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.
At all stages of training, the most crucial factor for successful research is mentorship. Identifying the right mentor can open many doors in research and career development. Who is the “right mentor” in research? This person understands the landscape and can provide opportunities that support and guide you to achieve your goals. The right mentor is not given but is sought after. As the emphasis on research continues to increase, so does the average number of publications for matched neurosurgery applicants. Therefore, identifying a mentor where there is a mutual benefit is necessary. Utilizing Pubmed and Google Scholar can provide insight into the type of publications produced through the department of neurosurgery and, more importantly, who is publishing. This can be a resident, attending or research faculty. Once identified, you can reach out with the intention that you will allocate time and effort to completing the projects provided. Not everyone who publishes is a good mentor. However, having a track record of publication is essential and a good start in identifying a potential mentor. Once established, medical student-specific grants such as the American Association of Neurological Surgeons (AANS) Neurosurgery Research & Education Foundation (NREF) Medical Student Summer Research Fellowship can be accessed.
For neurosurgery residents, your stage in training will drive who you seek out for mentorship. Most residents have performed some research before residency to be competitive enough to match. Matching in a program different from where you did medical school can feel like starting over. If undecided on a subspecialty, a similar process can be done using Pubmed and Google Scholar to identify an initial research mentor. If you have decided on a subspecialty, concentrating research efforts with mentors of that subspecialty may be more advantageous. Many programs have created protected research time within the 7-year residency, ensuring a dedicated approach to research can be pursued, especially in translational/basic science laboratories. The process of publishing includes collecting and analyzing data, manuscript writing and submission. It is vital to identify the ways to make this process more efficient. Incorporating medical students and research fellows in the various steps can allow greater productivity and the development of mentoring skills in research. Creating this track record as a resident can open doors with your mentor to apply for research grants. These grants can be funded by:
- National Institutes of Health, such as R25 (National Institute of Neurological Disorders and Stroke), F32 and T32 training grants;
- Society grants such as NREF; and
- Subspecialty society grants.
Establishing your research interests and track record during residency opens doors to these various grant opportunities. As a young attending neurosurgeon, building upon the foundation established during residency can help continue the academic progression with starting your lab. If your residency wasn’t as productive in terms of publications, then utilizing mentors to help create a research laboratory will be key. Advice given to young attending neurosurgeons is to start early and ask questions that you want answered. Once you’ve identified what you want to pursue, then accessing supportive programs to help you is the next step.
Along with society grants mentioned above, other available grants include fellowship grants, early career grants (e.g., AANS Young Clinician Investigator Award), industry-sponsored grants, and foundational grants. One program that has gained interest in early career neurosurgeons is the K12 Neurosurgeon Research Career Development Program, which is intended for junior neurosurgeon faculty to mentor and facilitate advanced research career development. Utilizing institutional resources such as the grants office and collaborators can help jumpstart your academic career in research.
While this is an overview of early career development, everyone’s academic neurosurgery path may differ. All paths have one element in common: finding good mentorship. As you climb the academic ladder, you should also consider giving back to the field by mentoring the next generation.
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.
Aladine A. Elsamadicy, MD
Yale Department of Neurosurgery
New Haven, Conn.
However, when I saw the magic of focused ultrasound showing immediate relief of tremors following a real-time thalamotomy under magnetic resonance imaging guidance, I knew the field would never be the same. I then embraced this new technology, as Dr. Grady would have insisted. I was privileged to continue to lead this program at Stanford during my time there and work with terrific colleagues such as Pejman Ghanouni, MD, PhD; Jaimie M. Henderson, MD, FAANS; Kim Butts-Pauly, PhD and an international team of experts to get this treatment FDA-approved.
Deep brain stimulation remains commonplace in my practice, but offering treatment options is key to program-building and patient care. I liken this optionality to brain aneurysm management. There was a time when neurosurgery could have lost control of this space due to interventional radiology’s offering of incisionless coil procedures. However, the sub-specialty of endovascular neurosurgery was created, and our necessary role in both the angiography suite and operating room was solidified. Stereotactic and functional neurosurgeons must embrace ablation techniques using focused ultrasound in much the same way. Patients want options, and finally they have them.
Casey H. Halpern, MD, FAANS
