Allan H. Friedman, MD, FAANS (left)
The Guy L. Odom Professor of Neurological Surgery
Department of Neurosurgery
Duke University Health System
Durham, NC
Robert M. Friedlander, MD, FAANS (right)
Chair, Walter E. Dandy Professor of Neurological Surgery
University of Pittsburgh Medical Center
Pittsburgh, PA
We take the brightest and most creative medical students on the planet and place them in a neurosurgical apprenticeship, commonly known as residency or graduate medical education (GME). When they start this residency, they are suddenly confronted with a whole new body of knowledge and skill sets to master. They are no longer judged by multiple choice tests; rather their patient’s lives depended on their getting the answers right.
Once they get their footing, around their third post-graduate year (PGY-3), the time is optimal to nurture the creativity and imagination that first got them interested in neurosurgery. I don’t recall any applicant on the interview circuit who has great ideas for conquering neurosurgical problems. The RUNN, short for Research Update in Neuroscience for Neurosurgeons course, is a unique GME program designed to rekindle neurosurgical residents’ interests in neuroscience and imagination.
The course was founded in 1984 by renowned neurosurgeon Henry H. Schmidek, MD and his wife, Mary Schmidek. Initially, the course ran for two weeks and consisted of lectures aimed at increasing literacy in basic biological sciences. Over time, the RUNN course has evolved significantly. Residents still are exposed to cutting-edge advances in neuroscience that are ripe for translation into neurosurgical therapies, at the same time they also receive counseling on establishing a viable research career. For example:
- How to choose a project compatible with a clinical practice.
- How to choose a mentor.
- How to negotiate with a future chairman.
- How to get funding and protected time needed to succeed.
The course doesn’t just concentrate on basic science research. Translational research, collaborative research, and clinical research are also addressed. To this end, half of the speakers are successful neurosurgeons and scientists who not only present their original research but also give advice on getting started in research and how it can enhance the resident’s clinical practice.
It continues to be a bare bones course held in the marine biology lab in Woods Hole, Massachusetts. The remote location extracts the residents from their usual busy hospital environment, and the rustic beauty of fall in New England is a perfect environment in which the residents can just think. The housing is best described as “early dorm” which pushes the residents out of their rooms and into interactions with the faculty and fellow residents. The course lasts six long days (8:30 am to 9:00 pm), with lectures one and a half hours long allowing sufficient time for questions, idea sharing, and discussion.
We have been fortunate to attract a faculty of world-class scientists who present their work in a stimulating fashion. Recently discussed topics include:
- Small molecules which slow down the aging process;
- ATP-regulated calcium channels which mediate ischemic and traumatic neuronal damage;
- Spine biomechanics;
- Molecular genetics of brain tumors;
- Anatomy of cognition;
- Regeneration within the central nervous system;
- Re-opening the critical periods of brain development;
- Mechanisms of cell death in neurological diseases; and
- Comparative effectiveness research.
As an example, MacArthur Award winner Beth Stevens, PhD, spoke on “wiring and rewiring the brain: the role of glia and immune molecules.” Since her inspiring talk at the RUNN course, she has published two high impact articles, one on schizophrenia and the second one on glial driven cognitive impairment both of which were widely reported in popular news media.
The essence of the RUNN course is the running conversation that continues throughout the course. While the discussion between the residents and the speakers is stimulating, some of the magic are the conversations between the residents as noted in the following comments:
“Perhaps the most rewarding aspect of the week though was the interaction amongst the participants. Whether during lectures, over meals, or at the nightly trips to Captain Kidd’s [Woods Hole’s most happening, and only, night spot in the off season] fellow resident’s discussed everything from research topics and career paths to our respective programs to NFL football….
While I know that we were fortunate to be able to hear lectures by world-renowned physician-scientists, I am sure that the pre-eminent academic neurosurgeons of tomorrow were actually sitting alongside me in the audience.”
-Peter Grossi, MD
“The real substance happened in the thirty-minute intervals between lectures, at meals, and over beers at Captain Kidd well after sunset. Every resident –something like one hundred and two in all – viewed each lecture through unique lenses. Everyone brought subtly different areas of expertise and interest. And as we communally digested the content of the lectures, whether it was neuroprosthetics or frontiers in immunotherapy, we were simultaneously generating and refining ideas of our own. Which, in retrospect, is probably the goal of the experience – not learning science, but providing the environment for us to learn to think as scientists, together.”
-Vadim (Eddie) Tsvankin, MD
Clearly, the 106 residents who attended the 2015 RUNN course and the many others who attended over the last two decades have benefited from this remarkable educational program. The next RUNN course will take place from Oct. 29 to Nov. 5, 2016. Neurosurgery is proud to lead the way with this GME program that inspires innovation and imagination.
