Just as we may turn to our parents for parenting advice, as neurosurgeons we rely upon the sage advice of older colleagues as we deal with neurosurgical issues. Beginning with our days as medical students and residents, we turned to senior and chief residents to show us the ropes. Later, as young attendings, we look to older partners and more seasoned practitioners to help us navigate the world of independent practice. As such, the AANS Neurosurgeon wanted to highlight the lifecycle of a neurosurgeon; initially, thinking somewhat simplistically, that this could be classified into early-career, mid-career and late-career stages. What emerged was a sense that such discrete boundaries and distinctions are artificial, and perhaps, arbitrary.
I have always encouraged my trainees and mentees to consider their life goals — personal and professional — and how best to achieve them. Having a daily sense of purpose ultimately can lead to moments of joy and a lifetime of happiness. Work-life balance is not so much the goal as it is a pursuit of passions that contribute to a meaningful life. Nevertheless, a neurosurgical career is a journey like other journeys of life — with its challenges, triumphs and transitions.
Dr. Wright writes eloquently about her first year in practice as a neurosurgeon; who remembers the early days of being an attending when one tried to honestly answer queries about your surgical experience. At the opposite end of the spectrum, Dr. Neal, a mid-career neurosurgeon, writes about the culmination of his career as a military neurosurgeon and the birth of his career as a private practice neurosurgeon.
As many have documented, the neurosurgical career offers many rewards and challenges; attempting to simultaneously achieve personal goals outside of the world of medicine adds another layer of complexity. The American Association of Neurological Surgeons (AANS), with its recent creation of the Diversity Committee, recognizes the need for diversification of the neurosurgical workforce to meet the evolving demographic of the U.S. population. Many of our neurosurgical colleagues are spearheading these efforts locally at their institutions and communities to expose youth to medicine and the field of neurosurgery. In this issue, two of the first scholarship recipients of such an effort at the University of Utah describe their start to what is hopefully the beginning of a neurosurgical career and journey.
In 2004, the Journal of Neurosurgery published Dr. Richard Rovit’s historical vignette, “To everything there is a season and a time to every purpose; retirement and the neurosurgeon”. The analysis of the data available at the time suggested that the average age of surgeons at retirement was 60 years; life expectancy was 80 years. As such, a full 15 to 20 years post retirement was predicted. More importantly, the manuscript includes free text/qualitative responses from 75% of the surveyed surgeons who retired from academic practice. In the setting of the COVID-19 pandemic induced Great Resignation, these statistics may no longer be accurate. The most recent data from the AANS membership committee suggests that average age at the time of FAANS status is achieved is 39 years with 64.8 years being the average age at which lifetime membership status is achieved, culminating in a career lifespan of 25.8 years.
In the last issue of the AANS Neurosurgeon, neurosurgeons discussed their extra-neurosurgical passions; in this issue, we suggest that the neurosurgeons’ lifecycle divisions are somewhat arbitrary. This highlights the importance of identifying and pursuing these extra-neurosurgical passions throughout a surgeon’s life — from the early (in training) to the later (beyond retirement) years.
