NEUROLOGY TRAINING IN CANADA FOR FOREIGN NATIONALS OPPORTUNITIES AND CHALLENGES

1. NEUROLOGY TRAINING IN CANADA FOR FOREIGN NATIONALSOPPORTUNITIES AND CHALLENGES A Keith W Brownell Department of Clinical Neurosciences University of Calgary and Alberta Health Services

3. DISCLOSURES The opinions expressed in this presentation are based on my own experience and the experiences collected from other educational leaders (primarily Canadian) over the past more than 30 years I have been involved with leadership activities in post-graduate education. There is virtually nothing in the published literature on this topic.

4. OUTLINE • Definition of terms • Accredited and fellowship programs • Current Canadian contribution • Why offer this type of training • Opportunities and challenges • Conclusions • Challenge for the AAN

5. DEFINITION OF TERMS • Foreign national • Fellowship training

6. ACCREDITED NEUROLOGY EDUCATION/TRAINING • Royal College of Physicians and Surgeons of Canada (RCPSC) accredited • University based • 5 years duration • Certification examinations conducted by the RCPSC

7. ACCREDITED NEUROLOGY EDUCATION/TRAINING PROGRAMS • Adult Neurology 16 (126 in USA) • Pediatric Neurology 10 ( 69 in USA) • Subspecialties 0 ( ? # in USA)

8. NEUROLOGY FELLOWSHIP EDUCATION/TRAINING

9. CANADIAN CONTRIBUTION 2009 – 2010DATA SOURCES

10. CANADIAN CONTRIBUTION 2009 – 2010 ACCREDITED PROGRAMS • Numbers 20 [19 (A), 1 (P)] • Stages of training RI (3), RII (6), RIII (4) RIV (2), RV (5)

11. CANADIAN CONTRIBUTION 2009 – 2010 FELLOWSHIP PROGRAMS • Numbers 52 • Program types 15

12. Bahrain Brazil China Columbia Costa Rica Egypt England Iceland India Jamaica Japan Kuwait Libya Malaysia Mexico Netherlands New Zealand Nigeria Oman Romania Russia Saudi Arabia Spain Sweden Tunisia United Arab Emirates Ukraine COUNTRIES OF ORIGIN(27)

13. COUNTRIES OF ORIGIN • Saudi Arabia 19 • India 8 • 4 countries @2 8 • 21 countries @1 21 • Not documented 16 • TOTAL 72

14. Behavioral neurology EEG (pediatrics) Epilepsy General neurology Movement disorders (& DBS) MS Neuro critical care Neurology/neurophys Neuromuscular Neuro-oncology Neuro-ophthalmology NICU Pediatric neurology Sleep Stroke FELLOWSHIP TYPES

15. MORAL BASIS OF OBLIGATION TO PROVIDE EDUCATIONAL OPPORTUNITIES TO FOREIGN NATIONALS • CMA Code of Ethics • Justice • Altruism • International responsibilities

16. OPPORTUNITIES FOR SPONSORING PROGRAMS • ___________________________ • ___________________________ • ___________________________ • ___________________________ • ___________________________ • ___________________________ • ___________________________ • ___________________________

17. CHALLENGES FOR SPONSORING PROGRAMS • Recruitment • Educational program • Social

18. RECRUITMENT • Assessment of credentials • Assessment of language skills • Trainee expectations • Interview

19. Program objectives & expectations Medical ethics Professionalism Communication End of life issues & critical care Evaluation Integration Orientation EDUCATIONAL PROGRAM

20. SOCIAL • Isolation • Family support • Language fatigue • Social network • Spiritual & religion concerns • Legal issues • Ombudperson • Impact of a termination

21. CONCLUDING REMARKS • _______________________________ • _______________________________ • _______________________________ • _______________________________ • _______________________________

22. OPPORTUNITIES FOR ORGANIZED NEUROLOGY • ______________________________ • ______________________________ • ______________________________ • ______________________________

23. COMMENTS/QUESTIONS