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Brain Tumor Nonprofit StacheStrong Donates $110,000 for the Launch of the SNS Neurosurgeon-Scientist Training Program

By Brain Tumor, Career, TumorNo Comments

The Society of Neurological Surgeons (SNS) has established a Neurosurgeon-Scientist Training Program (NSTP) to increase the pool of neurosurgery residents conducting research and to enhance their success rate in becoming independent neurosurgeon-scientists. The NSTP will serve as a formal mentored research program for those neurosurgery residents who are beginning a protected research year or have already completed their protected research year.

The primary goal of this new program is to improve human health by providing participants with the skills, mentorship, education and experience needed to successfully compete for individual research funding (e.g., National Institutes of Health K awards and R01 research grants). Additional research by clinician-scientist neurosurgeons is critical to the fundamental discovery that advances new methods of care and new cures.

A donation of $110,000 by the non-profit StacheStrong provides crucial funding for brain tumor-related grants with the launch of the NSTP. StacheStrong is devoted to raising funds and awareness for brain cancer research. Defeating brain cancer and improving the quality of patients’ lives is the mission of StacheStrong.

Click here to read the press release.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery, @SNS_Neurosurg and @StacheStrong and using the hashtag #BrainCancerResearch.

January 13, 2023
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Cross-Post: It’s Never Too Late to Pivot From N.F.L. Safety to Neurosurgeon

By Career, Cross PostNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in the New York Times on Oct. 11 as part of the “It’s Never Too Late” series. The article discusses how Myron Rolle, MD, a PGY-6 neurosurgery resident at Massachusetts General Hospital in Boston, Mass., transitioned from playing in the NFL to neurosurgery.

Dr. Rolle notes that he was inspired to become a neurosurgeon by the book “Gifted Hands” by Benjamin S. Carson, MD, FAANS (L) — a memoir that detailed how Dr. Carson went from being an inner-city youth with poor grades to the director of pediatric neurosurgery at Johns Hopkins University Hospital. Dr. Rolle’s long-term goal is to practice neurosurgery in the U.S. and spend a portion of the year in the Caribbean, developing neurosurgical services in the Bahamas and member states of CARICOM, an organization of Caribbean countries.

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

October 28, 2022
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Myths and Truths: A Medical Student Perspective of Neurosurgery

By Career, Women in Neurosurgery, Work-Life BalanceNo Comments

Janine S. Hsu, MD

Diana Ghinda, MD, PhD

Neurosurgery is undeniably one of the most intriguing, challenging and rewarding specialties. It is also considered one of the most competitive specialties — as a result, many medical students self-exclude from neurosurgery based on preconceived notions of the field. This is especially true of female trainees, who see in neurosurgery a specialty dominated numerically by men. However, at the University of Ottawa, the Neurosurgery Medical Student Chapter is working to change these existing biases about the specialty. In terms of gender-based interest in neurosurgery, a third of the members of the neurosurgery interest group are female. In 2020, out of the 91 aforementioned students seeking surgical mentorship, four out of 13 who listed neurosurgery as their top choice were female. All of the club executives are female, as is our staff sponsor, Eve Tsai, MD PhD, FAANS, as well as our resident mentors, Diana Ghinda, MD, PhD, and Janine S. Hsu, MD. Having an all female organizing committee was not intentional. Perhaps some subconscious part of us gravitated towards seeking female mentors — a testament to the need for representation. Dr. Tsai, the only female staff neurosurgeon at the University of Ottawa, has provided us with this representation and serves as unspoken encouragement for other women to pursue a traditionally male dominated field such as neurosurgery.

Her leadership and mentorship have dispelled some of the most common myths we held about the specialty, as well as brought to light some of the important realities of being a female neurosurgeon.

Myths about neurosurgery

Adam Sachs, MD, MA

Myth #1: Having a family is difficult, especially as a female neurosurgeon

“It’s possible; you can have a family, that shouldn’t stop you. Dr. Tsai [female neurosurgeon] has done it, as have many others” according to Adam Sachs, MD, MA. The AANS Neurosurgeon has published articles on this topic, including The Challenges of Starting a Family During Neurosurgical Residency Training and Women in Neurosurgery: Walking the Balance Beam of Life.

 Myth #2: Your whole life must be about neurosurgery

Safraz Mohammed, MBBS, FRCSC

Many neurosurgeons have interests outside of their work that they are able to pursue: advocacy, sports and artistic endeavours. Read the six-article series Hustle, Think, Work, Play: Sports & Neurosurgery published in the AANS Neurosurgeon.

Myth #3: Poor patient outcomes

 “A lot of neurosurgical patients go on to live regular, normal lives, or even better lives than before. Patients often think that when they are referred to see a neurosurgeon that their prognosis is going to be grim, but this isn’t always the case. There is so much you can do as a neurosurgeon to help restore a patient’s quality of life” according to Safraz Mohammed, MBBS, FRCSC. A recent report from the Great Ormond Street Hospital for Children suggests that adverse events are a minority in neurosurgery.

Myth #4: I’ll be operating for hours on end on one case

One of the benefits of a career in neurosurgery is the variety of procedures one can perform. These procedures all vary in length and you can tailor your practice accordingly. Many neurosurgical procedures can be lengthy, but as the surgeon you are engrossed in the task at hand and time will fly.

Truths about neurosurgery

Truth #1: The hours are long, but it gets better

Residency is grueling and the hours are long. Neurosurgery is one of the busiest services at a hospital and thus requires a large time commitment. As you progress in your career, you gain the ability to tailor your schedule to your liking. You will always be busy, but there are ways to adapt and adjust.

Truth #2: You won’t be a trainee forever, but it will take time

Neurosurgery has one of the longest residency programs and many often go on to pursue fellowships. The length of the training required prepares you to be confident as a staff surgeon on call when confronted with a challenging case in the middle of the night.

Truth #3: Neurosurgery requires relentless dedication

Neurosurgery is demanding, like any specialty, and it requires continuous training, responding to urgent cases and dedication.

Truth #4: It is a physically, mentally and emotionally demanding career

It is true, but that’s why residency is a training program. You are trained to become a competent surgeon, which includes developing physical, mental and emotional resiliency.

Our mentors have helped us to better understand the myths and truths of a career in neurosurgery. The keys to dispelling myths are early exposure to neurosurgery, more hands-on opportunities in the form of workshops and demonstrations, mentorship programs pairing students with residents, fellows and staff and increased representation for women. For those who think that a career in neurosurgery is unattainable, there are ways to steer yourself toward the path — find a mentor and find out how they did it. Seek feedback from your mentor on how you can improve yourself as an applicant and person. Seek guidance from as many people in the field as you can. Spend time in the division learning about the specialty, finding out the myths and truths yourself. Get involved in research or service projects related to neurosurgery and the neurosciences. This AANS Medical Student Chapter at the University of Ottawa has been working in collaboration with the Division of Neurosurgery to offer as much early exposure as possible and hope to stimulate more interest in neurosurgery!

Editor’s note: We hope that you will share what you learn from our posts. September is Women in Medicine Month, which honors physicians who have offered their time and support to advance women with careers in medicine. We invite you to join the conversation on Twitter by following @Neurosurgery and @WINSNeurosurge1 and using the hashtag #WIMmonth.

Eve Tsai, MD, PhD, FAANS
Ottawa Hospital Research Institute
University of Ottawa
The Ottawa Hospital
Ottawa, Canada

 

Alexandra Beaudry-Richard, MD-PhD Candidate
University of Ottawa
Ottawa, Canada

 

 

Anahita Malvea, MD
University of Ottawa
Ottawa, Canada

 

 

September 29, 2022
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The Long Game: The CNS’ Investment in the NINDS/CNS Getch K12 Scholar Award

By Career, DEI, Guest Post, HealthNo Comments

In 2012, the Neurosurgeon Research Career Development Program (NRCDP) set a goal to grow a diverse corps of neurosurgeon scientists at institutions across the United States. The Congress of Neurological Surgeons (CNS) and the CNS Foundation became early partners in this effort by establishing the National Institutes of Neurological Disorders and Stroke (NINDS)/CNS Getch K12 Scholar Award, named in honor of the CNS Past President Christopher C. Getch, MD, FAANS, a respected neurosurgeon, friend and leader, who passed away unexpectedly soon after his presidency.

Having invested $500,000 to fund Getch Scholars alternate years since 2015, why is the CNS doubling down with a $1,200,000 pledge for the next five years to make the Getch K12 award annual?

According to the CNS Past President Ganesh Rao, MD, FAANS, who championed the CNS’s investment in the K12 Awards, “NRCDP is a major driver for improving neurosurgical patient care. Support for neurosurgical research is critical, particularly at the beginning of one’s career; the commitment to mentorship is unparalleled, and we are seeing increasingly diverse awardees. I am a firm believer that the K12 program will improve neurosurgery overall.”

New data from Emad N. Eskandar, MD, FAANS, director of the NRCDP, reveals that the program has successfully hit the three drivers mentioned by Dr. Rao. The result is a remarkable increase in overall grant support for neurosurgeons.

Protected Research is Linked to Subsequent Funding

The following data points demonstrate the continued success of K12 scholars:

  • From 2013 through 2017, the NRCDP supported thirteen scholars. Eleven out of the thirteen scholars received subsequent National Institutes of Health (NIH) funding for an overall success rate of 85%.
  • The second five-year cycle, 2018 through 2022, looks equally promising. During this period, the NRCDP supported sixteen scholars. Thus far, six have completed the program, and three have received additional substantive grants.
  • The number of years from a scholar’s initial NRCDP application until they obtained subsequent NIH funding also revealed success. Within five years, 50% of program alumni received NIH funding, and 85% received NIH funding within nine years.

According to 2017 winner Jennifer Strahle, MD, FAANS, “Winning a K12 award provided me with time and resources to complete the foundational hydrocephalus and iron metabolism experiments that laid the groundwork for my subsequent successful R01.”

While all K12 awards provide two years of protected research time, unique to the Getch award, the awardee may remain at their institution. Preserving this continuum of established relationships and research in their home laboratory is essential to the CNS.

Babacar Cisse, MD, of Weill Cornell Medical School and a 2018 winner of the NINDS/CNS Getch K12 Scholar Award, explained, “When I was hired by my chairman, we both agreed that I needed at least 50% of protected research time. The K12 solidified that agreement and extended it to 5 years.” Three years later, Dr. Cisse is about to publish his findings for the first time.

Diversity of Neurosurgeon Scientists is Just Beginning

The CNS shares the NIH goal to increase the diversity of all health care providers and, in particular, researchers. According to NRCDP data, the K12 program has seen critical areas of improvement since 2012:

  • In the first five years (2013-2017) of the NRCDP, two (15%) of the total thirteen scholars were women, and zero (0%) were underrepresented minorities.
  • In the second five years (since 2018), female scholars increased to three (20%) and underrepresented minorities increased to four (27%).

Sustainable Mentorship

Like all early-career neurosurgeons, mentorship and a community of colleagues are valuable to the K12 awardees. All awardees must attend the annual retreat hosted by the CNS for five years, and new awardees seek the guidance of the Advisory Committee and past K12 winners. Since awardees are committed to attending the retreat for five years, mentees naturally transition into mentors. One awardee responded, “the NRCDP K12 community represents an important community of mentors and colleagues with whom we can envision and affect future paradigm changes in the care of patients with neurological diseases.”

Galvanizing Investment

Compared to other surgical specialties — including orthoapedic surgery, otolaryngology and urology — neurosurgery saw a significant increase in grant funding from 2012 to 2021 (265%). One cannot help but marvel at the increased funding that has occurred since the inception of the NRCDP.

The CNS and the CNS Foundation are proud partners of the NIH, the Foundation for the National Institutes of Health, the NINDS and the NRCDP. The future for our specialty is bright.

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery, @CNS_Update and @NINDSnews.

Alexander A. Khalessi, MD, MBA, FAANS
UC San Diego Medical Center
San Diego, Calif.

May 6, 2022
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Faces of Neurosurgery: An Interview with Volker K. H. Sonntag, MD, FAANS (L)

By Career, Faces of NeurosurgeryNo Comments

In Episode 4 of Neurosurgery Blog’s Faces of Neurosurgery interview series, we spoke with Volker K. H. Sonntag, MD, FAANS (L) about his proudest achievements, his favorite surgery to perform and one surgical instrument he couldn’t live without. Dr. Sonntag is an emeritus professor of neurosurgery at Barrow Neurological Institute in Phoenix, Ariz.

Dr. Sonntag is most proud of the nearly 300 residents and fellows he has trained over the years, and the legacy they carry from him. One of his biggest accomplishments was “putting spine on the map” in neurosurgery, and seeing spinal neurosurgery grow over the course of his career. His autobiography, “Backbone: The Life and Game-Changing Career of a Spinal Neurosurgeon,” is available now.

The full interview is available here and on Neurosurgery Blog’s YouTube channel.

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #FacesOfNeurosurgery.

September 21, 2021
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Faces of Neurosurgery: An Interview with Kim J. Burchiel, MD, FAANS, FACS

By Career, Faces of NeurosurgeryNo Comments

In Episode 3 of Neurosurgery Blog’s Faces of Neurosurgery interview series, we spoke with Kim J. Burchiel, MD, FAANS, FACS, about his passions, his early mentors and what has driven him throughout his career. Dr. Burchiel is currently John Raaf Professor and Chairman Emeritus of the Department of Neurological Surgery at Oregon Health & Science University (OHSU).

Dr. Burchiel is most proud of his contributions to trigeminal neuralgia and deep brain stimulation, as well as building the department at OHSU. His favorite neurosurgical instrument is the computer, something that has changed the field more than anything else.

To the neurosurgeon in need of a book recommendation, he suggests “Undaunted Courage” by Stephen Ambrose — a book about the Lewis and Clark expedition to the west.

When asked about advice for individuals starting a neurosurgery residency, Dr. Burchiel said, “It’s very much like Lewis and Clark. It is a voyage into the unknown — a lot of difficulties lay ahead, and you need to be able to persevere, be resilient and you have to take it one day at a time.”

The full interview is available here and on Neurosurgery Blog’s YouTube channel.

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #FacesOfNeurosurgery.

July 13, 2021
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Faces of Neurosurgery: An Interview with R. Michael Scott, MD, FAANS (L)

By Career, Faces of NeurosurgeryNo Comments

In Episode 2 of Neurosurgery Blog’s Faces of Neurosurgery interview series, we spoke with R. Michael Scott, MD, FAANS (L), about his early mentors, proudest achievements, and musical hobbies. Dr. Scott is currently Neurosurgeon-in-Chief-emeritus at Boston Children’s Hospital and Christopher K. Fellows Family Chair in Pediatric Neurosurgery.

Dr. Scott says that one of his proudest achievements is leaving behind an extensive legacy of patients throughout his career, as well as the residents he helped train. He is also proud of helping to better define Moyamoya disease and its surgical treatment.

He offers the following advice for neurosurgery residents, “Becom[e] an expert in something that interests you as you’re getting into residency.”

The full interview is available here and on Neurosurgery Blog’s YouTube channel.

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #FacesOfNeurosurgery.

June 21, 2021
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Motherhood and Neurosurgery: How to Make it Work

By Career, Women in NeurosurgeryNo Comments

The challenge of being a mother and a neurosurgeon is a topic that is rarely discussed, even in today’s society. It often feels like a taboo subject for women neurosurgeons and trainees, as if motherhood would somehow make one seem like a lesser neurosurgeon. With the extensive time dedicated to neurosurgical education, training and lifelong learning, it can be challenging to determine how motherhood fits into this life.

Perhaps one of the reasons this is not a widely discussed topic is that neurosurgery is still a male-dominated field. Women represent only 12% of neurosurgery residents and 5% of practicing neurosurgeons. In a recent survey of 126 women neurosurgeons and trainees, 49% of the respondents have children and 33% plan to have children. In addition to dealing with the challenges of achieving work-life balance, a startling barrier to become a neurosurgeon mom is that over 50% of survey respondents feel pressure or backlash from their colleagues for having children.

An unfortunate perception of neurosurgery is that one should delay having children if they wish to enter the field. Many female medical students report they decided to go into a different surgery specialty due to this belief. The average age for women neurosurgeons to become first-time mothers is 31.3 years versus 29.3 years for male neurosurgeons as first-time fathers. The delay in starting a family has consequences, as 25% of women neurosurgeons reported taking more than a year to get pregnant, and 18.9% required medical intervention such as in vitro fertilization. Moreover, 40.1% of female neurosurgeons reported serious perinatal complications in at least one pregnancy, which is higher than the national average of 14.5%. The more significant consequence not reflected in these statistics is losing out on highly qualified trainees and neurosurgeons because of these concerns.

There needs to be some adjustments in the field of neurosurgery to make being a mother less of a hindrance and more accepted. Change is necessary on both the policy front and in the culture of the field. Formal parental leave and return to work policies should be established at every institution to promote equitable, gender-neutral policies for women and men, including for adoption and other family structures. Family leave policies are highly variable across practice environments, and only 25% of female neurosurgeons reporting having access to program parental leave allowances. Accommodations must be made for those during pregnancy and the post-partum period to ensure the health of the mother and baby. Access to lactation facilities close to the operating room/clinic and childcare is also crucial to those returning to work after parental leave.

Even with such policies in place, it still will not be enough until the culture regarding motherhood changes within the field of neurosurgery. Many women neurosurgeons report backlash from their colleagues for being pregnant and taking parental leave — ranging from microaggressions to being passed for career advancement opportunities. To prove to others that they will not let motherhood interfere with their job, many women neurosurgeons who have children work until their due date or return early from maternity leave. We need to do a better job normalizing being a mother and a neurosurgeon, which means taking breaks in the operating room for the physical needs of pregnancy and lactation. We need to have our male colleagues normalize taking paternity leave as well. They also need to speak up when they witness discriminatory behaviors towards women neurosurgeons. Finally, we need to speak up and advocate for ourselves and support others in our field who choose to become mothers.

Being a good mother and a good neurosurgeon is not mutually exclusive. It is hard, and we are our own worst critics when juggling these demanding jobs. With support and change on institutional and cultural levels, it may just make these two jobs a little more manageable.

The Motherhood & Neurosurgery webinar offers candid reflections on pregnancy and starting a family as a neurosurgeon. Panelists — Lola B. Chambless, MD, FAANS, Catherine A. Miller, MD, Lauren Albert Sand, MD and Doris Wang, MD, PhD — share advice for working while pregnant or nursing, and discuss how medical institutions can better support women surgeons through pregnancy and parenthood.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtags #CelebratingWINSat30 and #WomenInNeurosurgery.

Catherine A. Miller, MD
UCSF Department of Neurological Surgery
San Francisco, Calif.

 

 

Doris Wang, MD, PhD
UCSF Department of Neurological Surgery
San Francisco, Calif.

June 7, 2021
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Faces of Neurosurgery: An Interview with Kalmon D. Post, MD, FAANS (L)

By Career, Faces of NeurosurgeryNo Comments

In Episode 1 of Neurosurgery Blog’s new Faces of Neurosurgery interview series, Kalmon D. Post, MD, FAANS (L) was interviewed about his proudest achievements, his advice to graduating residents and his favorite surgical instruments. Dr. Post is currently the Department of Neurosurgery chair emeritus at the Icahn School of Medicine at Mount Sinai Hospital.

“I’ve done about 10,000 operations over [the] years, and I think taking care of people and their families has always been number one to me,” Dr. Post reflected on his proudest accomplishment.

To residents graduating and starting their careers, he says to remember, “First you’re not a neurosurgeon; first you’re a doctor. Think about the fact that you have patients and families in front of you, and your first goal is to comfort them and make them better.”

The full interview is available here and on Neurosurgery Blog’s YouTube channel

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #FacesOfNeurosurgery.

June 3, 2021
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Diversity in Neurosurgery: Forcing Change Leads to Greater Success

By Career, Guest Post, Women in NeurosurgeryNo Comments

Should we take a stand to increase diversity? Yes! As neurosurgeons, we should talk about diversity in neurosurgery. If we don’t urge, even force change, it will not happen, or it will happen unbearably slowly. One hundred years into the history of neurosurgery, only 5% of all board-certified neurosurgeons are women. African-Americans are also underrepresented. The Association of American Medical Colleges (AAMC) calculates that African-Americans represent 4% of all active neurosurgeons in the U.S.

Why does diversity matter? There is a compelling business case to be made for supporting equity and striving for inclusion. Companies with 30% or more women in the C-suite have reported higher profits than companies without women in their leadership team. A diverse workforce brings diverse perspectives, experiences and skills to the table, and it pays off.

The benefits of diversity aren’t limited to the corporate world. Diversity of opinion leads to better outcomes and fosters innovation and creativity across a variety of disciplines. The diversity of our patients should be reflected in the physicians who provide them care. Although we are all the same under the scalpel — cultural, religious, socioeconomic, ethnic and racial differences play a significant role in patient-physician relationships and impact patient satisfaction, patient compliance and health care outcomes. As surgeons, we need to continually enhance our awareness of and ability to manage our biases and racial/ethnic identity. We need to apply our critical appraisal skills, honed to perfection, to treat our seriously ill patients, to recognize that both explicit (conscious) and implicit (subconscious) biases can stand in the way of increased diversity and inclusion and prevent some of our patients from having the best outcomes possible.

Although neurosurgery has a more diverse group of residents than ever before, we need to work hard to retain these residents long-term and make sure they succeed. Female gender is one of the leading factors associated with burnout and attrition in our specialty. This is not due exclusively to the long and unpredicted work schedules related to the specialty. Microaggressions, lack of collegial relationships and tolerance of unacceptable behavior by faculty should be considered as well. These insidious factors can fester in a workplace culture because of a lack of mechanisms and implicit barriers for reporting, such as fear of shame, retaliation, or not advancing. Many minorities experience overt and implicit forms of discrimination. This may be exhibited openly from patients who mistake someone for a nurse of a janitor or refuse care from a minority physician. Sadly, this can come in more hidden ways from peers who won’t put a resident in a challenging case because of race or gender.

It is not enough to focus on micro-level interventions — we also need to look at organizational structures and attitudes that push women and minorities away from neurosurgery. It has been shown that interventions focused on cultural competencies in health care organizations improved the hospital’s diversity climate. These interventions have focused, among other aspects, on diversity attitudes, implicit bias and racial/ethnic identity status. However, too many health care organizations and departments approach diversity with a sense of tokenism instead as a business imperative and driver of strategy.

In his 2004 bestseller, “Moneyball,” Michael Lewis wrote: “What begins as a failure of the imagination ends as a market inefficiency: when you rule out an entire class of people from doing a job simply by their appearance, you are less likely to find the best person for the job.” All medical specialties want to attract the best and brightest young people. Diversity strengthens neurosurgery. Attracting people with different strengths and backgrounds to our profession can help unleash new sources of talent and creativity that can only benefit our profession and our patients.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following @Neurosurgery and using the hashtag #WomenInNeurosurgery and #CelebratingWINSat30.

Martina Stippler, MD, FAANS, FACS
Beth Israel Deaconess Medical Center
Boston, Mass.

January 8, 2021
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