When I began my neurosurgical residency, a faculty member introduced me to the concept of lifelong learning. The gist of his not-so-delicate suggestion was that if I ever wanted to amount to anything, I would strive to learn something new each and every day for my entire career.
At that time the goals of education were strictly personal: to be an excellent physician in the long term, and in the short term, to pass the oral board examination of the American Board of Neurological Surgery. The educational material used to attain these goals seemed more than adequate — the Journal of Neurosurgery, a few classic texts, a hands-on lab experience, a national meeting, and immersion in clinical care of patients with neurosurgical disorders.
Move this simpler and admittedly idealized time forward more than two decades: Now it seems that neurosurgical education is everyone’s business! The Accreditation Council of Graduate Medical Education, the Institute of Medicine, the federal government, state licensing boards, consumer groups, and resident unions are among those with a say in this subject. Furthermore, the available educational opportunities have multiplied — more journals, more meetings, more societies, more texts — all important developments as our specialty becomes more complex and as documentation of competence becomes the standard by which all neurosurgeons will be measured.
What should we as neurosurgeons do? How can we maintain our edge and a sense that lifelong learning is imposed primarily by personal standards, and at the same time meet the regulatory requirements dictated by those outside of neurosurgery?
These are among the questions addressed in this “education issue” of the Bulletin. The cover story provides a comprehensive view of the revolutionary developments in continuing neurosurgical education, now a lifelong prospect in a formal sense. Representing the American Board of Neurological Surgery and the American Association of Neurological Surgeons — Volker K.H. Sonntag, MD, and Robert A. Ratcheson, MD, respectively — detail the rationale for the ABNS Maintenance of Certification Program and the AANS’ targeted response to it.
Education, a core value of the AANS as Roberto C. Heros, MD, observes in his President’s Message, also is an integral precept of the Bulletin.
Our primary aim for this and every issue of the Bulletin is to inform AANS members about socioeconomic, professional and association issues. Further, the Bulletin seeks to enhance understanding — to educate — by providing a context for the facts through expert opinions provided by colleagues and others with knowledge of specific topics.
For example, in this issue’s Governance column Dr. Heros is joined by Mark N. Hadley, MD, and Robert E. Harbaugh, MD, in a discussion of the International Subarachnoid Aneurym Trial. Representing organized neurosurgery, they take a stand on the conclusions drawn from the ISAT’s evaluation of clipping versus coiling and issue a call for further study.
Similarly, the Medicolegal Update column in this issue discusses the latest developments with regard to the professional liability crisis, an issue that returns to the front burner at this time of year with the arrival of every premium increase notice. The article provides an overview of recent legislation passed in a few states with the intent to combat the crisis and additionally offers a frontline view of what can be expected at the federal level in 2003. It also suggests ways for neurosurgeons to effect change and become part of the solution.
In my own work with neurosurgical residents, I often am reminded first hand of the value of experiential education — learning by doing. Extrapolating this experience to participation in resolving problems relating to our medical practice and our livelihood is not a great stretch. While neurosurgeons are not always able to participate in the various activities that organized neurosurgery is involved in today, alll can participate in our profession’s developing dialogue as expressed in every issue of the Bulletin.
To this end, I encourage you to see where we’ve been and where we’re going as a profession and as a professional association by reading through this issue, as well as past issues available at https://www.neurosurgery.org/aans/bulletin. I urge you to consider participating in the Bulletin by writing a Letter to the Editor [email protected], or by contributing an article idea for an upcoming issue.
At its best, the Bulletin does more than inform. Articles can engage the mind and inspire dialogue, debate, ideas and action. With your help, the Bulletin will continue to serve effectively as our primary organ of information, communication and education.
A. John Popp, MD, is editor of the Bulletin, president-elect of the AANS, and Henry and Sally Schaffer Chair of Surgery at Albany Medical College.