Clinical Requirements

Clinical Training Posts 

Clinical training posts facilitate workplace hands-on service learning and exploration in a range of training environments providing the opportunity for the trainee to develop, with supervision, the requisite experience, knowledge, skills and attributes necessary to become a competent independent specialist neurosurgeon. Click here to view information on the training posts and the training post allocation process
 

Professional Performance Assessment

The standards in the Professional Performance Assessment (PPA) Report are the minimum standards the Board expects trainees to have prior to entering the Training Program.  These minimum standards must be maintained or exceeded at all times during the Training Program.  Completion of the PPA Report, on the prescribed form, must be undertaken quarterly during each year of training as part of the Training Program or more frequently where requested by the Board Chair or where the supervisor identifies performance concerns. 

The current due dates for the Professional Performance Assessment Reports are as follows:

• 6 February 2022 (fourth quarter 2021)
• 13 May 2022 (first quarter)
• 12 August 2022 (second quarter)
• 11 November 2022 (third quarter)
• 10 February 2023 (fourth quarter)

For full details on the Professional Performance Assessment Report and performance related issues, please review the Regulations. 

Download the Professional Performance Assessment Report here  
Download the Training Program Regulations here

Operative Experience Assessment

Appropriately supervised operative experience obtained during clinical training, including good case mixes and caseloads, are essential learning opportunities for trainees to acquire the necessary technical skills and expertise to practice as an independent neurosurgical consultant.  Trainees must maintain an operative experience log of all procedures they participate in as part of the Training Program in accredited training posts using the Board determined system or report. A logbook summary report must be submitted at the end of each six-month clinical training period and must be verified by the surgical supervisor as an accurate record. The trainee is responsible for ensuring that the completed logbook summary report is submitted by the due date and that they have adequate records to justify the logbook summary report. 

Trainees have the option to use the RACS MALT system or submit the NSA Logbook Summary Report. The NSA Logbook Summary Report can be downloaded below.  To access MALT, you will need to sign into the RACS website. Full details can be found on the RACS website https://www.surgeons.org/en/research-audit/morbidity-audits/morbidity-audit-and-logbook-tool. If you require assistance gaining access or using MALT, please contact the MALT team by telephone on 08 8219 0939 or email at [email protected].

 The training requirements relating to operative experience are as follows:

• Participation in a minimum of 80 major neurosurgical procedures for each six months or pro rata equivalent for trainees on approved flexible training; and
• Participation in a minimum of 200 major neurosurgical operative procedures during Basic Training; and
• Participation in a minimum of 800 major neurosurgical operative procedures during Intermediate Training;
• Participation in a minimum of 50 major paediatric neurosurgical cases which can include those completed during Basic Training, Intermediate Training and Advanced Training;
• Participation in a minimum of 200 major neurosurgical operative procedures during Advanced Training of which at minimum of 100 must be as primary surgeon.

The current due dates for the Logbook Reports are as follows:

• 6 February 2022 (third and fourth quarter 2021) 
• 12 August 2022 (first and second quarter 2022
• 10 February 2023 (third and fourth quarter 2022) 

Download the Operative Logbook Summary Report here
Download the Training Program Regulations here

Direct Observation of Procedural Skills Assessments (DOPS)

The Neurosurgical Direct Observation of Procedural Skills Assessments (the DOPS) are designed to assess both knowledge and technical proficiency in discrete procedural skills. The procedure must be performed by the trainee and observed by an Assessor.  The Assessor must be the Surgical Supervisor or another Surgical Trainer recognised by the Board who has supervised the trainee undertaking the procedure on multiple occasions. Where the Assessor is not the Surgical Supervisor, the Surgical Supervisor must also sign the DOPS form to confirm they are confident with the assessment completed by the Assessor.

The trainee should initiate a DOPS when they feel they have a reasonable chance of demonstrating safe and efficient independent practice.  The Assessor, in completing the DOPS, is confirming the trainee can perform all the principal procedure independently in a consistently safe and effective manner based on their direct observations of the trainee performing the procedure.

Type 1 DOPS procedures must be assessed as satisfied by two different Assessors from two different training units. The Type 1 DOPS procedures are as follows:

• Acute Subdural Haematoma
• Chronic Subdural Haematoma – Burr Hole or Craniotomy
• External Ventricular Drain/ ICP Monitor    
• Opening and closing a pterional craniotomy

Type 2 DOPS procedures must be assessed as satisfied by two different Assessors from two different training units. The Type 2 DOPS procedures are as follows:

• Anterior cervical discectomy and fusion    
• Carpal Tunnel Decompression
• Cerebral Abscess Aspiration or Stereotactic Biopsy of a Cerebral Lesion
• Excision of Cerebral Metastasis
• Extradural Haematoma
• High Grade Glioma
• Intracerebral Haemorrhage Evacuation
• Lumbar Laminectomy for Canal Stenosis
• Lumbar Microdiscectomy
• Revision of Shunt
• Spinal Epidural Abscess/Tumour
• Ventriculo-Peritoneal Shunt

Type 3 DOPS procedures must be assessed as satisfied by one Assessor. The Type 3 DOPS procedures are as follows:
 

• Craniotomy and Clipping of Anterior Circulation Aneurysm
• Meningioma resection involving the Superior Sagittal Sinus
• Pituitary Tumour – Trans-sphenoidal resection    
• Posterior Fossa / Skull Base Tumour
• Posterior Fossa Decompression/Chiari Decompression   
• Spinal Cord Tumour
• Spinal Fusion: Posterior - Instrumented   
• Trigeminal Microvascular Decompression
• Ulnar Neurolysis

The SET Program training requirements are as follows:

• Trainees must be assessed by one Assessor as having satisfied each Type 1 DOPS procedure at the conclusion of Basic Training; and
• Trainees must be assessed by two different Assessors from two different training units as having satisfied each Type 1 DOPS procedure at the conclusion of Intermediate Training (including those completed during Basic Training); and
• Trainees must be assessed by two different Assessors from two different training units as having satisfied each Type 2 DOPS procedure at the conclusion of Intermediate Training (including those submitted during Basic Training):
• Trainees must be assessed by one Assessor as having satisfied any five of the Type 3 DOPS procedures at the conclusion of Advanced Training (including those submitted during Basic and Intermediate Training).

Any DOPS form can be submitted to the Board at any time during the SET Program. The DOPS will only be assessed as satisfied if:

• The DOPS form has been signed by the Assessor;
• The date the procedure was last observed by the Assessor is recorded on the DOPS form;
• The DOPS form is submitted to the Board by the trainee within two weeks of the date the procedure was last observed by the Assessor as recorded on the DOPS form; and
• Where the Assessor is not the Surgical Supervisor, the Surgical Supervisor has sign the DOPS form to confirm they are confident with the assessment completed by the Assessor.