Academic literature on the topic 'Chair of Neurosurgery'

It is not possible to capture all the depth that composes Dr. Linda Liau: chair of the Neurosurgery Department at the University of California, Los Angeles; second woman to chair a neurosurgery program in the United States; first woman to chair the American Board of Neurological Surgery; first woman president of the Western Neurosurgical Society; and one of only a handful of neurosurgeons elected to the National Academy of Medicine. Her childhood and family history alone could fascinate several chapters of her life’s biography. Nonetheless, this brief biography hopes to capture the challenges, triumphs, cultural norms, and spirit that have shaped Dr. Liau’s experience as a successful leader, scientist, and neurosurgeon. This is a rare story. It describes the rise of not only an immigrant within neurosurgery—not unlike other giants in the field, Drs. Robert Spetzler, Jacques Marcos, Ossama Al-Mefty, and a handful of other contemporaries—but also another type of minority in neurosurgery: a woman.

This article is dedicated to the 20th anniversary of the establishment, on November 25, 1999, of the Department of Neurosurgery of the State University of Medicine and Pharmacy „Nicolae Testemitanu” (Republic of Moldova). During these two decades, neurosurgery was not only established as a field of indigenous medical research and practice, but it has also developed fruitfully, currently going through three development stages. The first stage refers to the establishing of Neurosurgery in our country. With the help of neurosurgeons Zahar Sosonkin, Abram Cuciuc, Mina Lia Bondareţ, in year 1953, there has been founded the Neurosurgery Section, as part of the Republican Clinical Hospital of Psychiatry, being located in Costiujeni and counting 40 beds. In 1960, there was created the Chair of Neurology, Neurosurgery and Medical Genetics of the State Institute of Medicine from Chisinau. The second stage is characterized by the separation of Neurology and Neurosurgery branch from the Clinical Psychiatric Hospital, after putting into service of the first hospital block (in year 1960) on 48 Lomonosov Street (currently Korolenko, 2, INN) from Chisinau. In 1963, we can observe the definitive „separation” and the establishment of the Neurosurgery subsidiary of the Republican Clinical Hospital. The third stage starts in year 1999, together with the creation of the Department of Neurosurgery within the ”Nicolae Testemitanu” State University of Medicine and Pharmacy, a fact that remarkably boosted the field: in 2005, the Institute of Neurology and Neurosurgery (INN) has been established. During these 20 years of activity, with the contribution of the Neurosurgery Department, there has been implemented a variety of new treatment methods and procedures. In 2001, there has been founded the Association of Neurosurgeons of the Republic of Moldova (ANM), member of (EANS) and WFNS). In year 2000, the second clinical base of the Neurosurgery Department of the Institute of Scientific Research in the Field of Protection of Mother and Child Health has been created; in 2014 – the third clinical base of the Department within the Republican Clinical Hospital. The Department has already trained 7 generations of neurosurgical residents who are currently working in local clinics and abroad. Over the last few years, in Chisinau, more than 20 international scientific forums have been successfully organized.

OBJECTIVEThe position of neurosurgery department chair undergoes constant evolution as the health care landscape changes. The authors’ aim in this paper was to characterize career attributes of neurosurgery department chairs in order to define temporal trends in qualities being sought in neurosurgical leaders. Specifically, they investigated the hypothesis that increased qualifications in the form of additional advanced degrees and research acumen are becoming more common in recently hired chairs, possibly related to the increased complexity of their role.METHODSThe authors performed a retrospective study in which they collected data on 105 neurosurgeons who were neurosurgery department chairs as of December 31, 2016, at accredited academic institutions with a neurosurgery residency program in the United States. Descriptive data on the career of neurosurgery chairs, such as the residency program attended, primary subspecialty focus, and age at which they accepted their position as chair, were collected.RESULTSThe median age and number of years in practice postresidency of neurosurgery chairs on acceptance of the position were 47 years (range 36–63 years) and 14 years (range 6–33 years), respectively, and 87% (n = 91) were first-time chairs. The median duration that chairs had been holding their positions as of December 31, 2016, was 10 years (range 1–34 years). The most common subspecialties were vascular (35%) and tumor/skull base (27%), although the tendency to hire from these specialties diminished over time (p = 0.02). More recently hired chairs were more likely to be older (p = 0.02), have more publications (p = 0.007), and have higher h-indices (p < 0.001) at the time of hire. Prior to being named chair, 13% (n = 14) had a PhD, 4% (n = 4) had an MBA, and 23% (n = 24) were awarded a National Institutes of Health R01 grant, tendencies that were stable over time (p = 0.09–0.23), although when additional degrees were analyzed as a binary variable, chairs hired in 2010 or after were more likely to have an MBA and/or PhD versus those hired before 2010 (26% vs 10%, p = 0.04). The 3 most common residency programs attended by the neurosurgery chairs were Massachusetts General Hospital (n = 8, 8%), University of California, San Francisco (n = 8, 8%), and University of Michigan (n = 6, 6%). Most chairs (n = 63, 61%) attended residency at the institution and/or were staff at the institution before they were named chair, a tendency that persisted over time (p = 0.86).CONCLUSIONSMost neurosurgery department chairs matriculated into the position before the age of 50 years and, despite selection processes usually involving a national search, most chairs had a previous affiliation with the department, a phenomenon that has been relatively stable over time. In recent years, a large increase has occurred in the proportion of chairs with additional advanced degrees and more extensive research experience, underscoring how neurosurgical leadership has come to require scientific skills and the ability to procure grants, as well as the financial skills needed to navigate the ever-changing financial health care landscape.

Preface The leadership of Women in Neurosurgery (WINS) has been asked by the Board of Directors of the American Association of Neurological Surgeons (AANS) to compose a white paper on the recruitment and retention of female neurosurgical residents and practitioners. Introduction Neurosurgery must attract the best and the brightest. Women now constitute a larger percentage of medical school classes than men, representing approximately 60% of each graduating medical school class. Neurosurgery is facing a potential crisis in the US workforce pipeline, with the number of neurosurgeons in the US (per capita) decreasing. Women in the Neurosurgery Workforce The number of women entering neurosurgery training programs and the number of board-certified female neurosurgeons is not increasing. Personal anecdotes demonstrating gender inequity abound among female neurosurgeons at every level of training and career development. Gender inequity exists in neurosurgery training programs, in the neurosurgery workplace, and within organized neurosurgery. Obstacles The consistently low numbers of women in neurosurgery training programs and in the workplace results in a dearth of female role models for the mentoring of residents and junior faculty/practitioners. This lack of guidance contributes to perpetuation of barriers to women considering careers in neurosurgery, and to the lack of professional advancement experienced by women already in the field. There is ample evidence that mentors and role models play a critical role in the training and retention of women faculty within academic medicine. The absence of a critical mass of female neurosurgeons in academic medicine may serve as a deterrent to female medical students deciding whether or not to pursue careers in neurosurgery. There is limited exposure to neurosurgery during medical school. Medical students have concerns regarding gender inequities (acceptance into residency, salaries, promotion, and achieving leadership positions). Gender inequity in academic medicine is not unique to neurosurgery; nonetheless, promotion to full professor, to neurosurgery department chair, or to a national leadership position is exceedingly rare within neurosurgery. Bright, competent, committed female neurosurgeons exist in the workforce, yet they are not being promoted in numbers comparable to their male counterparts. No female neurosurgeon has ever been president of the AANS, Congress of Neurological Surgeons, or Society of Neurological Surgeons (SNS), or chair of the American Board of Neurological Surgery (ABNS). No female neurosurgeon has even been on the ABNS or the Neurological Surgery Residency Review Committee and, until this year, no more than 2 women have simultaneously been members of the SNS. Gender inequity serves as a barrier to the advancement of women within both academic and community-based neurosurgery. Strategic Approach to Address Issues Identified. To overcome the issues identified above, the authors recommend that the AANS join WINS in implementing a strategic plan, as follows: 1) Characterize the barriers. 2) Identify and eliminate discriminatory practices in the recruitment of medical students, in the training of residents, and in the hiring and advancement of neurosurgeons. 3) Promote women into leadership positions within organized neurosurgery. 4) Foster the development of female neurosurgeon role models by the training and promotion of competent, enthusiastic, female trainees and surgeons.

Kenneth McKenzie arrived in Toronto in 1923, bringing with him the legacy of being the first neurosurgeon in Canada. Since then,Toronto has established itself as the hub of Canadian neurosurgery, in both volumes of cases, the strength of trainees, as well asresearch output (1). As one of the largest training programs in North America (2), Toronto has had ongoing international connections,chiefly through the fellowship programs within our division. However, to our recollection,the earliest instance in which Torontodemonstrated a concerted effort towards the formal work in global neurosurgery was through the persistent and continued efforts ofAb Guha (1957-2009), who amongst many philanthropic activities, establish the National Neuroscience Institute in Calcutta (India), hiscity of birth, as his goal. Since then, interest in global neurosurgery has remained strong within our division, with multiple continuedand consistent collaboration areas. These include Mark Bernstein’s travels within Africa and SouthEast Asia, expanding the reach ofawake craniotomies; James Rutka’s efforts to strengthen local surgeons throughout Ukraine; George Ibrahim’s collaborations in Haiti toexpand the surgical treatment of pediatric neurosurgical conditions; and MojganHodaie’s work on structured curricula for neurosurgeryresidents. Simultaneously, Toronto neurosurgery has focused on encouraging fellows from low- and middle-income countries (LMIC’s)to join our center, in many cases funded by the first Chair in International Neurosurgery (3).

We are deeply saddened by the passing of Dr. William Harkness. A gifted surgeon, a caring clinician, a visionary leader and devoted family man, William left an indelible impression on pediatric neurosurgery and the many people whose lives he touched. Dr. William was educated at Eton School and qualified in medicine in 1979, at the University of Birmingham. His neurosurgical training commenced at the Radcliffe Infirmary, Oxford and later continued in Birmingham. Upon completion of his specialist training in 1991, he was appointed as a consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery, Queen Square and Great Ormond Street Hospital for Sick Children (GOSH), but it was the latter institution that became his professional home as he focused his career on pediatric neurosurgery, establishing a legendary partnership with Dr. Richard Hayward. Dr. William spent a year in North America undergoing training at UCLA, Seattle, Miami and Montreal. He enthusiastically embraced the multidisciplinary team approach, enabling him to establish a world-leading children’s epilepsy surgery service together with Helen Cross at GOSH. While this is where he had his greatest scientific impact, he was a consummate pediatric neurosurgeon who thought deeply and wrote on a wide range of conditions. William was known to be an exceptionally skillful surgeon, with many neurosurgical trainees citing him as the one of the leading technical neurosurgeons they had worked with. He served as clinical lead for pediatric neurosciences at GOSH and led the development of a national plan for epilepsy surgery services in Great Britain. Throughout his career William was an ardent advocate for pediatric neurosurgery, representing the specialty in many forums including the Society of British Neurological Surgeons. Dr. Willian was a participant in the first ever European Society for Pediatric Neurosurgery (ESPN) educational course, where he struck up a legendary friendship with the late Jim Goodrich, he went on to become one of the most sought-after lecturers worldwide, including many Latin American Courses of Pediatric Neurosurgery (LACPN). In ISPN, there are few who have contributed more to the society. Dr. William served as scientific chair, communications chair, treasurer and ultimately president, (2016-2017). Combining his organizational and technical skills, he worked with Jim Johnson to develop InterSurgeon, a web-based platform promoting international collaboration through linking neurosurgeons and related organisations across the world. Supported by among others, the ISPN, UAB and the G4Alliance, InterSurgeon has grown beyond neurosurgery and will be a lasting tribute to William’s vision and drive. Dr. William was also an integral member of the Global Neurosurgery Committee of the World Federation of Neurosurgical Societies (WFNS). He worked tirelessly to propel the field, and always made sure he was available to provide advice and assistance. During his time with the committee, he expanded the knowledge base on global neurosurgery, worked to align the multitude of projects in the field, and improved collaboration amongst neurosurgeons around the world. He married Philippa Lubomirski in 1982. She survives him as do their four children, Fran, Ed, Gabi and Letitia, their grandchildren, Arlo, Joanie, Betsy, Peggy and Ari, and his sister, Nicola. Above all else, we remember William’s devotion to his family most vividly. His beloved wife Philippa, who accompanied him on most of his travels. And his four children, Fran, Ed, Gabi and Letitia, their grandchildren, Arlo, Joanie, Betsy, Peggy and Ari, and his sister, Nicola. We extend our sincere condolences to his family and close friends

✓ W. James Gardner, a skillful neurosurgeon and inventor, is best remembered for his cervical tongs and hydrodynamic theory of syringomyelia. A pioneer of modern neurosurgery, Gardner trained under Charles Frazier in Philadelphia, and in 1929 he moved to Ohio where he became chief of neurosurgery at the Cleveland Clinic, a position he was to hold for the next 33 years. A large surgical practice made it imperative for Gardner to develop surgical methods that were quick, effective, and advantageous for patient and surgeon. He was an early proponent of the sitting position for patients undergoing cranial surgery, which led to the development of a neurosurgical chair with a head fixation device. To reduce the risks of hypotension and air embolism when the patient is in the sitting position, Gardner invented the clinical G suit. He was the first to advocate and use induced arterial hypotension for intracranial surgery and the first neurosurgeon in the US to publish his experiences performing lumbar discography. He converted an operating table so that he could induce hypothermia during aneurysm surgery and then applied pneumatic cuffs to occlude the major arterial supply to the brain. His pioneering work has been documented in many other areas such as hemifacial spasm and trigeminal neuralgia, for which he performed the first vascular decompression, in cervical sympathectomy for treatment of various ailments, and in the use of intrathecally delivered steroid drugs for sciatica. During his career, he authored 256 publications and one book on the dysraphic states. Many of his contributions to the discipline of neurosurgery are now taken for granted.

The history of neurosurgery at University of São Paulo comes from 1918, since its origins under the Department of Neurology from Chair of Psychiatric Clinic and Nervous Diseases. Professor Enjolras Vampré was the great inspiration for such medical specialty in the State of Sao Paulo. In 1929, the first neurosurgical procedures were performed in the recently (at time) organized Section of Neurosurgery. The official inauguration of the Division of Functional Neurosurgery occurred at June 1977, with the presence of worldwide well-known neuroscientists. The division suffered a deep streamlining under the leadership of Professor Raul Marino Jr., between the decades of 1990 and 2000. At this time, it was structured with the sections of neurological surgery, functional neurosurgery and neurosurgical emergency. Since 2008, Professor Manoel Jacobsen Teixeira is the Chairman of the Division and has provided the Division with the best available technological resources, performing more than 3,000 surgeries a year and training professionals who will, certainly, be some of the future leaders of brazilian neurosurgery.

The history of neurosurgery at UT Southwestern Medical Center in Dallas, Texas, is reviewed. Kemp Clark, MD, started the academic neurosurgical practice at Parkland Hospital in 1956. Clark developed a robust training program that required the resident to operate early. In 1972, the Dallas Veterans Affairs Hospital was added to the training program. Duke Samson, MD, became chair in 1988. He emphasized technical excellence and honest reporting of surgical outcomes. In 1989, Zale Lipshy University Hospital opened and became a center for neurosurgical care, and Hunt Batjer, MD, became chair in 2012. The program expanded significantly. Along with principles established by his predecessors, Batjer emphasized the need for all neurosurgeons to engage the community and to be active in policy leadership through local and national organizations. During his tenure, the pediatric neurosurgery group at Children’s Medical Center Dallas was integrated with the department, and a multidisciplinary spine service was developed. In 2014, the Peter O’Donnell Jr. Brain Institute was established, and the William P. Clements Jr. University Hospital opened. For 64 years, UT Southwestern Medical Center has been fertile ground for academic neurosurgery, with a strong emphasis on excellence in patient care.

Abstract The Iowa-Benton (I-B) school of neuropsychological assessment dates back more than four decades. In 1950, Arthur Benton set up a small neuropsychology unit at the invitation of Dr. Adolph Sahs, who was the Head of the Department of Neurology at the University of Iowa Hospitals and Clinics (UIHC). Benton’s service was placed in the Department of Neurology, where it has remained until the current day, and this close affiliation with neurology has been an important influence in the development of the Iowa approach. In the initial arrangement, Benton agreed to evaluate patients referred by either Dr. Sahs or Dr. Russell Meyers, who was the Chair of the Division of Neurosurgery at UIHC. In return, Benton and his students were permitted to use case material from neurology and neurosurgery for research purposes.

Despite progress and advancements made to achieve gender equality, a glass ceiling still exists for women in surgery. Women remain largely underrepresented in academic surgery, with appointments to only 18% of surgery program director roles and 6.3% of surgical chair positions in the United States as of 2018. Inequities across various surgical subspecialties are also significant, especially in the areas of neurosurgery, orthopedic surgery, otolaryngology, and plastic and reconstructive surgery. Additional barriers exist for women in academics, including lack of high-quality female mentorship, implicit bias within letters of recommendation, and a greater incidence of reported moral injury and burn-out. Further efforts to address these inequities are necessary to retain the talents and contributions of women in surgery. Interventions that may counterbalance the continued gender gap within surgical fields include the implementation of implicit bias training, increasing institutional support, establishing formal mentorship initiatives, the introduction of early exposure programs during medical training, transparent institutional promotion policies, childcare support, and accommodation of maternity leave. The purpose of this chapter is to educate the reader regarding gender inequality in surgery and related fields and to highlight key issues central to the propagation of gender biases specifically as they relate to female surgeons across various roles and responsibilities (e.g., clinical practice, education/training, and leadership) within the contemporary academic landscape.

This discussion between Turing, Newman, R. B. Braithwaite, and G. Jefferson was recorded by the BBC on 10 January 1952 and broadcast on BBC Radio on the 14th, and again on the 23rd, of that month. This is the earliest known recorded discussion of artificial intelligence. The anchor man of the discussion is Richard Braithwaite (1900–90). Braithwaite was at the time Sidgwick Lecturer in Moral Science at the University of Cambridge, where the following year he was appointed Knightsbridge Professor of Moral Philosophy. Like Turing, he was a Fellow of King’s College. Braithwaite’s main work lay in the philosophy of science and in decision and games theory (which he applied in moral philosophy). Geoffrey Jefferson (1886–1961) retired from the Chair of Neurosurgery at Manchester University in 1951. In his Lister Oration, delivered at the Royal College of Surgeons of England on 9 June 1949, he had declared: ‘When we hear it said that wireless valves think, we may despair of language.’ Turing gave a substantial discussion of Jefferson’s views in ‘Computing Machinery and Intelligence’ (pp. 451–2), rebutting the ‘argument from consciousness’ that he found in the Lister Oration. In the present chapter, Jefferson takes numerous pot shots at the notion of a machine thinking, which for the most part Turing and Newman are easily able to turn aside. Jefferson may have thought little of the idea of machine intelligence, but he held Turing in considerable regard, saying after Turing’s death that he ‘had real genius, it shone from him’. From the point of view of Turing scholarship, the most important parts of ‘Can Automatic Calculating Machines Be Said to Think’ are the passages containing Turing’s exposition of the imitation game or Turing test. The description of the test that Turing gave in ‘Computing Machinery and Intelligence’ is here modified in a number of significant ways. The lone interrogator of the original version is replaced by a ‘jury’ (p. 495). Each jury must judge ‘quite a number of times’ and ‘sometimes they really are dealing with a man and not a machine’. For a machine to pass the test, a ‘considerable proportion’ of the jury ‘must be taken in by the pretence’.

Abstract When the Presbyterian Hospital in the City of New York joined with the Columbia University College of Physicians & Surgeons, they adopted guidelines that have remained in place ever since. Chairs of the departments are university officers, and they are the ones who nominate new members of the faculty. If a clinical department is involved, the person has two titles, one at the university and the other in the hospital. For instance, an assistant professor of neurology in the medical school is an assistant attending neurologist in the hospital. In the medical school, Tracy Putnam’s title was professor of neurology. At Presbyterian Hospital, he was director of two separate services, Neurology and Neurosurgery. He held these positions with “tenure,” which ordinarily means that he could not be forced to relinquish his positions without cause. Tenure was designed to protect the right of university professors to speak and write without fear of being fired for expressing unpopular views. Tenure is granted by the university, not the hospital. It is a promise to pay a salary if other sources are lost but has never been tested at Columbia as far as the author knows.