below:
- Enfolded fellowships in neurocritical care may be taken prior to the trainee’s chief resident year
- CNS endovascular training requires an initial training experience in the performance of angiography. This training period may occur prior to the chief resident year. The second year of CNS endovascular interventional training, as of July 1, 2021, must occur after the chief resident year, thus PG-7
For avoidance of doubt, the ABNS does not require fellowships (enfolded or otherwise) as a requirement for initial ABNS certification.
A fellowship may be required for neurosurgeons who wish to achieve an ABMS “Focused Practice Designation” in certain areas of neurological surgery practice.
“The new MOC/CC test is a VAST improvement over what it was previously! A major high-five to whoever realized that at this point in our careers, one does not need to necessarily calculate the acid gap in an ICU patient nor remember every esoteric muscular dystrophy to take good care of patients. If you have not had a chance to look it over, it is now based on Level 1 evidence data and recent randomized clinical studies. Please extend my thanks to whoever had the good sense to finally fix this!!!
Patients want peace of mind when it comes to their care. Being board certified means physicians are skilled, knowledgeable and experts in their specialty. It also means they’ve met a higher standard.
Neurological Surgeons participating in the American Board of Neurological Surgery MOC satisfy the American College of Surgeons COT continuing educational requirements necessary to participate in Level 1 Trauma Center coverage. No additional trauma related CME are required. The ABNS considers trauma and emergency neurological practice and principles part of every diplomates “core knowledge”. The ABNS will use their MOC/continuous certification process to update and educate our diplomates on these emergency neurological surgery principles as new evidence based data evolves.