04-08-2024, 02:20 AM
I'm an MD/PhD considering a career in functional neurosurgery. My interest primarily stems from the recent advances in functional neurosurgery especially for things like DBS, focused ultrasound, and gene therapy. Functional really seems to be at the forefront of therapeutic advancement in these fields.I'm particularly inspired by some of the gene therapy programs at places like Ohio State (Dr. Bankiewicz, Dr. Lonser), Arizona (Dr. Paul Larson), UCSF, and Cornell (Dr. Kaplitt), which are all propelled forward by neurosurgeons. I totally realize gene therapy is in its infancy but I think it will be much further along 1- years from now and ripe for further advancement and implementation by the time I am done.
My background is in biomedical engineering and I ultimately envision a career where I treat neurodegenerative and genetic diseases. I initially thought about pursuing this route as a neurologist but it seems it's really the neurosurgeons who are driving innovations in treatment delivery. It's not the only reason I would consider NSG over neuro (I also really liked the OR including procedures "tangential" to my core interests like tumor removal and neurotrauma, working with my hands, etc). I want to be in a role where I am implementing the treatments rather than only doing the pre-op/post-op evaluations (which I assume is the responsibility of the collaborative neurologist in these procedures).
- What are your thoughts on the future stake of functional neurosurgeons in these procedures, especially as there is an emphasis on minimal or non-invasive procedures. Do you think it will be possible for neurologists to get more involved and perhaps even drive focused ultrasound procedures and gene therapy programs in the next 10-20 years or will it likely remain the domain of neurosurgeons. I was at one point considering neurointerventional IR through the neurology route and am wondering whether a similar turf war may brew as neurologists get involved in some of the more "minimally" invasive procedures.
- I keep hearing mixed reviews about enveloped fellowships. As an MD/PhD, my route is already pretty long and while I think I am fine with a 7 year residency that includes an enveloped fellowship, the thought of doing another 1-2 years afterwards does honestly deter me from pursuing this path. I read a few posts saying that enveloped fellowships are on the way out but I've primarily seen this stated for spine, skull base, and endovasc. Is there a similar outlook for functional?
- While there is a strong stigma against successful surgeon-scientists, it does seem like functional neurosurgery is the one space where neurosurgeons appear to have consistent success. In addition to the examples I mentioned above, it seems like there are more who run basic science labs, particularly in neurocircuitry and mechanisms of epilepsy.
OP here. One additional question I wanted to ask is what does the life of a functional neurosurgeon look like? I was having a hard time finding this online but did talk to a few mentors and from the ones I talked to it seems like it's relatively chill especially if you're doing research. The procedures are more elective, so can be planned in advance and depending on the institution, you can limit time on call. A lot of that extra time seems to then be used to write grants and do research.
I only talked to two functional neurosurgeons so I'm hoping to get a more general perspective.
My background is in biomedical engineering and I ultimately envision a career where I treat neurodegenerative and genetic diseases. I initially thought about pursuing this route as a neurologist but it seems it's really the neurosurgeons who are driving innovations in treatment delivery. It's not the only reason I would consider NSG over neuro (I also really liked the OR including procedures "tangential" to my core interests like tumor removal and neurotrauma, working with my hands, etc). I want to be in a role where I am implementing the treatments rather than only doing the pre-op/post-op evaluations (which I assume is the responsibility of the collaborative neurologist in these procedures).
- What are your thoughts on the future stake of functional neurosurgeons in these procedures, especially as there is an emphasis on minimal or non-invasive procedures. Do you think it will be possible for neurologists to get more involved and perhaps even drive focused ultrasound procedures and gene therapy programs in the next 10-20 years or will it likely remain the domain of neurosurgeons. I was at one point considering neurointerventional IR through the neurology route and am wondering whether a similar turf war may brew as neurologists get involved in some of the more "minimally" invasive procedures.
- I keep hearing mixed reviews about enveloped fellowships. As an MD/PhD, my route is already pretty long and while I think I am fine with a 7 year residency that includes an enveloped fellowship, the thought of doing another 1-2 years afterwards does honestly deter me from pursuing this path. I read a few posts saying that enveloped fellowships are on the way out but I've primarily seen this stated for spine, skull base, and endovasc. Is there a similar outlook for functional?
- While there is a strong stigma against successful surgeon-scientists, it does seem like functional neurosurgery is the one space where neurosurgeons appear to have consistent success. In addition to the examples I mentioned above, it seems like there are more who run basic science labs, particularly in neurocircuitry and mechanisms of epilepsy.
OP here. One additional question I wanted to ask is what does the life of a functional neurosurgeon look like? I was having a hard time finding this online but did talk to a few mentors and from the ones I talked to it seems like it's relatively chill especially if you're doing research. The procedures are more elective, so can be planned in advance and depending on the institution, you can limit time on call. A lot of that extra time seems to then be used to write grants and do research.
I only talked to two functional neurosurgeons so I'm hoping to get a more general perspective.
