Preparing Residents to Navigate Neurosurgical Careers in the 21st Century: Implementation of a Yearlong Enhanced Didactics Curriculum

Background: Neurosurgery residency, known for its rigorous training, must adapt to evolving healthcare demands. Formal education should now encompass areas like quality improvement and patient safety, machine learning, career planning, research infrastructure, grant funding, and socioeconomics. We share our institution's experience with a yearlong enhanced didactics curriculum, complementing our traditional teaching. Methods: Our resident and faculty team evaluated essential skills for trainee success and leadership, identified knowledge gaps, and addressed them with 31 lectures. We conducted pre- and 6-month surveys using a Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree) to assess resident education. Survey results were analyzed using Student t-tests, with P < 0.05 indicating statistical significance. Results: Eleven out of 12 residents completed the pre- and 6-month surveys. The surveys revealed improved scores in areas such as research career preparation (3.0/5–4.33/5, P = 0.002), building research skills (3.18/5–4.33/5, P = 0.002), and comfort with quality and patient safety (4.09/5–4.75, P = 0.04). Residents found the lectures highly effective in supplementing their residency training (4.58/5). Qualitative feedback from faculty was highly positive as well. Conclusions: Organized neurosurgery excels in clinical and technical training for residents but lacks formalized training in crucial nonclinical areas, such as quality improvement and patient safety, machine learning/artificial intelligence, research infrastructure, and socioeconomics. Our formal curriculum focused on these topics, with positive resident engagement and feedback over the first six months. However, continuous longitudinal monitoring is needed to confirm the curriculum's efficacy. This program may guide other neurosurgery departments in enhancing resident education in these areas.