CHAPTER 3: ABOUT BRAIN SURGEONS
Brain surgeons, or neurosurgeons, are physicians who have specialized in the practice of brain surgery, or neurosurgery. After completing medical school, certain individuals apply for and are selected in neurosurgical training programs. These physicians thereby become neurosurgery “residents”, or neurosurgical “trainees” or “registrars”, depending on the country in which they are trained.
Neurosurgery is one of the most intricate and challenging fields of medicine to learn and practice. Owing to the highly “emergent” nature of many brain disorders, the field of neurosurgery demands an extraordinary level of personal commitment to patient care.
Formal training programs vary in their length, but in the U.S., such programs are typically 7 years. The final year of neurosurgical residency training is referred to as the Chief Resident Year in the U.S. This is still a supervised but also more autonomous and critical year that serves as a bridge between being a neurosurgery resident-trainee and a consultant neurosurgeon. At the completion of his or her training, a neurosurgeon can elect to do one or more Fellowships, or none.
A Fellowship is a period of time that an individual spends learning and practicing one or more particular areas of neurosurgery in greater depth. A Fellow usually travels to another institution for a year or so to acquire certain skills under a more experienced colleague. This process is known as subspecialization.
Neurosurgery fellowships include the following:
· Pediatric: Specializing in the treatment of neurosurgical disorders affecting children. This type of neurosurgeon is referred to as a pediatric neurosurgeon.
· Cerebrovascular and skull base: Specializing in the open surgical treatment of brain blood vessel disorders such as brain aneurysms, arteriovenous malformations (AVM), and cavernous malformations and of complex tumors occurring at the base of the skull. This type of neurosurgeon is referred to as a cerebrovascular and skull base microneurosurgeon.
· Endovascular: Specializing in the treatment of brain disorders through catheter-based techniques, i.e., not through open surgery. This type of neurosurgeon is referred to as an endovascular neurosurgeon. Some endovascular neurosurgeons practice both catheter-based and open surgical techniques.
· Spine: Specializing in the treatment of disorders of the spine and spinal cord. This type of neurosurgeon is referred to as a spinal neurosurgeon.
· Stereotactic radiosurgery: Specializing in the treatment of CNS disorders through focused radiation using equipment such as Gammaknife®, Linear accelerator or Linac, Cyberknife®, and so forth. This type of neurosurgeon is referred to as a stereotactic radiosurgeon.
· Other fellowships include those in epilepsy, peripheral nerve, oncology or CNS tumor treatment, functional or CNS stimulator use, and neuroendoscopy or microtelescope use within the CNS. There are a variety of basic sciences and clinical research fellowships as well, that may be incorporated into any of the above.
