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
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
As neurosurgeons, continuous improvement is essential to our growth. Self-reflection and self-improvement are core tenets instilled in us throughout training. During residency, this is built into our education, with discussions of quality, service and opportunities for improvement at the forefront. Read More
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
On Feb. 16, published an article, “‘Blog MD’: Medical Blogs That Physicians Love,” including Neurosurgery Blog on their list of 10 medical blogs for physicians. The article states, “the blog authored by the AANS and CNS tackles topics beyond brain surgery. Physicians and other specialists could learn from writings about a neurosurgeon’s approach to mentorship, artificial intelligence in the treatment of stroke patients, and creating a pathway for the next generation of neurosurgeons.” Read More
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
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
