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Cross-Post: First Female Neurosurgeon to Become a Medical School Dean: Julie G. Pilitsis Shares Her Path to Success

By CareerNo Comments

Our current series on Making and Maintaining a Neurosurgeon discusses how one transitions from student to resident to practicing neurosurgeon. This cross-post highlights the second chapter after practicing neurosurgery. Eleven years ago, Julie G. Pilitsis, MD, PhD, FAANS, set a goal to become a dean for a college of medicine. Read More

Embracing Innovation: Adapting to New Surgical Technologies

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During my residency training at the University of Pennsylvania, M. Sean Grady, MD, FAANS, repeatedly counseled that residency is intended to teach us how to incorporate innovations in neurosurgery into our practice. Then, we can keep up with the pace of research and technology and, thus, always offer our patients the cutting-edge. My first year out of training was at Stanford University, and I was asked to take on a neurosurgical leadership role in the transcranial focused ultrasound program. I had come from a background where the reversibility and adjustability of deep brain stimulation would always supersede the permanence of an ablation technique. Read More

The Pros and Cons of Pursuing a Fellowship

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After fast-paced, rewarding, but often exhausting years of completing highly technical neurosurgical training as a resident, the decision to pursue an additional one to two years of fellowship training is ultimately highly personal. As a mid-level resident, I weighed the pros and cons of this path after graduating in the context of my professional and personal goals. Read More

M&M Conference: A Better Process for Better Outcomes

By Career, Quality ImprovementNo Comments

Morbidity and mortality (M&M) is a common conference across medical specialties. It originated in the early 1900s when a surgeon named Ernest A. Codman, MD, attempted to create a systematic way of reporting errors and standardizing practices and procedures. Back then, error tracking and reporting were not the norm, and he lost privileges at his hospital for trying to introduce any evaluation of surgeon competence. He persevered in his work and is now recognized as the founder of the M&M conference. This conference allows surgeons to reflect upon their performance and receive invaluable feedback from their peers on preventing future adverse outcomes. It is (generally speaking) a medicolegally protected peer-review conference to discuss complications and undesired outcomes and is an invaluable tool in resident education. Beyond individual surgeon performance, discussion of cases identifies systemic problems and errors that can be changed to create a more sustainable solution. Read More

Neurosurgery: Critical Resident Education in Quality Improvement and Patient Safety

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There is nothing more important to a neurosurgeon than patient safety. We strive daily to provide the right care to the right patient at the right time and place in the best possible way. Beyond each individual encounter, achieving this requires constant assessment and reassessment of all aspects of care delivery — a process called quality improvement. For decades, medicine and neurosurgery addressed quality improvement and patient safety (QIPS) but not in a focused, scientific way. Today, however, this represents one of the fastest-growing areas of investigation and implementation in almost every hospital and healthcare system. In response, the American Council for Graduate Medical Education (ACGME) launched the Clinical Learning Environment reviews (CLER) to achieve an optimal clinical learning environment to achieve safe and high-quality patient care. Early work with CLER led to another program, the Program Directors Patient safety and Quality improvement (PDPQ) program. Read More

The Future of Neurological Surgery: Adapting to GME Changes

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Until the 19th century, surgical training was haphazard with no standardization. The surgical trainee learned through observation of a mentor and finished training when the mentor decided it was time. As surgery evolved from a trade to a profession, surgical training also evolved, pioneered by William S. Halsted, MD. Dr. Halsted’s principles of surgical training included the need to understand the scientific basis of disease, provide supervised care of surgical patients and gain increasing responsibility during training, leading to independent practice. Read More

Cross-Post: Neurosurgery’s glass ceiling: Addressing the gender imbalance in the field

By Career, Cross Post, Women in NeurosurgeryNo Comments

Our current series on Making and Maintaining a Neurosurgeon discusses how one transitions from student to resident to practicing neurosurgeon. In particular, we highlight what our field is doing to improve diversity and the importance of mentorship to those considering neurosurgery. How impactful can mentorship be? Incredibly. Read More

Career Development in Neurosurgery Research for Medical Students, Residents and Young Neurosurgeons: From Finding Mentorship to Starting and Funding a Lab

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Research has always been integral to the field of neurosurgery. Its purpose is to improve patient treatment paradigms and stimulate innovation. Given these efforts, an emphasis on research quality and productivity has become a minimal requirement to enter and progress in academic neurosurgery. However, the barrier to entry in neurosurgery research remains relatively high for medical students, neurosurgery residents and young neurosurgeons — which may be prohibitive for academic progress. Providing transparency in the research process is a necessary step in reducing the barriers that have been formed. Read More

Building a Better Match: Efforts of the SNS Medical Student Committee

By Career, MentoringNo Comments

It has been a pleasure to serve as the chair of the Society of Neurological Surgeons (SNS) Medical Student Committee. This group of neurosurgical leaders is deeply engaged in finding better approaches to training future neurosurgeons. Our responsibilities include enhancing exposure to the field for students exploring future careers, providing a framework of mentorship for those considering a neurosurgical residency, and ensuring that The Match® is fair and efficient for both applicants and programs. It has been clear that forces are making this last goal more challenging for some time. Read More