So, you want to be an academic neurosurgeon, well here are some suggestions. First, reflect on your reasons for going into academic neurosurgery. There are several common ones. Some want to do great clinical cases and see an academic career as the way to accomplish this. This is not a great reason to go into academics. Remember you have only seen academic neurosurgery in action. There are many private practice situations in which you can focus on a specific area of neurosurgery and develop a great clinical practice. Because there are fewer distractions from clinical practice building, it may well happen faster than it does in academic practice. The desire to teach is a noble goal and most neurosurgeons think they can be great teachers. In many programs, full-time academic neurosurgeons can focus on education as their primary academic activity. However, if it is to be the basis for advancement, it generally requires a significant amount of scholarly work, developing curricula, teaching labs, and simulators, and writing scholarly papers about educational methodology. Many programs have affiliated private practices in which residents rotate. If teaching residents without the associated scholarly activity is what you want to do, such a situation may be a better choice. In all cases, you need to be pretty sure that the extra time required for resident teaching in and outside of the OR won't feel like a burden. Also be sure that helping residents operate rather than just showing them how you do it is something you can comfortably do. Scholarly activity is the fundamental thing that separates academic from private practice. Advancement in academic life depends on it. Fortunately, most medical schools have a good deal of flexibility in defining areas of scholarly activity that can be the basis for academic advancement. We have already discussed a focus on education and educational methodology. Many schools have a clinical track, sometimes called Master Clinician, for those whose primary focus is clinical neurosurgery. In most cases, it is expected that neurosurgeons on this track will collaborate in clinical research studies, do clinical and didactic teaching, and publish, at least as a co-author, case reports, case series, and reviews. The discipline of systematic review has added validity to this type of publication for this academic track. Research, of course, first comes to mind when thinking about an academic career. This can be basic neuroscience research, although it's becoming increasingly difficult to combine an active clinical practice, clinical teaching, and a research career that is competitive for national funding. To do so usually means limiting clinical practice to some degree. Other forms of research have real academic credibility. Quality and safety research, clinical epidemiology, the science of innovation, such as device development or design and validation of new operations, and bioinformatics are examples of legitimate research tracks, so long as they are acceptable to your department chair in the medical school. The key to academic success is to understand what scholarly activity really excites you, have that track in mind, set clear goals, and make them your mission. If you can convey that to your prospective department chair, you will have the best chance of obtaining a position that will allow and help you to succeed. Neurosurgery residency is long and hard. It is not focused on your academic career. For those with scholarly skills developed before residency, it can be a detour that puts you behind the non-clinical academics in your area of academic activity. You need to find ways to take advantage of opportunities during residency to further First, learn to be an excellent general neurosurgeon. No academic program should be interested in you if you are not a well-qualified general neurosurgeon. If you find that developing and maintaining the knowledge and skill necessary to accomplish this leaves no time for scholarly activity, you will find academic career opportunities difficult and ultimately unsatisfying. If possible, develop special expertise in the subspecialty you plan to pursue. You won't necessarily know this at the start of residency. It can be as informal as extra reading and choosing a mentor in that subspecialty who can provide some opportunities and recommendations. Most academic departments have some degree of subspecialization and it helps to be able to demonstrate some special interest, knowledge, and skill. Acquire some expertise in the area of scholarly activity you want to pursue. It is very difficult to either obtain an academic position or succeed in it if you start as a blank slate. The area of scholarly interest you want to pursue need not necessarily be officially recognized by organized neurosurgery. For example, the application of artificial intelligence to neurosurgical diagnosis has no official status but is potentially applicable to all of neurosurgery. You will be much better positioned to get a job where this is your focus of scholarly activity if you are a well-qualified neurosurgeon. Get a job where this is your focus of scholarly activity if you can present evidence that you have some expertise in the area. In summary, find ways during residency that allow you to offer something unique to your prospective employers. Provide the possibility that your expertise will add importantly to the program you join. It may be a completely new area of inquiry or strengthen an existing group in that program. Choose your fellowship or fellowships with care. Most applicants for academic positions will be pursuing one or more fellowships. Your fellowships should enhance the knowledge and skills that you will focus on in your academic position. Fellowship can strengthen an important area for which there wasn't time in residency. A research fellowship can strengthen your applications and help you catch up with your scientific community. Don't be afraid to take more than one fellowship if it helps you reach your goals. Consider whether an advanced degree will help you reach those goals. This is one area where the Van Wagenen Fellowship can offer a very special opportunity. The fellowship is designed by the fellow who picks an area of interest, identifies a mentor from outside of North America, and serves for a year under that mentor at no cost to the mentor or the mentor's institution. This is the ideal fellowship to prepare you for developing an innovative contribution to neurosurgery. There is no fixed topic, no defined list of potential mentors. It is the innovative content and quality of the application that determines the award. Don't rely on published ads for these positions, usually they don't appear until candidates have already been identified. You need to find available jobs before they are listed. Use everyone you can find. Obviously your faculty and chair should be prime resources. Other residents may hear about openings from many sources. Medical school classmates are probably widely distributed throughout the country and may have inside knowledge about openings. Your research collaborators can help identify programs that may be looking for a neurosurgeon with your research interest. Others who are focused on the academic track you want to follow can be helpful. Neurosurgeons you may have met at meetings or after giving presentations may remain interested and helpful. And I suspect that there are internet resources of which I am not aware. Deeply research the possible positions you find. Learn as much as possible about the institution, the program, and the faculty as you can. Decide how you can enhance their program. Share your goals, the preparations you have made, how your area of expertise and scholarly activity will enhance that program. Tell them how you offer something unique and special, and how you will help them make their program even better than it is. Your goal is to find the best fit between yourself and a program. It is better not to take a position at a program that is not a good fit. So now you have an offer. Read it carefully. If there's nothing to read, ask for it in writing. If your first question is about salary and benefits, you should be looking at private practice jobs. Remember, this is always a negotiation. Many offers are not made officially until several drafts have been evaluated and revised. Nobody gets the offer right the first time. You need to do some research before responding. Be prepared with a list of resources that you need to have a good chance of succeeding in your scholarly contribution. Similarly, if there are things you will need for your planned clinical practice, have a researched list of what is needed ready. 3. Understand as deeply as possible what resources other faculty have and how they develop them. If everyone has a PA or NP, it's reasonable to expect that kind of support. If no one does, don't ask. Have a good idea of your lowest acceptable offer, but don't start there or reveal it early in the negotiation. Be sure that performance expectations are clear for both you and your prospective employer. Believe that you can meet those expectations with the offered resources. And it's never a bad idea to have a contract lawyer help you evaluate offers.

academic neurosurgeons

motivations

clinical cases

private practice settings

teaching

scholarly work