Academic Advancement for the Neurosurgeon
The first years following graduation from residency or fellowship are crucial in determining the trajectory of an academic career. Regardless of their specialty and training, a junior faculty member in academic medicine must quickly determine how he or she will advance in a competitive field. In neurosurgery, many years of training have typically refined the individual’s chosen career path, but many variables remain that will affect how his or her career will proceed. The following represents my personal view on career development and observations I have made while mentoring and observing the careers of many talented young neurosurgeons.
It is important that the individual develop a sustainable research activity that will help define the young neurosurgeon’s career. They must specialize and focus. If this research activity is within the realm of clinical research, it will naturally align with the practice of the individual. If it is a translational science career they choose, it should ideally be aligned with the surgeon’s clinical activity and focus on research that is clinically relevant, with the ultimate goal of improving patient care in that specific clinical area. It is helpful to focus on science that can be done most readily in the position of the special role of the neurosurgeon. Implicit in this point is that the individual must become a specialist and strive to be considered an expert by peers in this field. This may be more readily achieved in a larger department with well-defined specialty areas.
At most, if not all, academic institutions, there is relentless pressure for clinical activity among neurosurgical faculty. Most young faculty respond to incentives, which are aligned for the betterment of hospital, departmental and individual financial success. For our talented young faculty, performing more cases is positive reinforcement, as they enjoy the development of a successful practice, which validates their goal of becoming a clinical leader in their specialty. This effort, however, is in competition with time to devote to research and academic productivity. In many cases, the talented surgeon becomes busy, as it is much easier and offers more immediate gratification to do more cases than it is to revise a paper or write a research grant. If the response by the surgeon is, “I should just be in practice,” this becomes a self-fulfilling prophecy and, very often, steers the careers of many talented academic surgeons into private practice. It requires strong mentorship to emphasize academic development in light of these dynamics. The young neurosurgeon must be given protected time to develop their academic career. Good mentors will meet routinely to set goals as well as for academic and clinical review (progress with publications, National Institutes of Health K/R grants or Department of Defense submissions). Specific scientific mentorship may require extra-departmental input to help in the respective scientific area.
Young faculty should strive to become leaders at his or her home institution first. They need to gain the respect of their patients, peers, referring doctors, hospital staff, administrators and research collaborators. Organized neurosurgery involvement, per se, is not a career goal in and of itself. Young faculty must concentrate on core activities — clinical care, academic contribution and teaching and mentorship of residents and fellows. When opportunity arises to serve the specialty, on committees or editorial boards for example, and if time permits, the individual should pursue this with the goal of giving back and serving the betterment of the specialty. Leadership in the specialty societies and academies will develop in due time with the recognition of this goal. One can readily lead only as far as you have been yourself.
In the final analysis, all men/women want to succeed, but some want to succeed so much they are willing to work harder. Although the training of a neurosurgeon is protracted, it is important to remember that graduation signals only the beginning of learning how to be a neurosurgeon. Perpetual optimism is a force multiplier, as behind every successful neurosurgeon there are a lot of years full of hard work. The young academic surgeon should be patient and enjoy the contributions, challenges and gratification associated with every stage of their career.
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