International Council on Perioperative Neuroscience Training
Society for Neuroscience in Anesthesiology and Critical Care
Amended October 10, 2018
A chair, secretary-treasurer and 5-7 members at large shall comprise this Council. The initial Council will be selected and approved by the SNACC Executive Committee. After initial appointed members' terms expire, Council members will be elected by the program directors participating in ICPNT accredited fellowships. Council members shall serve staggered three (3) year terms, and may serve a total of two (2) successive full terms in these positions. After the initial terms, the chair and secretary treasurer will be elected by the Council members. The SNACC Executive Committee will have the authority to replace any member of the Council if deemed necessary. The ICPNT chair will serve as a non-voting member of the SNACC Board of Directors. ICPNT may also have non-voting ad hoc members appointed by the chair.
ICPNT organization and function are maintained in a charter which shall be publicly available on the SNACC website.
Membership in the ICPNT will abide by the diversity and inclusivity policies of SNACC and the World Health Organization.
Description of Terms
Case Credit: In determining the experience of a fellow, credit for case participation, indicated in the summative evaluation transcript, is warranted when the fellow is significantly involved in the cognitive aspects of the anesthetic plan, conduct of anesthesia, and participates in the critical portion or portions of a procedure.
Competency: An element of expertise indicating that a fellow has sufficient familiarity with a topic, concept, or procedure to be able to safely perform or deliver that specific competency in the course of being a neuroanesthesiologist.
Core Faculty: Individuals introduced by the program director who meet the qualification criteria identified by ICPNT in Neuroanesthesiology, have a role in training and evaluating the candidates within a program. They may also be called core attending physicians or core consultants according to the vernacular of the local institution.
Fellow: An individual who is a trainee in a fellowship program. In this capacity the fellow, who otherwise can conduct an anesthetic independently may be granted varying degrees of autonomy as judged appropriate by the program director. In situations of an enfolded (in-residency) fellowship, wherein the fellow will not have been fully trained in anesthesiology, it would be expected that supervision will be consistent with the fellow's level of experience.
Fellowship: A post-graduate subspecialty training experience acquired during or after specialty training in anesthesiology. Fellowships are a minimum of one year in duration, but may be longer as determined by the requirements of the individual program, and qualifications and career goals of the trainee regarding the body of knowledge and the skills to be learned.
Fully trained anesthesiologist: A physician who has successfully completed a post medical school training experience in Anesthesiology consistent with the duration and demonstrated competencies as defined by the region or country where it is performed and who can practice anesthesiology independently. A minimum of two years of clinical anesthesiology training is expected for purposes of enrollment in an ICPNT accredited fellowship.
Graduate training or education: Training provided after graduation from medical school. It can encompass residency or fellowship types of training.
Program Director: The person in a sub-specialty leadership position among the core faculty responsible for ensuring subspecialty trainee candidates to successfully achieve curriculum-defined competencies in an ICPNT accredited program before graduating.
Residency: A post medical school specialty training program. In anesthesiology, a residency duration will be as mandated by the region or country where it is performed.
Subspecialty program: An academic setting within a clinical environment, comprising of teaching faculty, with appropriate staff support and facilities, which altogether delivers a curriculum to train subspecialists within a defined time period
Synthetic Knowledge: Synthesizing (based on Bloom's taxonomy) involves building a structure or pattern from diverse elements of perioperative neurosciences which is accepted within the framework of the ICPNT; it also refers to the act of putting parts together to form a whole. Its characteristics include: production of a unique communication, production of a plan, or proposed set of operations, derivation of a set of abstract relations...all related to combining and integrating a diverse combination of clinical and basic neurosciences knowledge relevant to Neuroanesthesiology. Achieving synthetic knowledge is the goal of a fellowship which differentiates the Neuroanesthesiology training experience from that acquired during residency.
The general responsibilities of ICPNT are to:
- Develop, review, and update the subspecialty training curricula in consultation with current subspecialty program directors, specifying duration and components of training requirements for facilities, faculty, affiliated services and minimum case material at the fellowship site.
- Establish fellowship requirements which must include
- A curriculum for knowledge and procedural objectives based on competencies approved by ICPNT.
- Allowance of adoption of subspecialty training curricula according to generally agreed or codified requirements of a region or country of a fellowship, while ensuring adherence to the general minimum standard set by ICPNT in the program requirements document.
- Receive and administer applications from programs, reviewing eligibility and program attributes, granting accreditation to subspecialty training programs, initially for three years and then at appropriate intervals up to five (5) years.
- Assign application fees for member programs according to set criteria and submit the overall fee schedule for Executive Committee approval
- Establish metrics for program directors to determine successful completion of a fellowship program, which will include ICPNT designated competencies; and may include examinations internally administered by programs.
- Communicate with program directors in order to keep records of individuals enrolled in each fellowship with respect to successful completion, unsuccessful completion, and program withdrawal or termination. Documentation of the basis for each outcome will be provided to ICPNT.
- Act as a consultative resource for programs that are new or for established programs undergoing change.
- Assure that each training program provide a certificate of successful completion and indicate SNACC ICPNT accreditation of the successfully completed fellowship program, as allowed by institutional protocols. Upon request of a successful graduate or program director, ICPNT may provide a supplemental certificate of completion of accredited training to candidates after confirmation of successful completion by the program director. This certificate shall be signed by the council chair, SNACC president and program director.
- ICPNT will not determine licensing required for fellowship training. Licensing requirements will be determined by the local institution and applicable licensing bodies in keeping with regional laws governing licensing to practice medicine.
V. Council Structure & Responsibilities
The Chair of ICPNT will have responsibility for directing the Council's activities and convening meetings as necessary to meet its responsibilities. The chair or a designee will be present during SNACC Board of Directors' meetings, or Executive Committee meetings as requested, for the purpose of communicating ICPNT deliberations and facilitating oversight of ICPNT activities. The chair shall have the responsibility to document outcomes related to fellowship training as subsequently delineated. The chair shall have the responsibility to assign and oversee the communications of the Council. The chair will be a member of the SNACC Board of Directors.
The Secretary/Treasurer of ICPNT will maintain records of ICPNT deliberations and actions as well as accreditation status and review cycles of accredited fellowships and the certification and certificate status of fellows. The Secretary/Treasurer will be responsible for pertinent and timely notifications of each member fellowship program in matters related to the accreditation process. The Secretary/Treasurer will present to the suggested application fee for programs to the Executive Committee and after Executive Committee approval, collect application fees and maintain financial books relative to income and disbursements. The Secretary/Treasurer functions will be performed with support of the SNACC management company unless the ICPNT, with Executive Committee support, chooses an alternate mechanism of administrative support. The ICPNT Secretary/Treasurer will be responsible for managing all accreditation appeals according to the prescribed procedures subsequently delineated.
- Financial Statements
The ICPNT shall have its own set of financial statements. The financials shall be incorporated as necessary with the SNACC Form 990 and other related tax documents.
In the event of dissolution of the Council, all of the assets and property of every nature and description whatsoever remaining after the payment of liabilities and obligations of the Council, but not including assets held by the Council upon condition requiring return, transfer or conveyance, which condition occurs by reason of the dissolution of the Council, shall be paid over and transferred to the Society for Neuroscience in Anesthesiology and Critical Care (SNACC) and no portion of said assets and property shall inure to the benefit of any member of the Council, SNACC Executive Committee or Board member, or any enterprise organized for profit.
- Council Members
- Review program applications or communications as assigned by the council chair or secretary/treasurer with as requested, a written recommendation and being prepared to provide a verbal summary of the recommendations.
- Participate in council activities assuring that subspecialty training requirements are reviewed and updated at least every five years, seeking input from the SNACC membership, in particular the Education Committee, and fellowship program directors.
- Council members shall abide by their established Conflict of Interest policy. Any perceived conflicts shall be disclosed to the Chair.
- Council members shall attend either physically or by remote connection all ICPNT meetings involving programs which they have reviewed and must be otherwise similarly present at 75% of ICPNT meetings.
- ICPNT meetings will be scheduled at least annually with a frequency and time determined by the chair but with due consideration of the international composition of the ICPNT.
VI. Fellowship Review
- Fellowships will be reviewed by at least two council members who will lead discussion and present recommendations for accreditation decisions to the full ICPNT. A vote will then follow upon which an accreditation decision will be made.
- For unusual situations or where expertise is not present among council, the ICPNT members may ask the SNACC or other world-wide subspecialists who are interested and knowledgeable in subspecialty competencies and fellowships to
assist ICPNT as consultants in the confidential review of programs, appeals, and development/maintenance of subspecialty training requirements.
- The Chair or Secretary/Treasurer of ICPNT will, with input from the SNACC Board of Directors, appoint these consultants for assisting in confidential review of applications for fellowship accreditation and making recommendations to ICPNT in this regard.
VII. Accreditation and Certification Process
- Accreditation is open to fellowships worldwide. Each program should send applications to ICPNT for evaluation which may include a site visit if substantive questions remain after review of the application. The application will
include a non-refundable fee. After review, the ICPNT will decide if the program meets the requirements and will give the program an initial three-year accreditation and subsequently up to a five-year accreditation.
- Numbers of fellows participating in a given fellowship will not be a criterion for accreditation.
- Fellowships enfolded within an institution's anesthesiology residency continuum will be allowed.
- Applications for fellowship accreditation and certification will be submitted to the ICPNT Secretary/Treasurer as per instructions posted on the ICPNT website. The Secretary/Treasurer of ICPNT will have the discretion to complete the review within ICPNT or utilize additional subspecialty reviewers.
- Judgments regarding accreditation will be made based on compliance with the established fellowship training requirements. All deliberations will be confidential. After the exclusion of the members with a conflict of interest, a minimum of half of the ICPNT members will constitute a quorum for participation in accreditation decisions. Accreditation decisions will be made by a majority vote of participating ICPNT members. Decisions to not grant accreditation or to place a program on probation will be accompanied by a summary of the basis for such judgments.
- ICPNT may at its discretion require a site visit to obtain information not adequately represented in the application. The expense of this visit will be predetermined to cover transportation, meal and lodging expenses and will be the responsibility of the sponsoring program's department/division. These arrangements will be made prior to the site visit.
- When an ICPNT accredited subspecialty fellowship makes a significant change in program structure or undergoes major changes in fellowship faculty, especially the fellowship program director, the fellowship program director or the institutional supervisor shall inform the ICPNT Secretary/Treasurer within six months of the change. Substantial changes such as a change in program director or institutional leadership may, at the discretion of ICPNT, be cause for a probationary status and review of fellowship and its accreditation. The cost of such reevaluation events will be included in the original application fee.
- After expiration of a program's accreditation, a new application with standard application fee will be required.
- Appeal of a decision by ICPNT will be submitted in writing to the ICPNT Secretary/Treasurer. The written communication must address specific concerns in detail. The ICPNT Secretary/Treasurer will present the appeal to the ICPNT for deliberation and voting. The appeal must be presented in writing by the fellowship director and/or program chair of the fellowship in question. The result of deliberation will be presented to the SNACC Executive Committee before informing the program. The SNACC Executive Committee should approve the decision before it is communicated with the program. If the SNACC Executive Committee disagrees with the appeals decision it will assign a separate Appeals Ad Hoc Committee consisting of three members with expertise in the subspecialty who are not members of ICPNT, have not participated in the original review and have no other conflict of interest to reevaluate the appeal. The recommendation of the Ad Hoc Appeals Subcommittee will be presented to the SNACC Executive Committee, which will provide comment as needed and forward to ICPNT for a final decision.
- Training program irregularities related to lack of compliance with ICPNT curricula and guidelines can be reported in writing to ICPNT by any individual associated with a given fellowship program.
- An ad hoc committee can be formed, appointed by the ICPNT chair, to address issues and facts forming the basis for a given complaint.
- Internal issues are not addressed by ICPNT (e.g. interpersonal issues, finances, etc.)
- A transcript describing the experiences of each fellow who successfully completes the accredited fellowship program will be provided to ICPNT by the program director. ICPNT will maintain such records as part of its mandate to collate outcomes of fellowship training. The graduate may request or approve that such information may be provided to any external source.
- Outcome studies relative to fellowship training will be directed by ICPNT members so charged. Appropriate areas for review may include review of fellowship training experience, impact of fellowship on residents within the institution if applicable, proficiencies and special competencies gained from fellowship training, the role of fellowship training for future practicing and academic subspecialists, post fellowship appointments and productivity, as well as other outcome issues.