Ask a neurosurgery resident anything

[neusu]

Have you ever said "its a beautiful day to save lives" before performing a surgery?

Nope. I may have said, "it's a great day for neurosurgery," or that may have just been in my dreams!

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[Status Sciaticus]

Nope. I may have said, "it's a great day for neurosurgery," or that may have just been in my dreams!

I think you should try it... see if anyone picks up on it. Bet all the hot nurses will be following you after that

 

[neusu]

What is your opinion on medical students that are graduating in their late 20s or early 30s (31-33) and want to go into neurosurgery? Is it worth being close to your 40s at the end?

Typically a non-issue. There are a fair number of MD/PhD neurosurgery residents who start residency in their late 20s or early 30s. As we get older, dealing with lack of sleep can be a tougher issue to deal with and often family obligations come in to play. From what I gather, it is still worth it, if you go in to it for the right reasons.

 

[The Buff OP]

Typically a non-issue. There are a fair number of MD/PhD neurosurgery residents who start residency in their late 20s or early 30s. As we get older, dealing with lack of sleep can be a tougher issue to deal with and often family obligations come in to play. From what I gather, it is still worth it, if you go in to it for the right reasons.

Yeah. I will have to really think about it once I'm up on that level.
Thank you for your answer.

 

[neusu]

how is dating life in med school vs residency?

Do you feel that your residency choice has impacted your dating life? (in a positive or negative way)

Dating in residency is a mix. Certainly, being a resident is more attractive to the opposite sex than a medical student because you are gainfully employed and in a profession that is respected. The schedule certainly has its drawbacks. Trying to see someone on a somewhat routine basis can be difficult due to just time factors, but certainly can be done. This can be somewhat taxing to a relationship, both those first starting and those that have been well established.

I'd say my residency choice has both positive and negative impact. Some people, in and outside of medicine, are interested in or impressed with neurosurgery and being a resident in the field is an advantage when pursuing those individuals. That being said, the hours are tough, and negatively impact dating. Some days/weeks, having enough time just to get the bare minimum done is difficult, let alone trying to meet someone new, show interest, find time to spend together.

 

[wholeheartedly]

Along those lines, do you find yourself worried what your potential partner's motivation is for being with you? i.e. because of your profession/status/earning potential vs a genuine interest in you as a person.

Dating in residency is a mix. Certainly, being a resident is more attractive to the opposite sex than a medical student because you are gainfully employed and in a profession that is respected. The schedule certainly has its drawbacks. Trying to see someone on a somewhat routine basis can be difficult due to just time factors, but certainly can be done. This can be somewhat taxing to a relationship, both those first starting and those that have been well established.

I'd say my residency choice has both positive and negative impact. Some people, in and outside of medicine, are interested in or impressed with neurosurgery and being a resident in the field is an advantage when pursuing those individuals. That being said, the hours are tough, and negatively impact dating. Some days/weeks, having enough time just to get the bare minimum done is difficult, let alone trying to meet someone new, show interest, find time to spend together.

 

[neusu]

Along those lines, do you find yourself worried what your potential partner's motivation is for being with you? i.e. because of your profession/status/earning potential vs a genuine interest in you as a person.

This naturally plays some role in every relationship: smart successful high school student going to a top college; smart successful college student, premed, going to a great medical school; smart successful medical student going in to neurosurgery at a wonderful program; smart, successful neurosurgery resident with a bright future.

Clearly, I'm being facetious, over using smart and successful. Nonetheless, you have to realize only 20% of people in the US have a college degree. Despite the common trend to belittle people who are intelligent, successful, and motivated by academics, most people are truly impressed in the long run. When I visit with friends in the past, the common theme is never "I wish I partied more in high school/college/med school," but instead "I wish I studied harder and applied myself more."

That being said, every step of the way there are people, men and women alike, who want to place themselves in a position of status because of you. The ability to recognize this, and not fall in to it, can be difficult, but for me it hasn't been an issue. Certainly, there are plenty of people who exploit the inverse, e.g. dangle the possibility of the association with profession/status/earning potential disingenuously for their own personal interests.

For me, it has always been somewhat easy finding someone sincere who I actually care for. For now, though, I know I can't devote my best interest and prefer not to bite off more than I'm willing to chew, so to speak.

Hope that helps.

 

[Guero]

This naturally plays some role in every relationship: smart successful high school student going to a top college; smart successful college student, premed, going to a great medical school; smart successful medical student going in to neurosurgery at a wonderful program; smart, successful neurosurgery resident with a bright future.

Clearly, I'm being facetious, over using smart and successful. Nonetheless, you have to realize only 20% of people in the US have a college degree. Despite the common trend to belittle people who are intelligent, successful, and motivated by academics, most people are truly impressed in the long run. When I visit with friends in the past, the common theme is never "I wish I partied more in high school/college/med school," but instead "I wish I studied harder and applied myself more."

That being said, every step of the way there are people, men and women alike, who want to place themselves in a position of status because of you. The ability to recognize this, and not fall in to it, can be difficult, but for me it hasn't been an issue. Certainly, there are plenty of people who exploit the inverse, e.g. dangle the possibility of the association with profession/status/earning potential disingenuously for their own personal interests.

For me, it has always been somewhat easy finding someone sincere who I actually care for. For now, though, I know I can't devote my best interest and prefer not to bite off more than I'm willing to chew, so to speak.

Hope that helps.

Great reply!

To get another view of your typical day, which has already been asked, how about your day today? Can you please give us a specific description of what you did today and for how long at each step? (Hopefully you're not post-call, lol.)

I believe this will provide us with a random sample of sorts of a neurosurgical resident's day and will add to the generalized description you gave us earlier in the thread. Of course, if you feel it's redundant and pretty well matches what you've already provided, no worries. Don't waste your time. I'll think of a better question down the road.

Cheers and get some rest.

 

[Kahreek]

This naturally plays some role in every relationship: smart successful high school student going to a top college; smart successful college student, premed, going to a great medical school; smart successful medical student going in to neurosurgery at a wonderful program; smart, successful neurosurgery resident with a bright future.

Clearly, I'm being facetious, over using smart and successful. Nonetheless, you have to realize only 20% of people in the US have a college degree. Despite the common trend to belittle people who are intelligent, successful, and motivated by academics, most people are truly impressed in the long run. When I visit with friends in the past, the common theme is never "I wish I partied more in high school/college/med school," but instead "I wish I studied harder and applied myself more."

That being said, every step of the way there are people, men and women alike, who want to place themselves in a position of status because of you. The ability to recognize this, and not fall in to it, can be difficult, but for me it hasn't been an issue. Certainly, there are plenty of people who exploit the inverse, e.g. dangle the possibility of the association with profession/status/earning potential disingenuously for their own personal interests.

For me, it has always been somewhat easy finding someone sincere who I actually care for. For now, though, I know I can't devote my best interest and prefer not to bite off more than I'm willing to chew, so to speak.

Hope that helps.

Can you give a couple of examples on the bold fragment? Not talking about relationships.

 

[MD or PhD]

READ THIS PLEASE



Hey neurosurgery resident dude where did you go for college and what was your major? And do you have any helpful tips for us admiring pre-meds =D. We here at SDN really admire you .

 

[neusu]

Great reply!

To get another view of your typical day, which has already been asked, how about your day today? Can you please give us a specific description of what you did today and for how long at each step? (Hopefully you're not post-call, lol.)

I believe this will provide us with a random sample of sorts of a neurosurgical resident's day and will add to the generalized description you gave us earlier in the thread. Of course, if you feel it's redundant and pretty well matches what you've already provided, no worries. Don't waste your time. I'll think of a better question down the road.

Cheers and get some rest.

Ha, I was post-call so my day consisted of mostly sleeping. From mid-night until 6 I took new consults or evaluated patients on our current list. From 6 until 7 we rounded with the team. From 7 until 8 we had breakfast and morning teaching conference. After than I went to the OR for a cervical laminectomy and fusion. Then a quick stop at the gym, the grocery store and home to bed. I woke up in the afternoon and went for a run, ate dinner, read for a bit and fell asleep around 10.

I can try to give you a typical day for another day, I'll try to remember sometime in the next week.

 

[Guero]

Ha, I was post-call so my day consisted of mostly sleeping. From mid-night until 6 I took new consults or evaluated patients on our current list. From 6 until 7 we rounded with the team. From 7 until 8 we had breakfast and morning teaching conference. After than I went to the OR for a cervical laminectomy and fusion. Then a quick stop at the gym, the grocery store and home to bed. I woke up in the afternoon and went for a run, ate dinner, read for a bit and fell asleep around 10.

I can try to give you a typical day for another day, I'll try to remember sometime in the next week.

Actually, that was pretty cool, too. It'll give those unfamiliar with the hospital setting an understanding of what a post-call day is like.

Just to add to that, for those new to the concept of post-call, it's the period immediately after a resident stays in the hospital overnight to "take call," which consists of admitting new pts and covering those already in the hospital, most often a far larger census (pt list) than you'd have on a regular day, as you'll be taking care of other teams' pts, too (a concept called "cross cover"). The period of post-call also has a deadline for you to GTFO the hospital and dictates that you can't be bothered for a minimum rest period thereafter, which, correct me if I'm wrong here, I believe is about 8 hours or so...

Thanks neusu! I look forward to hearing about your next average day. Cheers!

 

[neusu]

Can you give a couple of examples on the bold fragment? Not talking about relationships.

Well, I was mostly talking about relationships there meaning from high school through the rest of life. Even so, outside of relationships a similar trend is present. For example, pairing with classmates for assignments. If you're seen as someone who is easy to get along with and will do well (e.g.get a good grade) and likely pull than your own weight, certain personalities will attempt to position themselves to take advantage of this.

 

[Dick Jones]

Neusu, you're freakin' awesome! If I do research, on epilepsy, with a neurologist will this look good for matching into neurosurgery? I don't have any prior research experience. Also, I really want to give it a shot. The neurologist tht does the research said he will help me create my own research project and conduct it at a nearby level 1 trauma center. Do you recommend this?

 

[neusu]

READ THIS PLEASE



Hey neurosurgery resident dude where did you go for college and what was your major? And do you have any helpful tips for us admiring pre-meds =D. We here at SDN really admire you .

I PM'd you the details, but you have subsequently been banned so I am unsure if you can see them. Nonetheless, I majored in biochemistry at a top school (I'll leave the name out for privacy/anonymity sake). My advice is generally the same for pre-meds or med students. Pick the best school for you where you will do well. Factors such as location, family proximity, cost, and school reputation are all considerations. There is no magic formula that fits everyone as to which school to pick. That being said, do your best in your current environment with respect to grades and standardized tests. Look for opportunities to increase the breadth of your application such as volunteering, study abroad, internships, research, or extracurricular activities. All too often it is easy to fall in to a closed-minded perspective of life in that each step is merely preparation for the next step. Doing so, the qualities of the experiences obtained at each step tend to be diluted. Live life to its fullest as it is, prepare for the future, but don't let this preparation overcome you.

 

[AlteredScale]

Are you currently conducting any research at this moment??

 

[neusu]

Neusu, you're freakin' awesome! If I do research, on epilepsy, with a neurologist will this look good for matching into neurosurgery? I don't have any prior research experience. Also, I really want to give it a shot. The neurologist tht does the research said he will help me create my own research project and conduct it at a nearby level 1 trauma center. Do you recommend this?

Any research looks good, neurosurgery research looks better. Epilepsy does have significant crossover to neurosurgery, especially if the center you work with does epilepsy surgery and your study has something to do with that. PM me regarding your project and perhaps I can give you some more specific advice.

 

[ToldYouSo]

http://www.ncbi.nlm.nih.gov/pubmed/22136645

Any opinion on this study which stated that there was no statistically significant difference in neurosurgeons' surgical skill pre and post call, vs. a significant reduction (~27%) in general surgeons?

Are you guys innately more resistant to the effects of sleep deprivation or is it the nature of the training which makes errors less likely?

 

[neusu]

Are you currently conducting any research at this moment??

I have a couple of ongoing clinical projects that I have been working on and our center is part of several national trials for trauma, gbm, spine, and dbs so I am working with the attendings here that are investigators on those.

It is rather difficult to do bench research during residency outside of an elective so I don't have any basic science projects right now.

 

[juliebethmarie]

I'm in the middle of applying for med school and I have a few questions...

I'll be shadowing a pediatric neurosurgeon next month for about 4 weeks. Any advice (besides the obvious "Don't touch anything," "Be clean and ready and on time," "Shut up")? I've shadowed other doctors, but not in the OR setting.

How bad were interviews? What did you do to prep?

 

[neusu]

http://www.ncbi.nlm.nih.gov/pubmed/22136645

Any opinion on this study which stated that there was no statistically significant difference in neurosurgeons' surgical skill pre and post call, vs. a significant reduction (~27%) in general surgeons?

Are you guys innately more resistant to the effects of sleep deprivation or is it the nature of the training which makes errors less likely?

My sense is these studies are under-powered. Certainly, both general surgery residents and neurosurgery residents deal with a large amount of call and there is something to be said for the ability to learn from the experience of being tired and how it changes your thought processes and technical ability.

Speaking from my own personal experience, the adrenaline rush associated with putting an EVD in, while post-call, for a trauma or SAH certainly increases my awareness and ability to perform such a task. Double-scrubbing a spine surgery or assisting a micro-discectomy with someone who doesn't let you do anything can lead to nearly falling asleep while standing up.

 

[Vinay01]

What are you doing/did you do for July 4th

 

[neusu]

I'm in the middle of applying for med school and I have a few questions...

I'll be shadowing a pediatric neurosurgeon next month for about 4 weeks. Any advice (besides the obvious "Don't touch anything," "Be clean and ready and on time," "Shut up")? I've shadowed other doctors, but not in the OR setting.

How bad were interviews? What did you do to prep?

The OR is a bit of a different world. Try not to take offense if people are blunt or dismissive. Everything in blue is sterile, try to stay to the edges of the room, look around you before you move so you don't inadvertently step in to a sterile table/tray and contaminate it. If you do contaminate something, announce it so that it can be discarded. If you feel faint, sit down in the nearest chair or on the floor.

Med school interviews were rather easy. Most consisted of an information session, a tour, lunch, and a number of interviews with faculty/staff/students. The largest number of places that I recall either had two attendings/admissions staff or one staff and one student.

Residency interviews were a bit more grueling. For neurosurgery, it typically involves a dinner the evening before the actual interview date. The dinner varied by program from residents only, attendings only, a mix, or everyone at first and then the attendings leave. Some programs keep you out rather late, others everything settles down fairly early. The interview day itself starts early. Programs vary by how they do things specifically, but most often an introduction/information session with a light breakfast is followed by some mixture of a tour/conferences/interviews and lunch. The interviews nearly always involved the entirety of the available faculty for that program. Many programs would involve at a minimum the current PGY-5 residents (who will be chief when the interviewees are PGY-2), but several have an interview with each resident individually or the rest of the residents as a group. As you can imagine, an average program with 10 attendings and 2 PGY-5s works out to be 5-6 hours of 30 minute interviews. Needless to say, after doing 5 or 10 of these, the typical questions become a little mundane.

For any interview, to prepare I would review my application and go over what my responses would be regarding possible questions related to publications, extra-cirriculars, and life-experiences. I would try to review the program structure and particular strengths to be able to ask informed questions about each program and, if possible, the people I would be interviewing with.

Hope this helps

 

[neusu]

What are you doing/did you do for July 4th

Nothing too exiting, Roman Candle fights http://www.youtube.com/watch?v=RxIZd11Jk44 and barbecuing with family/friends.


Not serious about the former!

 

[hypadude]

What did you do in the summer before your residency started?

Have you ever had a problem with blood? I sometimes feel lightheaded if I'm standing still and someone is bleeding all over me, Is there a way to get over or used to this?

 

[AlteredScale]

Do you enjoy bench research more than clinical research?

What is your opinion on the future robotic neurosurgery?

 

[neusu]

What did you do in the summer before your residency started?

Have you ever had a problem with blood? I sometimes feel lightheaded if I'm standing still and someone is bleeding all over me, Is there a way to get over or used to this?

I think I may have mentioned this previously, but if I have not, then I apologize. I mostly spent time with friends and family, went to a ton of weddings, on a trip or two, and continued working in the lab that I worked in as an undergrad. Towards the end of the summer, before classes started, I approached some of the neurosurgeons at my school to see if anyone would be interested in having me help with a project. Fortunately, I was able to get a small piece that turned out to be something worthwhile.

I can't recall ever having a problem with blood. The one time it made me feel uneasy was during a C-section when my hands were in the field and the gush of warm blood/amniotic fluid flooded everything. Typically, the surgeries we do and patients we are involved with are not bleeding all over you so it is not often a major issue. Even so, taking a step back from the field and focusing on something else can help. Sit down if you feel lightheaded. I suspect you'll overcome it with sufficient exposure.

On a sardonic note, there is a phrase "all bleeding stops."

 

[hypadude]

I think I may have mentioned this previously, but if I have not, then I apologize. I mostly spent time with friends and family, went to a ton of weddings, on a trip or two, and continued working in the lab that I worked in as an undergrad. Towards the end of the summer, before classes started, I approached some of the neurosurgeons at my school to see if anyone would be interested in having me help with a project. Fortunately, I was able to get a small piece that turned out to be something worthwhile.

I can't recall ever having a problem with blood. The one time it made me feel uneasy was during a C-section when my hands were in the field and the gush of warm blood/amniotic fluid flooded everything. Typically, the surgeries we do and patients we are involved with are not bleeding all over you so it is not often a major issue. Even so, taking a step back from the field and focusing on something else can help. Sit down if you feel lightheaded. I suspect you'll overcome it with sufficient exposure.

On a sardonic note, there is a phrase "all bleeding stops."

Thank you! sorry if I am repeating questions. What I meant is the May and June before the July 1st residency start date after commencement from medical school. It seems like there is a mysterious gap there for moving/studying/vacation.

I didn't really have a summer before medical school, as I am in a program that started in January and has no M1-M2 summer. I'm hoping that I'll get a substitute "last summer" after my commencement in April of 2016

Was the very first surgery you did as a resident terrifying, or what?

 

[neusu]

Do you enjoy bench research more than clinical research?

What is your opinion on the future robotic neurosurgery?

Bench research can be relaxing and intellectually stimulating. I'd say it's probably a toss-up, can't say I've ever really done dedicated clinical research without doing clinical work at the same time.

I suspect neurosurgery will incorporate robots more in the future. As opposed to other fields, though, the current technology does not apply particularly well to neurosurgery. We use tactile feedback a lot in our surgeries and often this is lost with robots. Likewise, I suspect, the experience and discerning eye required for differentiating normal brain tissue from infiltrating tumor would be difficult to train a robot

 

[neusu]

Thank you! sorry if I am repeating questions. What I meant is the May and June before the July 1st residency start date after commencement from medical school. It seems like there is a mysterious gap there for moving/studying/vacation.

I didn't really have a summer before medical school, as I am in a program that started in January and has no M1-M2 summer. I'm hoping that I'll get a substitute "last summer" after my commencement in April of 2016

Was the very first surgery you did as a resident terrifying, or what?

Sorry, I misread your question!

Prior to residency I didn't really do anything fun or productive. Mostly packed and moved, got settled in to my new environment.

A lot of friends took extended trips reasoning that it would be the last time they have a fair amount of time off.

 

[seattlewapremed]

Obviously you work a lot but enjoy the work you do. Do you feel constantly stressed? Are you constantly sleep deprived?

 

[neusu]

Obviously you work a lot but enjoy the work you do. Do you feel constantly stressed? Are you constantly sleep deprived?

Feeling stress depends on the day. As a junior resident, there was quite a bit of stress on a day to day basis making sure everything that needs to get done happens and learning how to be an effective neurosurgery resident. The stress diminishes as those issues become more familiar and routine. With respect to sleep, it is tough to say. Certainly, I could probably do with more sleep. That being said, I typically only sleep 4-6 hours when given the opportunity. On holidays or vacation, when I don't have other plans, I can get 6-8 hours, but that is rather rare. I try to find something else to do be it spend time with friends and family or hobbies.

 

[911 Turbo]

Feeling stress depends on the day. As a junior resident, there was quite a bit of stress on a day to day basis making sure everything that needs to get done happens and learning how to be an effective neurosurgery resident. The stress diminishes as those issues become more familiar and routine. With respect to sleep, it is tough to say. Certainly, I could probably do with more sleep. That being said, I typically only sleep 4-6 hours when given the opportunity. On holidays or vacation, when I don't have other plans, I can get 6-8 hours, but that is rather rare. I try to find something else to do be it spend time with friends and family or hobbies.

Aren't you worried about what the lack of sleep will do to your lifespan?

 

[tiedyeddog]

Aren't you worried about what the lack of sleep will do to your lifespan?

Do you have a study that relates lack of sleep to decreased life span?

I am sure Michael DeBakey lost plenty of sleep over the years and wiki how long he lived... I would guess lifestyle choices, like diet, drinking, and smoking, are much greater determinants of life span.

 

[NeedtobeinNeuro]

On the trail there were students who had no research experience and there were people with 20+ publications and there were MD/PhDs. I would say my application was average to above average. Like any challenge in life, I tried to be over prepared instead risk regretting not doing enough.

As a disclaimer, I did bench research (molecular biology/biochemistry) as an undergrad and had publications from that. They count towards residency as well. I started research in medical school during my first year, approached people with ongoing projects and just latched on. As a student, a lot of what you can do relatively easily is collect data and build a database to mine information and write papers. Find someone at your school who has an interest in research, write a broad IRB, and then crunch numbers.

Sorry if this has been touched on but I'm in lab and can't go through all 12 pages!

How true is the "first author or nothing" mentality when it comes to publications for applying for a neurosurgery residency? I currently do research in a top ten Neurosurgery department and I am on papers but my author order has varied from in the middle to second author. I was going to be first author on one paper but unfortunately I am not allowed to run the instruments in our lab (its a mass spec lab and I have no mass spec training) and it took forever to get the samples run by the people controlling the machines because there were always other projects that were more exciting/closer to publication that got priority. I am leaving now to do a postbac program so I can have a more competitive GPA for med school apps. Hopefully with my previous research experience I can get some first author papers from my program (we are required to do research) but if I only end up with one first author out of 10+ papers (I'll already have quite a few from this job) will that hurt me?

For the record the people who are first authors on these papers are all postdocs, residents or fellows. I understand why it is more important that they were first author but should I have tried harder to get a first author paper?

 

[Dr.Forssmann]

How do you time manage?

 

[neusu]

Aren't you worried about what the lack of sleep will do to your lifespan?

Well, as I mentioned I typically don't feel sleep deprived. People require different amounts of sleep, I seem to be one of the lucky ones who can get away with less than the 8 hours. On another note, sleeping less can be learned/ trained. I'm better at it now than I was before residency.

 

[neusu]

Sorry if this has been touched on but I'm in lab and can't go through all 12 pages!

How true is the "first author or nothing" mentality when it comes to publications for applying for a neurosurgery residency? I currently do research in a top ten Neurosurgery department and I am on papers but my author order has varied from in the middle to second author. I was going to be first author on one paper but unfortunately I am not allowed to run the instruments in our lab (its a mass spec lab and I have no mass spec training) and it took forever to get the samples run by the people controlling the machines because there were always other projects that were more exciting/closer to publication that got priority. I am leaving now to do a postbac program so I can have a more competitive GPA for med school apps. Hopefully with my previous research experience I can get some first author papers from my program (we are required to do research) but if I only end up with one first author out of 10+ papers (I'll already have quite a few from this job) will that hurt me?

For the record the people who are first authors on these papers are all postdocs, residents or fellows. I understand why it is more important that they were first author but should I have tried harder to get a first author paper?

For the most part, first author is the best position to be in. However, having a publication, as an author at any position, is good, so long as you can discuss the relevant topic of the manuscript and describe, in detail, your role in the study.

You should be ok. Keep working on things and, if you can, get at least one first author publication before your application is submitted.

 

[mwall003]

I think I may have mentioned this previously, but if I have not, then I apologize. I mostly spent time with friends and family, went to a ton of weddings, on a trip or two, and continued working in the lab that I worked in as an undergrad. Towards the end of the summer, before classes started, I approached some of the neurosurgeons at my school to see if anyone would be interested in having me help with a project. Fortunately, I was able to get a small piece that turned out to be something worthwhile.

I can't recall ever having a problem with blood. The one time it made me feel uneasy was during a C-section when my hands were in the field and the gush of warm blood/amniotic fluid flooded everything. Typically, the surgeries we do and patients we are involved with are not bleeding all over you so it is not often a major issue. Even so, taking a step back from the field and focusing on something else can help. Sit down if you feel lightheaded. I suspect you'll overcome it with sufficient exposure.

On a sardonic note, there is a phrase "all bleeding stops."

How did you approach neurosurgeons at your institution that you had interest in getting a piece of a research project? Did you approach them early your M1 year to setup something for M1 summer? Did you attach a CV to the e-mail you sent if you contacted them via e-mail? Thanks so much for doing this!

 

[neusu]

How do you time manage?

I don't use any sort of formal time management algorithm and generally do it all in my head. For the most part, I give everything a mental priority and determine what is the most pressing and prioritize. Here are two examples:

At work
Depending what year you are in residency, this varies, but I'll give you the junior resident perspective as I successfully navigated it and it does require a fair amount of juggling. The team meets in the morning to see the patients in the house and discuss the daily plan. As the junior, you are in charge of carrying out that plan. Different programs split this responsibility differently such as cutting the patients in to services, having specific residents for new consults or managing the ICU. In any case, you are assigned a number of tasks and have to determine which to get done when as well as how to re-prioritize when new comes. Hypothetically, you have 50 patients you are in charge of, 10 are in the ICU, 40 are on the floor. Post-ops need to be visited by physical/occupational therapy, dressings need to be removed, drains need to be pulled, new patients coming from the OR need to be post-op checked, new consults from other services need to be seen, new cases that develop need to be booked. So how do you prioritize this? Everyone does it differently, but at the end of the day all of it needs to get done. I tended to see all of the patients early in the day to "lay eyes" on them and get my gut feeling/give them the plan. I'd be brief, pull drains or dressings on the way, and work on discharge paperwork in the interim. New patients that need the OR that day had priority, if it was the next day or so, it could be put off. Consults can be tricky, the other service doesn't always know what they are talking about so the person who is "GCS 15" in the ED could very well be 13 and dropping. Part of time management is becoming efficient so you don't waste time unnecessarily. Look for ways you can streamline the process, don't go somewhere far away in the hospital (e.g. MRI to check a shunt or the rehab unit in the far off building) without thinking of at least 3 things you could do on the way there or back.

Personal life
Work will dominate this. People always ask if neurosurgery can be a lifestyle specialty. During residency I think it would be almost impossible. That being said, there is plenty of time to have a life during residency and to do the things you enjoy. Being efficient in your personal life certainly helps as well. Planning a grocery trip on your way home from the hospital vs going home and then out to the store makes it easier. Also, sometimes the trade-off of just not doing something to get extra sleep or rest is necessary. Prioritizing your own health and well-being with respect to work is more important than being the social butterfly around town.

 

[neusu]

How did you approach neurosurgeons at your institution that you had interest in getting a piece of a research project? Did you approach them early your M1 year to setup something for M1 summer? Did you attach a CV to the e-mail you sent if you contacted them via e-mail? Thanks so much for doing this!

The summer before my M1 year, I e-mailed a couple of neurosurgeons at my medical school inquiring about possible projects. A couple got back to me and I set up a face-to-face meeting where we discussed their ongoing research and how I could fit in. During my M1 year, I didn't really do much in the way of research, but I did apply for funding for my project between my M1 and M2 year and spent that summer on a project.

If your CV is substantial it may be worth adding to an e-mail. It also helps to read some of the recent publications from the group to get a feel for what they are doing and have questions prepared and possibly a project you'd like to work on.

 

[The Buff OP]

How far are you into your residency?

 

[neusu]

How far are you into your residency?

I'm in my 5th year.

 

[dahassa]

Thanks a lot for taking the time to answer so many questions!

In your particular program are there any female residents? Do you feel like there are certain challenges that female residents face that contributes to the low number of women going into neurosurgery?

Given that it is a male dominated field, do you think it is open to women and would women face any social challenges? Essentially, what is the general attitude towards female neurosurgeons?

 

[neusu]

Thanks a lot for taking the time to answer so many questions!

In your particular program are there any female residents? Do you feel like there are certain challenges that female residents face that contributes to the low number of women going into neurosurgery?

Given that it is a male dominated field, do you think it is open to women and would women face any social challenges? Essentially, what is the general attitude towards female neurosurgeons?

We do have female residents. From what I gather talking to former female classmates and current residents, a lot of the challenges are personal choices. It seems more difficult for a woman to start a family during residency given the physical constraints of being pregnant for 9-months as well as a 7-year residency for neurosurgery. Likewise, it is a demanding field both in and after residency. Having a life-style wherein you can be at home a significant portion of the time is less feasible than some other fields. This accounts for some of the lower number of females in neurosurgery. Historically, neurosurgery, and medicine in general, was a male dominated field. Medicine has started to reach parity with male and female admissions to residency, but this has not yet trickled down to all fields. For many students, having a role-model in the field helps to imagine success for them-self. Neurosurgery is beginning to see the effect of more women in medicine, but again it is a 7-year training period and a significantly longer time to become an established, nationally known neurosurgeon, so there just aren't as many women in the position of full professor to influence younger women than there are men.

Certainly, it still is a male dominated field. From what I gather, the attitude towards women is welcoming. Most programs do their best to accommodate the needs of any resident. My sense is the general attitude towards women is to treat them, and their male colleagues, gender neutral. Essentially, if they fit the job and excel, it does not matter their gender.

 

[anon12380]

Hypothetically, would you be willing to allow someone to shadow you for a predetermined amount of time? I have been told that shadowing neurosurgeons, in general, is a bit rough simply because of the demands of the field.

In addition, did you do anything during your undergraduate years that you believed set yourself apart from the rest when applying to med schools?

Thanks for doing this too--very impressed that you are helping the SDN community like this.

 

[Mr Avante]

Is CNS membership worth it? When would be the best time to request it?
endovascular vs skull base?
Fellowship vs residency alone, concerning the job market?

Cheers Nes.

 

[coffeeman]

http://www.ncbi.nlm.nih.gov/pubmed/22136645

Any opinion on this study which stated that there was no statistically significant difference in neurosurgeons' surgical skill pre and post call, vs. a significant reduction (~27%) in general surgeons?

Are you guys innately more resistant to the effects of sleep deprivation or is it the nature of the training which makes errors less likely?

Looks to me like the study was underpowered.

 

[pgoyal]

hi neusu,

1. for someone starting med school with no previous publications/substantial research would the following "plan" generally apply to qualify for a neusurg spot:

a. do well in classes & rotations
b. do well on usmles
c. do a summer research between 1st & 2nd year (or is it 2nd & 3rd year?) - get a clinical project related publication
d. do an EC
e. Profit??? or No Profit???

or is an extended long term research project necessary? I am getting quite old already as a non traditional applicant and would like to spend as much time as possible with the lady (maybe kids) before any sort of residency kicks in.

2. expanding on a previous comment you made - What is your perspective on robots/AI (i.e. watson) + mid levels combo playing a role in the future in terms of a) patient care (both surgical and nonsurgical) b) gainful employment for physicians. i.e. how far is the future where DNPs evaluate the patient and input data into watson which spits out a treatment plan far superior to that of a physician. perhaps more of a concern for family practice than surgery but nonetheless.

thanks man.

 

[neusu]

Hypothetically, would you be willing to allow someone to shadow you for a predetermined amount of time? I have been told that shadowing neurosurgeons, in general, is a bit rough simply because of the demands of the field.

In addition, did you do anything during your undergraduate years that you believed set yourself apart from the rest when applying to med schools?

Thanks for doing this too--very impressed that you are helping the SDN community like this.

We allow students of all capacity (e.g. high school, college, medical school) to shadow for fixed and indefinite amounts of time. It is a fairly demanding field, but you can set up your shadowing schedule to your needs. We currently have an undergrad who is helping a professor with a research project who comes to the OR and watches cases etc. You don't always have to show up at 5 or 6 and round etc.

As an undergraduate I did what I did. My intention wasn't to set myself apart from others but to gain life experience. The whole thought of "building character" is true. If it were not for some of my experiences I wouldn't be who I am currently.

Happy to do it, hopefully you guys are inspired to pursue medicine, regardless of which field, and perhaps, some are interested in neurosurgery!