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

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.

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

DEFINITION OF TERMS Foreign national Fellowship training

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

ACCREDITED NEUROLOGY EDUCATION/TRAINING PROGRAMS Adult Neurology16 (126 in USA) Pediatric Neurology10 ( 69 in USA) Subspecialties 0 ( ? # in USA)

NEUROLOGY FELLOWSHIP EDUCATION/TRAINING

CANADIAN CONTRIBUTION 2009 – 2010 DATA SOURCES

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)

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

COUNTRIES OF ORIGIN (27) 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 Saudi Arabia19 India Not documented16 TOTAL72

FELLOWSHIP TYPES 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

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

OPPORTUNITIES FOR SPONSORING PROGRAMS 1.___________________________ 2.___________________________ 3.___________________________ 4.___________________________ 5.___________________________ 6.___________________________ 7.___________________________ 8.___________________________

CHALLENGES FOR SPONSORING PROGRAMS 1.Recruitment 2.Educational program 3.Social

RECRUITMENT 1.Assessment of credentials 2.Assessment of language skills 3.Trainee expectations 4.Interview

EDUCATIONAL PROGRAM 1.Program objectives & expectations 2.Medical ethics 3.Professionalism 4.Communication 5.End of life issues & critical care 6.Evaluation 7.Integration 8.Orientation

SOCIAL 1.Isolation 2.Family support 3.Language fatigue 4.Social network 5.Spiritual & religion concerns 6.Legal issues 7.Ombudperson 8.Impact of a termination

CONCLUDING REMARKS 1._______________________________ 2._______________________________ 3._______________________________ 4._______________________________ 5._______________________________

OPPORTUNITIES FOR ORGANIZED NEUROLOGY 1.______________________________ 2.______________________________ 3.______________________________ 4.______________________________

COMMENTS/QUESTIONS