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“I’m happy to write a letter of recommendation for you, but you should know that I will only mentor you if you decide to stay here for the summer…”

This was my introduction to mentorship as a first-year medical student. The offer was straightforward, and as a first-generation student without any external mentors, I took the opportunity and applied for a summer American Association of Neurological Surgeons Neurosurgery Research & Education Foundation grant to work with a neurosurgeon-scientist at my home institution. He denies having said that to this day, though I stand by my account. It marks the beginning of a long-standing mentorship and friendship that continues to shape my journey today.

This neurosurgeon challenged me to explore why some patients with pituitary tumors regain their vision after surgery while others do not. What began as a summer project evolved into an intensive two-year research endeavor. During this time, I became a part of the Academic Research Track program, pursued a Masters in Neurobiology and Anatomy and eventually achieved the remarkable milestone of being the first author of a paper published in Science Translational Medicine.

Despite the multidisciplinary nature of our project, much of the work was undertaken in relative isolation, without significant external guidance. At the outset, my scientific approach mirrored the nature of my mentoring relationships — I placed all my efforts into a single basket. Looking back, it seems almost unbelievable that our efforts culminated in such success — and that I matched into neurosurgery with a single prominent publication to my name.

This mentorship influenced my trajectory. Despite an emerging interest in spine surgery, I held onto the familiar mentorship I had come to rely on, applying for an enfolded external fellowship in endoscopic skull base surgery with my mentor’s encouragement. When I failed to match into that fellowship, I felt relief knowing that it was not my true passion but fear of starting over. It was a stark reminder that, once again, I had put all my efforts into one basket.

Faced with the challenge of finding new opportunities for my research year, I pursued an enfolded Society of Neurological Surgeons Committee on Advanced Sub-specialty Training accredited neurocritical care fellowship to strengthen my clinical acumen in my perceived weak clinical area. It was the first time during residency that I chose something solely for my own personal development rather than simply following the expectations of others. During the fellowship, I realized my passion for neurosurgery and neuroscience held the power to address the societal brokenness I witnessed. It became clear that my calling extended beyond the operating room; it intertwined with my commitment to advocate for social justice and equity. Neurotrauma, critical care, and spine bridge the gap between how I envision using my skill set and what I see as unmet needs in communities like mine.

As I delved deeper into my newfound passion for bringing neurosurgery to underserved communities, I connected with other neurosurgeons who shared similar experiences and challenges. These connections expanded my network beyond the boundaries of my institution, nurturing a sense of camaraderie and unwavering support. At the same time, the nation grappled with a renewed focus on diversity, equity and inclusion. In response, African-American neurosurgeons from across the country united, founding the American Society of Black Neurosurgeons (ASBN). The ASBN is a powerful platform, amplifying our voices, advocating for transformative change and fostering a nurturing community within our field.

Editor’s Note: We hope you will share what you learn from our posts in the Making and Maintaining a Neurosurgeon series. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #Neurosurgery.

David A. Paul, MD, MS
University of Pittsburgh Medical Center
Pittsburgh, Penn.

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