Job Security - what do you think?

[iwantneurosurg]

I think that neurosurgery will continue to be a high-demand field for a while, but it's undeniable that the general trend is going towards less surgery and less invasive procedures. This directly puts neurosurgeons in danger. After all, who really wants to go in for surgery when they can just pop some pills or something?

So my question to you is, if practicing neurosurgery for the next twenty or thirty years, how would you best secure your profession?

Many people here have suggested taking up an interventional neuroradiology fellowship after neurosurgery training just in case.

What do you suggest? I personally wanted a pediatric neurosurgery fellowship since I find working with children more rewarding, but I'm slightly concerned about personal feelings getting in the way; regardless, if neuroradiology actually is a more sound career decision, I'd much rather look into that.

By the way, I'm a first year medical student; I took up three different research projects in cardiothoracic surgery, orthopaedics, and neurosurgery because I was interested in all three, and only neurosurgery really stands out. Thus, I'm seriously considering going into neurosurgery; the guy I talked to who's part of the admissions committee says basically its all board scores and clinical year grades. That gets you an interview. After that, its all interview and recommendations. If you don't interview right, you better have a strong recommendation to back you up; chances are, they'll call that neurosurgeon who recommended you and ask about you. So I'm trying to really get my contacts in by doing research with neurosurgeons; I'm doing some stuff here, and this summer I'm trying to go to Cornell; I do hope to be able to do an off-site neurosurgery rotation at a school I'd like to end up doing residency at.

If there's anything else I should be doing, please let me know.

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[Pubby]

My understanding, from talking to a CT surgeon, is that neurosurgeons have done a good job limiting the supply of neurosurgeons in order to keep everyone working... A lot of neurosurgical procedures won't be going anywhere anytime soon. Maybe cancer & epilepsy treatments will get more pharmacologic, & I suppose endovascular tx might reduce the number of cranis for aneurysms, but any spine, trauma, bleed, transphenoidal procedures, etc. are going to be around for a long time. Even with neoplasms, I doubt surgical resection will be done away with --- probably the improvements will be in adjuvant and neoadjuvant tx. Plus, I think people saw what happened to CT surgery and are wary to keep their work volumes high -- I know some programs include endovascular training...

As far as subspecializing, I'd worry about it during residency -- who knows what will be appealing once you get in the thick of it!