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Table of Contents    
Year : 2021  |  Volume : 69  |  Issue : 3  |  Page : 751-752

A Letter on the Need for Uniform Residency Training Programs and the Challenges During COVID-19 Pandemic for India

Department of Neurosurgery, AIIMS, New Delhi, India

Date of Submission31-Mar-2021
Date of Decision01-Apr-2021
Date of Acceptance15-May-2021
Date of Web Publication24-Jun-2021

Correspondence Address:
Dr. A K Banerji
Department of Neurosurgery, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.319215

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How to cite this article:
Banerji A K. A Letter on the Need for Uniform Residency Training Programs and the Challenges During COVID-19 Pandemic for India. Neurol India 2021;69:751-2

How to cite this URL:
Banerji A K. A Letter on the Need for Uniform Residency Training Programs and the Challenges During COVID-19 Pandemic for India. Neurol India [serial online] 2021 [cited 2022 Jan 26];69:751-2. Available from:


This refers to the well-timed “Editorial: The need for uniform … India,” Neurology India 2020, 68; 1279-80. Seven years have passed since the recommendations were made with no visible effect. The reason, to my mind, is not including the decision makers, namely, the Medical Council of India (MCI) and the National Board of Examination (NBE) in the meeting. It is worth remembering the meeting organized by the Neurosurgery Department, All India Institute of Medical Sciences, New Delhi, in the 1980s, where two major changes took place: (a) introduction of 5-year courses and (b) stopping the two years M.Ch. and converting it to a 3-year course. This was possible because the MCI and NBE were represented by their respective presidents. I think it is time for us to consider doing so again with a firm plan of action proposed by the Neurological Society of India (NSI).

The major points of discussion could be the following:

  1. Selection of candidate:

  2. There is a distinct requirement of the candidate to be able to go through the rigorous training program. It can only happen if the candidate has been in a neurosurgery department as a house surgeon/resident for at least six months before applying for the entrance examination. There are several examples of trainees leaving off midway, and worse, taking their own lives, which is such a sad waste of young talent. It can be worked out within the NEET (National Eligibility cum Entrance Test) parameters by admitting those with neurosurgical experience or admitting them formally after 6 months, once they gain the required experience.

  3. Uniform single 6 years course:

  4. It is time we agree to do it. The reasoning had been given in the editorial. With the growing need for learning neurointervention procedures, endoscopy, and so on, this is not possible in a 3-year course. The 3-year course should be phased out.

  5. The need for exposure of a trainee to general surgery must be reconsidered. There are many countries where general surgery is not a part of the training requirement. Furthermore, 6 years neurosurgery trainees are a low priority compared with teachers of general surgery and other surgical specialties.
  6. Skills laboratory and cadaver dissections:

  7. It is essential to learn and master surgical techniques in a risk-free atmosphere. One month full-time training in the third and fourth years should be made compulsory. There are numerous such laboratories in the country, and I am sure these can accommodate all the trainees who do not have such laboratories in their own institutions.

  8. Visiting reputed centers:

  9. It is vital for the trainees to know how the other centers work. This could bring new ideas to their own centers. These visits should be for a period of six weeks to at least two centers. The choice of centers could be made mutually with the local faculty or teachers.

  10. Neurology rotation:

  11. The first three months should be full-time rotation in the neurology department. Proper neurological examination should be learned. Furthermore, exposure to neurophysiological investigation and procedures is needed for good all-around development.

  12. End-course assessment:

  13. The need for live operative surgery is a contentious issue. In centers where it is not possible to do so, an examination in a skills laboratory setting would be a good alternative.

    The traditional method of long case, short case, and so on should be abolished. If our aim is to select a person with the ability to diagnose and perform common procedures, with the capability to learn newer things in neurosurgery, then we should have a process followed by the exclusive clubs. A round of all admitted patients, including those in neurology and trauma, should be undertaken. Three candidates can be examined at a time in a 9-hour period. All aspects of diagnosis, investigations, and treatment, including ICU (intensive care unit) and postoperative management, can be explored.

  14. My suggestion for NSI is to form subcommittees on various aspects of neurosurgical training, including aims and objectives, admission criteria, departmental criteria, details of posting periods, and so on, leading on to end-course assessment. Online meetings, in which we have become experts, could produce a final document in a time-bound frame.

The influential NSI members could then contact the MCI and NBE and request for a half-day meeting where the conveners of the subcommittees could submit brief reports for final consideration.

I understand this requires patience, time, diplomacy, and politically savvy behavior. There are several that I can count on in our community of NSI who have these attributes and can rise to the occasion to leave a rich legacy for the future.

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Conflicts of interest

There are no conflicts of interest.


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