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AANS Neurosurgeon | Volume 28, Number 1, 2019

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Alternative Mind: How Non-traditional Experiences Enrich Neurosurgical Training Part 1

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Although neurosurgery attracts a relatively diverse range of personalities, by virtue of its competitiveness, academic orientation and close ties to translational science, the common pathways into residency are relatively homogeneous. A prototypical resume might include undergraduate training with a biosciences focus, laboratory research experiences throughout college and medical school as well as a smattering of team sports, volunteer experiences or esoteric hobbies that invest the aspiring neurosurgeon with the appearance of “well-roundedness.” The resulting pool is typically viewed as positive, in that it selects for individuals who are not only prepared to advance clinical and translational science from an early stage of their careers, but who are also well-equipped to endure the emotional, intellectual and physical demands of training and practice.

Notwithstanding, considerable human resources research demonstrates that, with respect to both organizational productivity and the promotion of an environment that privileges creativity, innovation and competitive advantage, the optimal workplace is enriched by individuals with unique strengths drawn from diverse backgrounds. For example, an education in business, publishing, engineering or the military would potentially enhance the mind of an individual trained under their relative dogmas in ways that would augment their abilities to:

  • Communicate strategy;
  • Articulate complex ideas;
  • Analyze problems; or
  • Accomplish missions, respectively.

Translated into the clinical context of surgical training, the singular mentality with which most trainees reach residency has empowered excellence for generations. However, as neurosurgery and medicine have become increasingly oriented towards a broader and more inclusive interpretation of the needs of the patient, the powerful lens provided by an individual whose training or experiences allow them the perspective of an alternative mind has expanded remarkably.

Where’d You Learn to Do That? Skills & Experiences as Intellectual Cross-training

Looking beyond communication skills, other advantages gleaned from more diverse or non-traditional experiences prior to medical education include tangible skills and the associated mentalities that those skills foster in their disciplined acquisition. MIT’s motto of Mens et Manus or “Mind and Hand” reflects the value placed by the institution’s founders on the “cooperation of intelligent culture with industrial pursuits.”1 The education of every engineer prioritizes the balance between thought and action: rigorous study not only in memorizing higher level concepts, but in the direct application of knowledge to innovation. Work matures students into engineers — not only do they learn how to apply theory to the real world, but they also learn how to develop useful tools not in their proverbial toolbox. Although the scientific method underlies both medical and engineering pathways, this focus on the practical, measurable and reproducible is less apparent in the more theoretical musings of pathophysiology or bioplausibility that frequently dominate medical discourse.

A pillar of engineer training is the three-phase approach from theory to execution:

  • Assessment
  • Planning
  • Implementation

This mindset is practical, organized and a powerful mechanism for numerous aspects of routine hospital work. These range from solving complex patient care problems, to managing a busy service. Further, the approach:

  • Is rooted in data;
  • Explicitly optimizes processes with respect to outcomes; and
  • Can be readily adapted to tasks ranging from direct patient care to clinical research or quality improvement with ease.

Still, other experiences that inform an alternative mindset are drawn from more peripheral spheres, such as the liberal arts. A yin to the scientific method’s yang, the techniques of critical analysis developed in philosophy, comparative literature and the arts provide a salient example. In contrast to the cycles of observe, hypothesize, experiment and analyze that are infused throughout traditional premedical education, analysis within the liberal arts is a practice of reasoned abstraction, which allows considerable room for interpretation and anticipates subjectivity. In this way, the information presented is used to construct a narrative and derive meaning from the work — a technique that promotes creativity, pattern recognition and intellectual robustness. From a practical perspective, the alternative mindset refined by this approach has numerous clinical applications ranging from assessment of confounding patients, to data interpretation and, perhaps most importantly, compelling, narrative articulation of one’s ideas in writing.

Continue reading in Part 2.

References

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1. Stratton, J. A., & Mannix, L. H. (2005). Mind and hand: the birth of MIT. Cambridge, MA: MIT Press.

2. Whelan, E., Dacy, M. D., & Rownd, J. E. (2017). The little book of Mayo Clinic values: a field guide for your journey. Rochester, MN: Mayo Foundation for Medical Education and Research. 

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