1. 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

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 Neurology16 (126 in USA) Pediatric Neurology10 ( 69 in USA) Subspecialties 0 ( ? # in USA)

8. NEUROLOGY FELLOWSHIP EDUCATION/TRAINING

9. CANADIAN CONTRIBUTION 2009 – 2010 DATA 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. 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

13. COUNTRIES OF ORIGIN Saudi Arabia19 India 8 4 countries @2 8 21 countries @121 Not documented16 TOTAL72

14. 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

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 1.___________________________ 2.___________________________ 3.___________________________ 4.___________________________ 5.___________________________ 6.___________________________ 7.___________________________ 8.___________________________

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

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

19. 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

20. 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

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

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

23. COMMENTS/QUESTIONS