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The Transformative Power of Mentorship: Establishing a Personal Board of Directors

By Career, MentoringNo Comments

Stepping into the inaugural American Society of Black Neurosurgeons (ASBN) dinner in 2022, surrounded by almost 30 Black neurosurgeons, residents and medical students, was an indescribable experience. In that room, I encountered past program neurosurgery department chairs and senior attendings, who welcomed me into the fold with open arms. The presence of such accomplished individuals who shared my background and experiences left an indelible impact on me.

Joining the ASBN shed light on a critical flaw in my approach to mentorship. To truly flourish and reach my full potential, I recognized the need to cultivate a diverse team of mentors around me. Effective mentorship entails a combination of peer mentors, career mentors, life mentors and sponsors. I had been burdening my primary mentor unfairly, expecting him to fulfill all these roles single-handedly. Yet, he had somehow managed to keep me afloat throughout my journey — a testament to his unwavering dedication to my success. It is somewhat humbling to admit that I failed to grasp this crucial aspect of mentorship earlier in life. My experience is not unique, particularly for individuals from underrepresented groups who may face similar challenges in finding the right support network.

With this revised approach to mentorship, I have begun to forge my own path in the field of neurosurgery. With that, I present a structured approach to finding mentors, assembling a personal board of advisors, each playing a unique role but sharing a common dedication to one’s success.

  1. Peer Mentors: These are individuals in a similar or adjacent career stage, such as co-residents, fellows, or junior faculty members. This group is the one you can reach out to bounce ideas, seek advice on resident politics, prepare for cases, avoid common residency pitfalls and become involved in research.
  2. Career Mentor: A career mentor is a seasoned faculty member who can guide and refine your professional trajectory. This mentor may be from within or outside your home institution. They assist in networking, identifying fellowship opportunities and setting and achieving mid- to long-term career goals through regular check-ins.
  3. Sponsor: A sponsor is someone who knows you well and works behind the scenes to advocate for your success. This person may not be someone you communicate with regularly, but they are individuals you meet along your journey, such as at conferences or sub-internships. Sponsors are familiar with your research work and career path. They are pivotal in advocating for you when you apply for awards, grants and advancements within neurosurgery.
  4. Life Mentor: Your life mentor ideally exists outside the confines of your direct medical community. This can be a spiritual advisor, life coach or an older family member. Their role is to help you navigate the challenges of residency and beyond while staying true to yourself. Having a life mentor reminds us that we are multifaceted human beings and to maintain balance and nurture our well-being beyond just being neurosurgeons.

By assembling a mentor team, you will have a comprehensive support system that empowers you to navigate the complexities of a career in neurosurgery while fostering personal growth and resilience. This also provides a rubric for you to engage in mentoring others, paying it forward to the next generation of neurosurgeons. Recognizing the importance of mentorship, it is crucial that, as neurosurgeons, we actively incorporate teachings on mentorship in our training programs and support mentorship organizations like the ASBN and Women in Neurosurgery so we can ensure the future success of a diverse cohort of resident trainees.

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.

December 15, 2023
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How (Not) to Approach Mentorship: A Neurosurgeon’s Perspective

By Career, MentoringNo Comments

“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.

December 8, 2023
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Cross-Post: How artificial intelligence is changing health care in treating stroke victims

By Digital Neurosurgery, StrokeNo Comments

On the Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they may interest our readers. Today, we wanted to bring attention to a recent op-ed in Fox News titled, “How artificial intelligence is changing health care in treating stroke victims.” Neurosurgeon Paul S. Saphier, MD, FAANS, discusses the importance of early intervention and how artificial intelligence (AI) is helping surgeons save even more patients.

On Thanksgiving, Dr. Saphier received an emergency stroke call and quickly sprang into action, “While Thanksgiving dinner is my favorite family tradition, this patient needed help fast. Within minutes, the team and I brought the patient to the operating room to restore blood flow to his brain. His symptoms began to improve immediately.” Early intervention is crucial for patient outcomes.

Dr. Saphier states that AI algorithms have shown remarkable capabilities in treating stroke victims, “AI can analyze brain scans, such as computed tomography (CT) to not only detect the presence of a stroke but also classify its type.” This helps health care professionals select the most appropriate course of action.

Click here to read the full article.

We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and @cvsection and using the hashtag #DigitalNeurosurgery.

Paul S. Saphier, MD, FAANS
Altair Health
Morristown, NJ

December 7, 2023
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Cross-Post: Gender Differences in Medicare Practice and Payments to Neurosurgeons

By Cross Post, Medicare, Women in NeurosurgeryNo Comments

From time to time on the Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they may interest our readers. Today, we wanted to bring attention to a recent publication in JAMA Surgery.​ The article — “Gender Differences in Medicare Practice and Payments to Neurosurgeons” by Temitope O. Oshinowo, AB, et al. compares practice metrics and earning potential between female and male neurosurgeons and examines gender disparity in Medicare reimbursement.

The authors state that despite efforts to promote diversity within the neurosurgical workforce, individuals from underrepresented groups face significant challenges. Females account for approximately 50% of medical school graduates but comprise just 18.2% of neurosurgery residents and only 6% of board-certified neurosurgeons. Female physicians in the U.S. are estimated to be compensated 25% less, or the equivalent of $2 million, in career-long earnings.

Using Medicare data across practice settings, the authors examine patterns of significant disparity in procedural volume and payments and found significant gender-based variation in practice patterns and reimbursement among neurosurgeons serving the Medicare fee-for-service population. Female surgeons were reimbursed less than male surgeons for performing the same primary procedure. “While there has been a trend of increased female representation in neurosurgery, women continue to face challenges in establishing, maintaining, and progressing within their neurosurgical careers,” according to Oshinowo et al.

Click here to read the full article.

We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and @WINSNeurosurge1 and using the hashtag #WomenInNeurosurgery.

December 1, 2023
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Pathway to Neurosurgery Program: Creating the Next Generation of Neurosurgeons

By Career, MentoringNo Comments

Diversity, equity and inclusion (DEI) are vital components of strategic planning in a growing number of organizations across all sectors. The health care sector is especially relevant since DEI directly affects health outcomes. In the United States, most people are aware of the racial reckoning that has resulted in the necessary dialogue around implicit bias’s harmful effects. It has also drawn attention to the Black, indigenous, and people of color who are disproportionately impacted by long-standing systems that were not created with their whole personhood in mind. Together, we can foster equitable access to high-quality care for a wide range of people while building cultural competencies that increase a sense of belonging in spaces where people might not have been able to feel included before. Within neurosurgery, DEI initiatives that engage and educate teams have great potential.

One of the major goals of the Congress of Neurological Surgeons (CNS) DEI committee includes eliminating barriers to attract a diverse pool of future neurosurgical applicants. Concrete milestones with measures of success and failure support these goals, culminating in a groundbreaking program called Pathway to Neurosurgery. The CNS DEI committee developed the program to diversify applicants for neurosurgical residency. In honor of Timothy M. George, MD, FAANS, we presented the inaugural Pathway to Neurosurgery program at the CNS Annual Meeting in Austin in 2021.

2021 Pathway to Neurosurgery Program

Now led by the CNS Foundation, the program welcomes local high school students from backgrounds underrepresented in science, technology, engineering and mathematics (STEM) to the CNS Annual Meeting. A day-long symposium designed exclusively for them takes place near the general sessions so they spend the day surrounded by neurosurgeons and are introduced to considering a medical career, possibly even a career in neurosurgery. In 2021, 35 students from Austin joined us for an immersive experience at the convention center alongside other attendees of the annual meeting. Students who participated also applied for a one-year stipend and mentorship opportunity with a Dell Medical School neurosurgeon. We were thrilled to announce that two students were awarded a stipend for the year and a chance to spend one year with a local neurosurgeon. This tradition continues each year as longitudinal mentorship occurs with these students.

The Pathway to Neurosurgery program held its second event at the CNS Annual Meeting in San Francisco in 2022. On that day, 24 Oasis for Girls and San Francisco Achievers students, dressed in full surgical gowns and protective gear, visited multiple stations with tools and demonstrations used daily in neurosurgery. Volunteer neurosurgeons paired up with each student through the experiments, giving them feedback on holding surgical instruments and answering questions. Frank J. Bova, MD, PhD, kept a crowd of students’ interest as he described how to place an external ventricular drain shipped to San Francisco from the University of Florida just for the occasion.

2023 Pathway to Neurosurgery Program

“This is how I practice!” said an early career neurosurgeon to a wide-eyed high schooler, trying not to grip the egg too tightly as she carefully drilled through the shell. “Everyone has become involved in making this a great event for the kids,” said Maryam Rahman, MD, FAANS, one of the spearheads of the original program. Between station rotations, the students listened to speakers from various backgrounds talk about their own pathways to becoming neurosurgeons.

“I am passionate about the Pathway to Neurosurgery program because I know how meaningful it is to see someone like me in a STEM field. I spent my young life repeatedly told that I would never be a neurosurgeon. Neurosurgery must be a career option for them because we need more neurosurgeons that represent our broad spectrum of patients”, states Tiffany R. Hodges, MD, chair of the CNS Foundation’s DEI Committee.

During lunch, volunteer neurosurgeons sat at round tables with the students and casually answered their questions. Laughter and conversation bubbled throughout the day. Not only were the students enjoying themselves, but volunteer neurosurgeons also said it was one of the highlights of the CNS Annual meeting.

2023 Pathway to Neurosurgery Program

Weeks later, the CNS Foundation received feedback from many of the guests. “I never even heard of neurosurgery before I came to the event,” replied one student. “Now I’m seriously considering it for my future.” Mission accomplished.

The CNS Foundation hosted its third annual Pathway to Neurosurgery Program in Washington, D.C., during the CNS Annual Meeting in September 2023. It was a very successful event, and in recognition of this noteworthy program, the District of Columbia Mayor Muriel Bower proclaimed Sept. 7-13 as Pathway to Neurosurgery Week.

The CNS Foundation is excited to continue to expand this program.

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.

Tiffany R. Hodges, MD
Co-Chair, CNS DEI Committee
University Hospitals
Cleveland, Ohio

November 21, 2023
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Training the Next Generation of Neurosurgeons: Inclusive Excellence in Neurosurgery

By Career, MentoringNo Comments

The Department of Neurosurgery at Stanford University is committed to inclusive excellence at all levels of education and training. Investing in outreach and pipeline programs exposes students to knowledge and opportunities otherwise unavailable. Our reach extends beyond Stanford and the surrounding community — we have reached students from all over the world who are interested in the neurosciences and are dedicated to learning. We are proud of the department’s work with outreach, including students locally, nationally and internationally. The future of neuroscience is bright.

Our multi-faceted initiatives aim to attract students to neurosciences throughout stages of their education, each with growing success in subsequent years. Through sharing our experience, we hope that others can create programs to assist with continuing to attract a diverse population to the neurosciences.

Stanford High School Neuroscience Forum
The forum is an opportunity for students from around the world to share a project related to the neurosciences — neurology, psychology, mental health and more. The audience is local, national and International, including Stanford community members and students from around the world. This event allows connections of shared passions. This forum’s genesis, organization and implementation came from the idea and vision of four students who organize and moderate the events each year. For the 2023 Forum, we received applications from over 10 states, eight countries and four continents.

Neuroscience JClub
Three young students initiated the Stanford Neuroscience JClub. This group intends to mentor high school students in critically analyzing a scientific paper and encourage participants to consider a career in the neurosciences. The club focuses on increasing access to the literature and the field. During the once-per-month meetings, students discuss scientific literature with expert Stanford scientists. We create a low-pressure and welcoming environment where students thrive, ask questions and learn. Since we have transitioned to a virtual setting, we have received interest from students from around the world. We had over 500 students apply to the 2023-2024 school year.

Harris Internship
The Harris Internship is a school-year-long program that pairs students with Stanford faculty and trainees with expertise in neurosciences. The mentors are committed to the year-long program. The students have the opportunity to build a relationship with their mentor and receive guidance on navigating college applications and a future career in neuroscience. Students are also asked to promote increased engagement with women and/or underrepresented minorities. For 2022-2023, there are eight Harris interns. We have received triple-digit applications for the 2023-2024 school year. Twelve interns were selected for the academic year and have been paired with mentors.

Explore and inspire
Explore & Inspire allows all college and medical students to join an intimate conversation with the Stanford Neurosurgery Department and team. The focus is on inclusive excellence. Career paths and overcoming obstacles are also discussed. We hope that students will receive guidance in navigating the neuroscience field and build a community of those interested in the neurosciences. Over 500 individuals registered for the event from approximately 36 states in the U.S. and 23 countries. We hope to continue hosting this event each year with different themes.

Summer of Neurosciences
An innovative, multi-faceted summer learning experience aimed at allowing access and exposure to neuroscience and medicine in a virtual format. The Summer of Neurosciences program is designed to provide a learning experience and expose students to the many aspects and opportunities in Neuroscience. It includes career insights, grand rounds and a weekly journal club. In the summer of 2022, we hosted 50 participants from four countries, nine states, seven universities and 37 high schools.

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.

Julia Blanchet
Stanford Department of Neurosurgery
Stanford, Calif.

 

 

 

Maria Ceja
Stanford Department of Neurosurgery
Stanford, Calif.

 

 

 

Odette Harris, MD, MPH, FAANS
Stanford Department of Neurosurgery
Stanford, Calif.

 

 

Reena P. Thomas, MD, PhD
Stanford Department of Neurosurgery
Stanford, Calif.

 

October 30, 2023
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Cross-post: Fix the broken Medicare physician payment system that threatens patient access  

By Access to Care, Cross Post, MedicareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting to items published elsewhere that we believe will interest our readers. Today’s post originally appeared in The Hill on Oct. 17. In the op-ed, Reps. Larry Bucshon, MD, (R-Ind.), Ami Bera, MD, (D-Calif.), Raul Ruiz, MD, (D-Calif.), and Mariannette Miller-Meeks, MD, (R-Iowa) state that the Medicare payment system fails to reimburse physicians adequately for the critical services they provide. Unlike other providers, the Medicare Physician Fee Schedule (MPFS) does not have an automatic inflationary update and physician payments declined by 26 percent from 2001 to 2023 when adjusted for inflation.

To address this flaw, Reps. Bucshon, Bera, Ruiz and Miller-Meeks introduced the Strengthening Medicare for Patients and Providers Act (H.R. 2474) to modernize the Medicare physician payment system while protecting patients’ timely access to care. This bill would apply a permanent, inflation-based update to the MPFS.

Click here to read the full op-ed and here to contact Congress and urge your representatives to co-sponsor H.R. 2474. Additional information and resources are available at the American Medical Association’s (AMA) Fix Medicare Now website.

The American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) endorse H.R. 2474. The AANS and the CNS also joined several coalition letters endorsing the bill, including the AMA, Alliance of Specialty Medicine and a coalition of more than one million physician and allied health professional groups.

We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery.

October 25, 2023
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