With continued recognition of the need to improve diversity in our specialty, in 2021, the Department of Neurosurgery at the University of Utah announced a call for applications for a two-month summer scholarship intended to improve access to and foster interest in neurosurgery among individuals from diverse and historically underrepresented backgrounds. Ashley M. Carter from Eastern Virginia Medical School (EVMS) and Gabriela F. Sarriera-Valentin from the Larner College of Medicine at the University of Vermont (UVM) were selected as the inaugural interns. They spent the summer of 2022 shadowing in the clinic, operating room and research spaces.
The program is structured to offer maximum exposure to the many subspecialties within neurosurgery that the University of Utah’s neurosurgery department has to offer, including spine, neuro-oncology, pediatric, peripheral nerve, trauma, functional and cerebrovascular. Additionally, there is built-in protected research time, with a research mentor of each student’s choosing. This year’s scholarship recipients worked with Douglas Brockmeyer, MD, FAANS, and Rajiv Iyer, MD, on craniocervical junction spine research and with Howard Colman, MD, PhD, a neuro-oncologist at the Huntsman Cancer Institute studying glioblastomas.
Early exposure is essential to a student’s specialty training decision. The availability of neurosurgical clerkships to third-year medical students and the timing of preclinical neuroscience education impacts interest and recruitment in the field. Obstacles limit opportunities for the program applicants to obtain the experience needed to decide about their interest in neurosurgery. In Carter’s case, EVMS does not have an affiliated neurosurgery residency program, and for Sarriera-Valentin, the smaller size of the neurosurgery residency at Larner College of Medicine at UVM was limiting. Both students are involved in neurosurgery interest groups at their respective institutions, but craved a more in-depth experience.
The medical schools that produce the most neurosurgery residents typically have many neurosurgical clinical faculty, a neurosurgery interest group and National Institutes of Health funding. According to the 2022 National Residency Matching Program, 43% of medical students who matched into neurosurgery were from one of the top 40 U.S. medical schools with the highest NIH funding. At present, the majority of summer programs currently available to U.S. medical students are focused solely on research. With research being cited as one of the more important factors for matching into neurosurgery, students who do not attend R1 institutions are at a disadvantage, thus lending importance to these summer programs important. However, although most summer research programs accept students from all institutions, they usually require prior research experience as a prerequisite. For students without prior research experience or well-established connections, it can be challenging to secure a spot in a summer programs with a neurosurgical focus. Additionally, summer research programs seldom provide sufficient funding; often times, medical students are forced to choose between a non paying research position or a source of income. The University of Utah program allows access to resources and opportunities that may have otherwise been unattainable.
This program presents an opportunity to bridge the current gap in the neurosurgical workforce by increasing early clinical exposure, mentorship, research opportunities and encouraging cross-collaboration for participating students. “This summer program increased our understanding of the daily workflow of a neurosurgical service, offered a preliminary understanding of the responsibilities of neurosurgical residents and expanded our knowledge base through incremental daily acquisition of knowledge,” says Sarriera-Valentin.
The first two scholarship recipients noted that the program could be a model for neurosurgical programs across the country. Carter and Sarriera-Valentin notes that “We hope to share our experience and encourage other neurosurgical programs to provide similar opportunities for medical students from underrepresented communities in addition to those from underrepresented medical institutions.”
Question: What did you gain from participating in the program, and how has the program impacted your goals moving forward?
Carter: Participating in this program gave me a new perspective on the possibilities within the field of neurosurgery and a renewed confidence in my abilities to know that I can do it well. I left the program understanding what I need to do next, thanks to the residents and attendings who have given me advice and direction. The process of getting into neurosurgery residency can be intimidating, and statistics can breed insecurities, but with the insight, support and mentorship that I gained from the program, the journey will still be tough, but now I am prepared and not alone.
Sarriera-Valentin: This program has solidified my interest in neurosurgery. Although the largest gain has been the relationships I’ve established, I also had the opportunity to contribute to research while gaining invaluable clinical exposure. Through resident conferences I’ve learned the value of presenting research plans early and getting actionable feedback to ensure you’re contributing to a body of work that will not only advance neurosurgery but also improve patient outcomes.
Acknowledgments
We would like to thank the entire University of Utah Department of Neurosurgery, especially Erica F. Bisson, MD, FAANS, William T. Couldwell, MD, PhD, FAANS, and Randy L. Jensen, MD, PhD, FAANS.
