Ask a neurosurgery resident anything

[neusu]

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I apologize if these questions have been asked before. What are the best med schools that have the highest number of neurosurgery matches? Also, what score on Step 1 guarantees matching into neurosurgery?

The schools that have the highest number of people match in to neurosurgery changes through time. Generally, schools where the programs encourage student participation/rotations end up matching a lot of people. Likewise, it is important to look at the ratio of students applying from each school, the number of residents at that school, and the number that match. Uncle Harvey, http://www.uncleharvey.com has a list of the neurosurgery match for the last several years.

Unfortunately, there is no score that can guarantee matching. The application has many factors and different programs place different weights on different parts. As a rule of thumb, >240 historically will result in a match (~90% probability). Nonetheless, nothing is assured. The 2011 charting outcomes in the match indicates that 2 US seniors with a 241-250 did not match. http://www.nrmp.org/data/chartingoutcomes2011.pdf

 

[Dick Jones]

The schools that have the highest number of people match in to neurosurgery changes through time. Generally, schools where the programs encourage student participation/rotations end up matching a lot of people. Likewise, it is important to look at the ratio of students applying from each school, the number of residents at that school, and the number that match. Uncle Harvey, http://www.uncleharvey.com has a list of the neurosurgery match for the last several years.

Unfortunately, there is no score that can guarantee matching. The application has many factors and different programs place different weights on different parts. As a rule of thumb, >240 historically will result in a match (~90% probability). Nonetheless, nothing is assured. The 2011 charting outcomes in the match indicates that 2 US seniors with a 241-250 did not match. http://www.nrmp.org/data/chartingoutcomes2011.pdf

How far, in the past, can you go when listing activities on your residency application? Do you only list activities you participated in while in medical school?

 

[acslater99]

Was you're internship exciting or miserable?

 

[deleted393595]

Depends on the environment and indication. For epilepsy we'll often do EEG, ECOG, or an array of single cell recording. For DBS we'll do LFP or single-cell. We also do fMRI and other functional imaging modalities.

Thanks! I've seen papers where LFP was done for DBS, but I didn't know that you'll could do single cell on patients 😵

 

[Pose]

Do you experience much collaboration with ENT in the OR? Or do you have any input on how much surgical overlap there is between NSX and ENT (maybe head/neck or skullbase fellows) with cranial stuff?

Thanks!

 

[deleted393595]

Since you brought it up in our bb thread, can we please know what your Step I + bench score is?

We also came up with a new metric, which we named the NeusuR score in honor of you. It's your Bench/10 + Step I.

 

[neusu]

Was you're internship exciting or miserable?

It was exciting for about 2 weeks, then miserable for 50. Don't get me wrong, I learned a lot more about being a doctor during internship than I had during medical school. Neurosurgery formerly was like urology or ophthalmology where the match was for a PGY-2 position and interviews/applications had to be made separately for a PGY-1 preliminary surgery position. Depending on the program, affiliated prelim surgery residents can be treated pretty well or merely as cannon fodder for the call schedule.

 

[neusu]

How far, in the past, can you go when listing activities on your residency application? Do you only list activities you participated in while in medical school?

Different people go through medical school at different stages in their life. Some come straight from college while others have entire careers prior to medicine. If you have interesting/relevant activities, list them. I listed activities from high school that remained significant. No one is going to care that you were the valedictorian of your HS class, but if you won the Intel Science Award, that is worth listing.

 

[neusu]

Do you experience much collaboration with ENT in the OR? Or do you have any input on how much surgical overlap there is between NSX and ENT (maybe head/neck or skullbase fellows) with cranial stuff?

Thanks!

We work with ENT pretty closely for skull base tumors and trauma.

For trauma, we manage intracranial pathology and skull fractures aside from the ear (petrous portion of the temporal bone). ENT handles the ear/face.

For tumors of the skull base we work with ENT. For the transphenoidal approach to the sella, depending on the attending, ENT will do the exposure and closure. Likewise for trans-labyrinthian approaches to the ear organ. Some attendings have ENT involved in middle foss approaches, some don't.

Not a ton of overlap, but more than say ophtho.

 

[neusu]

Since you brought it up in our bb thread, can we please know what your Step I + bench score is?

We also came up with a new metric, which we named the NeusuR score in honor of you. It's your Bench/10 + Step I.

Haha, I'm quite honored to have a scoring system named after myself. If I recall correctly I was in the 550-600 range.

 

[stronghold]

The notion about strong and weak programs is rather silly. Neurosurgery is a 7-year training program. I can guarantee that things will be different in the department when you are chief from when you are intern. A currently strong program could have an exodus of staff and become a weak program. A weak program could hire a strong chairman with good foresight and vision and create the next top program.

Do the best you can in school, get the best scores you can, apply broadly, go on interviews, take notes. At the end of the season, see which program fits your personality, preferences, and needs best and make your rank list accordingly. If you prepared well, it is more than likely you will match at the top of your personal strong program list.

I know that programs keep changing...but most of solid programs work to keep the same system and always hire great professors and chairs

 

[neusu]

I know that programs keep changing...but most of solid programs work to keep the same system and always hire great professors and chairs

I agree. Likewise, weaker programs also work to attract great professors and chairmen. Nonetheless, things change. What I meant is think about this flux as you apply. Is the current chairman retiring soon (or old enough he'll suddenly announce it)? Is a weak program that you are dismissive of poised to become great?

 

[deleted393595]

Hi again! I was just wondering whether it's possible to do an additional year of research devoted to residency, and if it is possible as a surgeon to be involved in translational research and device creation.

Haha, I'm quite honored to have a scoring system named after myself. If I recall correctly I was in the 550-600 range.

Boy. I better be hitting my books and the gym once I get to med school so that I match into my first choice.

 

[eatsleepmed]

Hi neusu--

I have a couple questions for you (I apologize if you may have answered them previously)

1. You talk a lot about self selection, do you know how much of that self selection ends up being because of an individual's step 1? (i.e. were there many people that ceased to pursue neurosurg after their step 1 because of a score that was too low?)

2. In your experience what are some characteristics that you think fit well within the neurosurg residency environment.

3. You say that you are currently operating as many as 6+ hours per day as a PGY2. When did you have time in between internship and now to gain knowledge/skills to operate for that long? Would you say that you are using things you also learned in your neurosurg rotations and/or subI's?

Thanks in advance -- this thread is great!

one last thing: on a list of neurosurg residency qualification criteria how important is AOA?

 

[neusu]

Hi neusu--

I have a couple questions for you (I apologize if you may have answered them previously)

1. You talk a lot about self selection, do you know how much of that self selection ends up being because of an individual's step 1? (i.e. were there many people that ceased to pursue neurosurg after their step 1 because of a score that was too low?)

A little of both. We get plenty of people with a high step 1 score who come for a test-drive and plenty of folks with terrible step 1 scores who are absolutely devoted to becoming a neurosurgery. In either case, it will neither assure you a spot nor rule you out entirely, but makes it easier or more difficult should you choose to apply.

2. In your experience what are some characteristics that you think fit well within the neurosurg residency environment.

Neurosurgery is quite a unique field and having a genuine interest in it is fundamental for success in residency. Aside from that, a hard working, independent, team player is generally the mold. Program directors often talk about the story "A Message to Garcia" as the perfect neurosurgery resident. More than most services, neurosurgery has graduated responsibility and necessitates a self-motivated person who can get the job done without being told how or when to do it. Likewise, the team functions as well as each individual allows it to and individual sacrifice for the team makes everyone else's lives easier.

3. You say that you are currently operating as many as 6+ hours per day as a PGY2. When did you have time in between internship and now to gain knowledge/skills to operate for that long? Would you say that you are using things you also learned in your neurosurg rotations and/or subI's?

I'm actually a PGY-4, but I did have days where I operated 6+ hours as a PGY2. Some skills you can teach yourself such as suturing or knot tying. Get some silk ties and suture from the OR and tie knots on your scrubs/steering wheel or sew towels/pigs feet. The OR is not the place to learn to do these things. You, or any M3 interested in any surgical specialty, should work on one and two handed tying, with both hands, as well as simple interrupted, inverted interrupted, vertical/horizontal mattress, running whip, and running subcuticular stitches. Look on youtube for how-to videos. Also, many suture companies will send students free knot tying/suturing kits if you look under the education section.

I did learn to do many things during subIs including lumbar puncture/drain, ventriculostomy, and placing burr holes. Lately, there seems to be a tendency to let students due less due to medicolegal reasons, so ask around about which programs let students get involved. Regardless, no matter where you rotate, it is important to read about the cases prior to showing up for surgery, ask relevant questions to illustrate your understanding of the indication, procedure, operative anatomy, and post-operative course so that the resident and surgeon will want to involve you more in the case.

Read and read. Try to visualize the anatomy before you get there e.g. have xray vision. Know the next step(s), and what issues you may run in to before you get there. These are the kinds of questions you'll be asked and if you know how to answer them, you'll get to do more. in the OR

Thanks in advance -- this thread is great!

one last thing: on a list of neurosurg residency qualification criteria how important is AOA?

From the 2011 Charting Outcomes in the Match ( http://www.nrmp.org/data/chartingoutcomes2011.pdf ) For US seniors there were 44 AOA individuals who matched, 0 with AOA who did not match, 130 non-AOA individuals who matched, and 28 non-AOA who did not match. This suggests AOA is not important to match, but improves your likelihood of matching if you are AOA. From the Program Directors Survey ( http://www.nrmp.org/data/programresultsbyspecialty2012.pdf ) AOA was 3.7 out of 5 for "importance" in ranking, or not very important.

 

[eatsleepmed]

Thanks! That was very helpful! You have given me much to think about !!

 

[neusu]

Hi again! I was just wondering whether it's possible to do an additional year of research devoted to residency, and if it is possible as a surgeon to be involved in translational research and device creation.



Boy. I better be hitting my books and the gym once I get to med school so that I match into my first choice.

Though the new RRC requirements may change this, some places allow for up to 2 years of research time. Translational research is great, and many surgeons are involved. Likewise, many surgeons with bench research interests look for new treatments based on understanding gained in the lab.

 

[def1]

Hey neusu,

this thread has been great and you've already answered some of my questions but I wanted to ask one more.

I am starting in a neuroscience research lab this year. Assuming I get into medical school I will have from now til August to complete a project. I am working on a larger project with the PI, but I want to work on my own individual project. It will involve bench work only. Is there anything interesting that you've heard about in the neuroscience field that would be good for a 4-6 month project for me to work on. The lab I will be working in does mostly work with rat brains, so Im just wondering if you'd have any ideas for a good project dealing with this type of research?

Thanks.

 

[neusu]

Hey neusu,

this thread has been great and you've already answered some of my questions but I wanted to ask one more.

I am starting in a neuroscience research lab this year. Assuming I get into medical school I will have from now til August to complete a project. I am working on a larger project with the PI, but I want to work on my own individual project. It will involve bench work only. Is there anything interesting that you've heard about in the neuroscience field that would be good for a 4-6 month project for me to work on. The lab I will be working in does mostly work with rat brains, so Im just wondering if you'd have any ideas for a good project dealing with this type of research?

Thanks.

Neuroscience is a very broad field. What, in particular, does your lab do with rat brains? Are you studying pathology, physiology, molecular biology, networks and signalling? What techniques do you already know and what is available to you?

 

[def1]

Neuroscience is a very broad field. What, in particular, does your lab do with rat brains? Are you studying pathology, physiology, molecular biology, networks and signalling? What techniques do you already know and what is available to you?

Since I'm just starting the lab, I don't have all the answers. However, I do know that there is a lot of immunocytochemistry work going on. And the PI has done several publications on behavioral changes in rats, such as injecting chemicals or implants into the brains and observing physical changes and molecular changes. Aside form working with live animals, the lab also works with brain slices. Probably molecular biology and networks and signaling would be my guess as whats most common in the lab.

I am going to learn how to do brain slices and the immunocytochemistry next week. So probably a side project involving those two areas would be optimal, studying something in neuroanatomy.

From my previous lab I know most basic biological techniques but this is my first time enter into a neuroscience lab. I wanted to work with pathology research (ie. tumor models, epilepsy, etc.) but I am not sure if that would be out of reach, especially for a 4-6 month project.

Hopefully this gives you enough information to give me a general idea of a type of project I can do.

 

[eatsleepmed]

Since I'm just starting the lab, I don't have all the answers. However, I do know that there is a lot of immunocytochemistry work going on.

This is a pretty common technique in any lab, especially a neuroscience lab. That doesnt really narrow down what your lab does. IHC can be used to answer a multitude of questions. 4-6 mo. on a solo iHC project may be a stretch especially if you are just starting out with it. Protocols for antibodies can be hard to tailor as each may give you optimal staining in a very particular set of conditions. Often you will need to use more than one antibody (double, triple stains) to answer questions about expression, size, density, colocalization,etc, in which case it will be even harder to determine the optimal conditions for numerous primary and secondary antibodies in the same exp.

That being said, if your lab has optimized protocols for their specific antibodies you can save some time. However, fixing, sectioning, staining, imaging are all parts of the type of project that it *sounds* like you will be trained to do...

Anyways... FIRST thing you should do is go do a literature search on the general questions your lab is trying to answer. Find recent papers by your PI and figure out the direction of the lab. Read up on the topic, I am surprised your PI hasnt had you do it already.

pm me if you have more specific ihc, crysosectioning, confocal microcopy q's

just my 2 cents, neusu prob has more advice

 

[def1]

This is a pretty common technique in any lab, especially a neuroscience lab. That doesnt really narrow down what your lab does. IHC can be used to answer a multitude of questions. 4-6 mo. on a solo iHC project may be a stretch especially if you are just starting out with it. Protocols for antibodies can be hard to tailor as each may give you optimal staining in a very particular set of conditions. Often you will need to use more than one antibody (double, triple stains) to answer questions about expression, size, density, colocalization,etc, in which case it will be even harder to determine the optimal conditions for numerous primary and secondary antibodies in the same exp.

That being said, if your lab has optimized protocols for their specific antibodies you can save some time. However, fixing, sectioning, staining, imaging are all parts of the type of project that it *sounds* like you will be trained to do...

Anyways... FIRST thing you should do is go do a literature search on the general questions your lab is trying to answer. Find recent papers by your PI and figure out the direction of the lab. Read up on the topic, I am surprised your PI hasnt had you do it already.

pm me if you have more specific ihc, crysosectioning, confocal microcopy q's

just my 2 cents, neusu prob has more advice

Thanks and yeah I figured IHC would be too broad. Right now I know only what my PI has told me will be the main project I will be doing with him. Basically just neuroanatomy research focusing on different staining techniques. However, the lab is a big university lab so there are many undergrads and grad students who are working on their own projects, so I am not exactly sure what is feasible in this lab yet. I should know more within the next week or so.

I guess what I was basically looking for was just some broad new areas of neuroscience research that I could suggest to my PI and see what is feasible or not feasible, and something that could hopefully be completed in a 4-6 month time frame.

 

[neusu]

This is a pretty common technique in any lab, especially a neuroscience lab. That doesnt really narrow down what your lab does. IHC can be used to answer a multitude of questions. 4-6 mo. on a solo iHC project may be a stretch especially if you are just starting out with it. Protocols for antibodies can be hard to tailor as each may give you optimal staining in a very particular set of conditions. Often you will need to use more than one antibody (double, triple stains) to answer questions about expression, size, density, colocalization,etc, in which case it will be even harder to determine the optimal conditions for numerous primary and secondary antibodies in the same exp.

That being said, if your lab has optimized protocols for their specific antibodies you can save some time. However, fixing, sectioning, staining, imaging are all parts of the type of project that it *sounds* like you will be trained to do...

Anyways... FIRST thing you should do is go do a literature search on the general questions your lab is trying to answer. Find recent papers by your PI and figure out the direction of the lab. Read up on the topic, I am surprised your PI hasnt had you do it already.

pm me if you have more specific ihc, crysosectioning, confocal microcopy q's

just my 2 cents, neusu prob has more advice

I agree, IHC is a broad technique as is studying neuroanatomy a broad topic.

For the most part, eatsleepmed is right that you should search the literature to get an idea of what is going on in fields related to your PI. Depending on how involved and/or level or prior knowledge, one technique that works well here is look at papers put out by your PI, look at the references, and find review papers with similar topics. Then look at papers that cite those papers to get a feel for what's new and exciting. If your lab has postdocs often finding one to mentor you allows you to have a more hands on mentorship experience to develop your research project and guide your experiments so you both look good in front of the PI and stay out of his hair.

Feel free to PM me if you can share more in depth as to what the lab is studying or have questions about particular assays.

 

[MxSebas]

just wanted to say how helpful this thread is for the next cycle of aspiring surgeons. I'm starting M1 in August (c/o 2017) and this is a dope resource. thanks, neusu.

 

[Dick Jones]

For the MSSRF, we have to find our own members of the AANS. Would you happen to know where this would be listed?

 

[neusu]

just wanted to say how helpful this thread is for the next cycle of aspiring surgeons. I'm starting M1 in August (c/o 2017) and this is a dope resource. thanks, neusu.

Thanks! Glad I can help. Let me know if there's anything I can do for you.

 

[neusu]

For the MSSRF, we have to find our own members of the AANS. Would you happen to know where this would be listed?

There is a membership directory, but that's for members. Most faculty at academic institutions are members. The MSSRF ( http://www.aans.org/Grants and Fellowships/Medical Students Summer Research Opportunities.aspx ) is a great program and anyone interested in neurosurgery should consider applying.

 

[neusu]

So I'm assuming places like JHU and MGH pretty much require that extra year?

Not at all. Many students are successful at getting involved in basic science or clinical research and have a number of publications ready by the time applications roll around. A year off would add to this, but is unnecessary if you can be efficient and productive. Alternatively, an MD/PhD allows for a fair amount of research experience and, typically, covers the cost of medical school/pays a stipend.

 

[wlt217]

Thanks for all your insight; it's exciting to think about a career in neurosurgery even if I don't end up being able to pursue it. Hopefully you don't mind me reviving this thread, and don't feel any obligation to continue maintaining it.

You've said you first took interest in neurosurgery when you were an undergraduate. I'm wondering how did this affect the courses you took, research you engaged in, and any extracurricular reading you did. Or how did your interest otherwise manifest itself? Is it ever too early to start studying neuroanatomy? I know it's important to keep up with each step of my education, but is it a waste of time for me to read material that's over my head?

I'm actually opting not to take the neurobiology course offered by my school, and instead planning to take physical chemistry (there's a scheduling conflict between the two). I'm also planning to take several physics classes: waves and optics, quantum mechanics, as well as pre-req's. Is this completely nonconsequential? I guess I should rest assured that these are classes I'm interested in, but at the same time I'd like to not miss out on anything that could be particularly helpful in the future.

 

[Midifelder10]

You may have answered it before so let me ask couple of questions.

(1) If you have to give any advise to a pre-med what would it be.
(2) What is the main reason of your success, hard work, natural intelligence, combination or something else.

 

[neusu]

Thanks for all your insight; it's exciting to think about a career in neurosurgery even if I don't end up being able to pursue it. Hopefully you don't mind me reviving this thread, and don't feel any obligation to continue maintaining it.

You've said you first took interest in neurosurgery when you were an undergraduate. I'm wondering how did this affect the courses you took, research you engaged in, and any extracurricular reading you did. Or how did your interest otherwise manifest itself? Is it ever too early to start studying neuroanatomy? I know it's important to keep up with each step of my education, but is it a waste of time for me to read material that's over my head?

I'm actually opting not to take the neurobiology course offered by my school, and instead planning to take physical chemistry (there's a scheduling conflict between the two). I'm also planning to take several physics classes: waves and optics, quantum mechanics, as well as pre-req's. Is this completely nonconsequential? I guess I should rest assured that these are classes I'm interested in, but at the same time I'd like to not miss out on anything that could be particularly helpful in the future.

Thanks for the question. As an undergraduate, the coursework and research interests I had did not really deviate much, however they helped foster exposure to and interest in neuroscience and more specifically neurosurgery. I wouldn't be too worried regarding class choices as an undergraduate. Most of the topics covered, even in upper level classes, aren't in enough detail to have a strong understanding of the topics and require significant further study. Nonetheless, there are a lot of concepts, both in neurobiology/neuroscience and chemistry/physics that are fundamental and are useful to understand.

For what its worth, neuroscience is an exceptionally broad field and encompasses anything from physical chemistry of membrane potentials and protein folding/scaffolding interactions to psychology of why we do what we do to population health studies.

I'd say do what you are interested in and makes you happiest, the rest will fall in to place as you move along.

 

[Sophocles]

Thanks for the question. As an undergraduate, the coursework and research interests I had did not really deviate much, however they helped foster exposure to and interest in neuroscience and more specifically neurosurgery. I wouldn't be too worried regarding class choices as an undergraduate. Most of the topics covered, even in upper level classes, aren't in enough detail to have a strong understanding of the topics and require significant further study. Nonetheless, there are a lot of concepts, both in neurobiology/neuroscience and chemistry/physics that are fundamental and are useful to understand.

For what its worth, neuroscience is an exceptionally broad field and encompasses anything from physical chemistry of membrane potentials and protein folding/scaffolding interactions to psychology of why we do what we do to population health studies.

I'd say do what you are interested in and makes you happiest, the rest will fall in to place as you move along.

I'm glad you're still answering questions. I'm sure this has been asked but I couldn't find the answer.

When do you have time to publish in medical school? Is it only in your first two years? What if a school has a 1.5 yr curriculum, would you suggest that a person deviate from those schools in order to have more time to spend in research so that he can try to get more publications?

Lastly, I didn't apply MD/PhD but I have been accepted to a few programs that have alternate pathways. I'm an older student and would like to consolidate my time as much as possible. Would you suggest trying to get your PhD in your residency or in medical school (considering that neurosurgeons make enough that the debt incurred wouldn't be a deciding factor)? Before you ask, I would like to get my PhD because I would like to concentrate on an academic career that would allow me to have my own lab, running my own experiments, and would allow me to have more flexibility when it comes to writing grants. Sorry this is long and if it's dumb-just a naive premed here.

 

[neusu]

You may have answered it before so let me ask couple of questions.

(1) If you have to give any advise to a pre-med what would it be.
(2) What is the main reason of your success, hard work, natural intelligence, combination or something else.

1) Do the best you can, set realistic goals, keep your priorities straight, and have a life outside of school.

It is far to easy to get sucked in and not see the forest through the trees of the next exam, applications due, isolating culture of medicine and medical education.

Likewise, try not to be so neurotic with respect to needing to get the best x or y. There are plenty of kids from the 100th out of 100 medical school who end up at the #1 most competitive residency of their choice and plenty of kids at the #1 medical school who fail out, don't match, or are just plain unhappy.

Life is long enough without making it miserable for yourself along the way stressing such inconsequential things.

2) For me in particular it was a combination of hard work, natural gifts, and persistence. A strong work ethic is hard to learn. Coming early, staying late, being available and getting the job done is a big part of life, and feeling the need to put yourself in that position helps set up opportunities for learning and being involved in things.

Knowing what to do when, and how to do it helps, but without a strong work ethic will get you no where.

Most of all though, seeing setbacks as temporary limitations or a new challenge instead of an endgame, and continuing until the job is done keeps efforts from being wasted. I had plenty of friends who did not get in to medical school their first try who gave up, and plenty who did what they needed and reapplied and got in. Same thing goes for residency applications. I have friends who applied for plastics, derm, ortho, ent, even neuro who did not get it but kept at it and eventually got what they wanted.

 

[Anigma07]

Do you drink coffee/energy drinks? How many cups a day?

 

[Midifelder10]

1) Do the best you can, set realistic goals, keep your priorities straight, and have a life outside of school.

It is far to easy to get sucked in and not see the forest through the trees of the next exam, applications due, isolating culture of medicine and medical education.

Likewise, try not to be so neurotic with respect to needing to get the best x or y. There are plenty of kids from the 100th out of 100 medical school who end up at the #1 most competitive residency of their choice and plenty of kids at the #1 medical school who fail out, don't match, or are just plain unhappy.

Life is long enough without making it miserable for yourself along the way stressing such inconsequential things.

2) For me in particular it was a combination of hard work, natural gifts, and persistence. A strong work ethic is hard to learn. Coming early, staying late, being available and getting the job done is a big part of life, and feeling the need to put yourself in that position helps set up opportunities for learning and being involved in things.

Knowing what to do when, and how to do it helps, but without a strong work ethic will get you no where.

Most of all though, seeing setbacks as temporary limitations or a new challenge instead of an endgame, and continuing until the job is done keeps efforts from being wasted. I had plenty of friends who did not get in to medical school their first try who gave up, and plenty who did what they needed and reapplied and got in. Same thing goes for residency applications. I have friends who applied for plastics, derm, ortho, ent, even neuro who did not get it but kept at it and eventually got what they wanted.

Thanks and good luck! You mean well and I always learn something from people who have honest advise to offer.

 

[Sidereum]

Do you think it would be possible, as an attending, to work somewhere in the range of 60 hours a week? I know that would definitely be on the low end for neurosurgeons, but I'm very interested in this field, and I don't think I would mind the 80 hours/week during training, but I imagine I would want to have enough time for a family during my late 30s and 40s.

I realize lifestyle questions have been asked before, but I'm curious as to what the actual ranges are for fully trained neurosurgeons, and I can't seem to find actual data on this.

 

[Trisphorin]

As a student with an interest in surgery and possibly neurosurgery, I always wonders what it felt like after you have done your first surgical case or neurosurgical case. What was your role in those cases during your clinical rotation in medical school, and now in residency? I have heard that medical student was allowed to make the first incision while on neurosurgery rotation.

Also, during your internship year, how did you deal with being on-call at night alone while not knowing too much about this field? During your first couple of months in your intern year, you are on-call quite often but at the same time but you are only on this job for a very short time. It must be very challenging to treat patient with the limited experience you have.

Thank you for your time!

 

[MxSebas]

As a student with an interest in surgery and possibly neurosurgery, I always wonders what it felt like after you have done your first surgical case or neurosurgical case. What was your role in those cases during your clinical rotation in medical school, and now in residency? I have heard that medical student was allowed to make the first incision while on neurosurgery rotation.

Also, during your internship year, how did you deal with being on-call at night alone while not knowing too much about this field? During your first couple of months in your intern year, you are on-call quite often but at the same time but you are only on this job for a very short time. It must be very challenging to treat patient with the limited experience you have.

Thank you for your time!

just to piggyback on this,

I keep hearing about how crazy the neurosurgery "lifestyle" is. could you touch on this for both residents and attendings?

 

[Status Sciaticus]

how old will you be when you finish residency and become an attending physician?

 

[neusu]

I'm glad you're still answering questions. I'm sure this has been asked but I couldn't find the answer.

When do you have time to publish in medical school? Is it only in your first two years? What if a school has a 1.5 yr curriculum, would you suggest that a person deviate from those schools in order to have more time to spend in research so that he can try to get more publications?

Lastly, I didn't apply MD/PhD but I have been accepted to a few programs that have alternate pathways. I'm an older student and would like to consolidate my time as much as possible. Would you suggest trying to get your PhD in your residency or in medical school (considering that neurosurgeons make enough that the debt incurred wouldn't be a deciding factor)? Before you ask, I would like to get my PhD because I would like to concentrate on an academic career that would allow me to have my own lab, running my own experiments, and would allow me to have more flexibility when it comes to writing grants. Sorry this is long and if it's dumb-just a naive premed here.

Finding time to work on studies in medical school can be difficult, even more so for basic science where significant bench work is often involved. That being said, there is typically 3 months between 1st and 2nd year that can be used for initiating or continuing a project. Having ongoing projects though lets you work on them periodically, when time permits, and publish papers along the way.

Getting a PhD before or during medical school makes the most sense and often offsets costs of education. Extending residency may be possible, but as you stated would have an impact on future income. As an MD, you can apply for grants and run your own laboratory without a PhD. Some people pursue a post-doctoral position in research before or after residency to increase their research exposure/experience.

 

[LiamNeesons]

Great thread. Thanks for your time.

 

[neusu]

Do you drink coffee/energy drinks? How many cups a day?

I'll usually have a coffee in the morning. I have tried energy drinks before but am not a fan of sugary drinks. Most days I'll only have the cup in the morning, some days not even that.

 

[neusu]

Do you think it would be possible, as an attending, to work somewhere in the range of 60 hours a week? I know that would definitely be on the low end for neurosurgeons, but I'm very interested in this field, and I don't think I would mind the 80 hours/week during training, but I imagine I would want to have enough time for a family during my late 30s and 40s.

I realize lifestyle questions have been asked before, but I'm curious as to what the actual ranges are for fully trained neurosurgeons, and I can't seem to find actual data on this.

It certainly is possible. Like any career in medicine, you can build the job you want if you are willing to make other sacrifices. Most neurosurgeons tend to work more than 60 hours/week and be driven to pursue that kind of lifestyle. The old joke about where do you hide a dollar from a doctor, for neurosurgery was "with his family" or "give it to his son." This may not ring as true anymore. That being said, if you are willing to sacrifice income, practice privileges, and/or location, a practice with 60 hours a week (or less) should be achievable.

 

[Darrka]

In.

Question: Do you ever feel that your relationships suffer as a result of your elite career? Although being a neurosurgery resident is not comparable to me being a pre-medical student, I often times feel that relatives, and sometimes immediate family members, are offended that I am pursuing surgery as a career while the rest of them got/are in pursuit of 4 year degree's at community colleges (I know it sounds like I am talking those types of degrees down, but I am not, nor would I ever judge someones choice in a career besides acting.)

Do you ever feel as if people dislike you because they feel inferior to you?

How do you respond to this? Do you care?

 

[as1212559]

I could imagine people disliking someone who touts the fact that they are pursuing an 'elite' career.

 

[neusu]

As a student with an interest in surgery and possibly neurosurgery, I always wonders what it felt like after you have done your first surgical case or neurosurgical case. What was your role in those cases during your clinical rotation in medical school, and now in residency? I have heard that medical student was allowed to make the first incision while on neurosurgery rotation.

Also, during your internship year, how did you deal with being on-call at night alone while not knowing too much about this field? During your first couple of months in your intern year, you are on-call quite often but at the same time but you are only on this job for a very short time. It must be very challenging to treat patient with the limited experience you have.

Thank you for your time!

The first case I was involved in was during my M1 year, I was shadowing a neurosurgeon and he let me scrub in and assist. The M3 on the rotation at the time had no interest in surgery and was more than happy to let me take his place in the OR assisting. As a subI during my 4th year I scrubbed on cases every day and the residents or attendings let me make incisions, put in burr holes, do lumbar punctures, or extraventricular drains. As a student often the role is watching and helping if possible, but mostly staying out of the way. The surgeons let you do something small and safe. As a resident it is graded responsibility. At first it's like being a medical student, but as things go along you become increasingly responsible for things. At this point in my training I can do less complex surgeries on my own and the attending scrubs to help or check on things. For more complex surgeries I do what I am able and comfortable with and the attending helps with or completes the critical portion.

My year was the last year that did a traditional general surgery internship. There is always someone more senior available to run things by, but it takes a lot of self motivation to figure out both what is wrong and what to do about it. It was a very big challenge, but all doctors go through it and rise to the occasion.

 

[Darrka]

I could imagine people disliking someone who touts the fact that they are pursuing an 'elite' career.

Me too, but I don't do this. Asking about people who are offended or made to feel interior of their own accord, without the doctor/potential doctor elevating themselves.

Sent from my SPH-L710 using Tapatalk 2

 

[HeartArtist]

Do you know your child's name?

HAHAHA! I was gonna ask how many people he's killed, but this is much better!

 

[mcloaf]

HAHAHA! I was gonna ask how many people he's killed, but this is much better!

Always refreshing to see people take full advantage of a Nsurg resident freely donating his time to help out premeds.

Grow up.

 

[MedPR]

Is it true that you work 80 hours per week for all 7 years of residency?