Queen Square Realist Spine Course 2022

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Registration Form

Are you a UK Neurosurgery trainee?

Yes

Other:

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If yes to the above question, are you a London deanery trainee? (Please provide your training number on the Other section)

Yes

Other:

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First Name *

Surname *

Any dietary requirements / restrictions

GMC Number *

What specialty are you currently rotating in? *

Place of Work *

City *

What specialty training year are you?

Have completed any rotation in complex spine surgery?

Yes

Other:

Clear selection

Have you performed any procedures on the spine as the primary surgeon?

Yes

Other:

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If yes to the previous question, pick an approximate number of spinal ops that you have undertaken as a primary surgeon. (can use Other to give a number)

1-5

5-10

10-20

20-40

Other:

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Have you come across difficult and complicated cases based on spine? ( excluding routine procedures such as ACDF, microdiscectomies etc.)

Yes

Other:

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On a scale of 1 to 5 (5 being most confident), Do you feel confident at the level you are on spinal operations?

Clear selection

On a scale of 1 to 5 (5 being most interested), How interested are you in becoming a full time complex spine consultant?

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We want the QS Realist Spine course to be trainee focused. Please describe to us a challenging complex spine case (excluding identifiable patient information) that you were involved in and we will aim to include this in the teaching of the course.

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