I am interested in doing cranial cases mainly and although I enjoy spine as well. However, I would be ok with doing Orthopedics even though my true passion would be intracranial neuro cases. How long would it take me to build up a decent practice of intracranial cases. Is the even possible anymore? Id rather do Ortho if not.
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Hard to say but the reality is that neurosurgery has been mostly spine for a very long time outside of academics.
Do you like to win a lot or lose a lot?
Ortho for people who like to win more than they lose.
Neuro for those who are ok with losing most of the time.
Do you want to take care of sick people with really interesting problems or treat healthy people with really boring problems? All of my friends who did ortho absolutely hate taking care of really sick patients (eg CVA, GBM, etc.)
Do you want to save lives? Or do you want to save lifestyles?
Saving a stroked out patient who will live out their life with a hemiplegia and aphasia is hardly a success.
Some would argue that is a huge failure for the patient, the family and society.