THE ROLE OF AUDIT IN A NEUROSURGICAL TRAINING-PROGRAM IN SAUDI-ARABIA

Background: The future of a speciality depends on, among other factors , its training programme; this involves the education contract. Surgic al audit provides a mechanism for educators to monitor in real-time th e performance of residents and hospitals. Setting: Department of Neuro surgery, King Faisal University, Dammam, Saudi Arabia. Methods: A pros pective audit was established. 'Magnitude' of operations and 'intermed iate equivalent' (IE) were defined by the BUPA classification and assi gned weighting. Audit on audit was also done for 1990-1992 inclusive. Results: Total number of admissions was 1325. The commonest components of our case mix were trauma, congenital anomalies especially hydrocep halus and prolapsed disc; rare cases were vascular anomalies and infec tions. On average 50% of admissions were emergencies and 41% were oper ated upon. The Ifs were 398.2, 304 and 354.3 for the 3 years respectiv ely. Senior residents' share of the operative workload was 22% in 1990 , 35% in 1991 and 39% in 1992; for trainee residents, the correspondin g figures were 1%, 5% and 16%. Conclusions: First, contrary to clinica l impression, we found no evidence that the 'magnitude' of operations had declined. Second, residents received a fair share of the available operative workload. Third, audit had played a useful role in the deve lopment of our neurosurgical training programme.