Hey all,
I guess this topic has been discussed before, but I am wondering what the future of this speciality is. I feel like many subspecialties will be more or less obsolete in the foreseeable future. I don't see a big future for open cerebrovascular surgery for example, many will argue that therefore there is endovascular surgery, but in fact this is an interventional neuroradiology domain in most parts of the world, the US is one of few exceptions. I also don't see a bright future brain tumor surgery. The only subspecialties that seem to have a future are spine and functional neurosurgery. I feel like the field is kind of dying similar as heart surgery mostly did. I know it is always hard to read this and maybe give a realistic, honest opinion, which comes to this conclusion about a field that you love.
I agree with you that the way neurosurgery is being practiced will evolve as the available technology improves, as in the case of open cerebrovascular surgery that you have mentioned. However, I don't see how brain tumor surgery will disappear, even with the advancement in radio/chemo. A skull base tumor will always require resection, for example. Will there be better alternatives for GBM or infiltrating gliomas? Maybe. Similarly, pediatric, spine, functional are here to stay.
Would like to hear more opinions on this
Neurosurgery sits at the center of many interesting clinical dilemmas. It has always attracted those attracted to hard problems. Yes, Cushing took out meningiomas and pituitary tumors but how about with virtual reality and endoscopic 3D. Stereotaxy started a 1/2 century ago but look at today's precision and overlays of fibertract mapping, etc. Mapping, technology, the Brain initiative, inexorably working to fight GBM.....this is truly a place where those attracted to challenges can thrive....and that makes for an exciting and stimulating career.
Hard to believe the field would be dying with the salary offers I heard this year. Seem to be rising, not going down. Also can't really see tumor going anywhere, maybe open vascular.
Cerebrovascular is done. No idea why all these people are people are freaking out to be trained at these institutions that clip everything. Five years down the road, you are going to be considered a hazardous dinosaur. Endovascular is (unfortunately) the future.
Spine will always be there.
Tumor will always be there, too...but rad onc is taking away more and more, which in my opinion is a good thing. Who honestly wants to spend all day picking away GBM?
Trauma and spine will always be there. Neurosurgery isn't going anywhere. If anything, we'll be working better hours because of it.
(05-24-2017, 10:50 PM)Guest Wrote: Cerebrovascular is done. No idea why all these people are people are freaking out to be trained at these institutions that clip everything. Five years down the road, you are going to be considered a hazardous dinosaur. Endovascular is (unfortunately) the future.
Spine will always be there.
Tumor will always be there, too...but rad onc is taking away more and more, which in my opinion is a good thing. Who honestly wants to spend all day picking away GBM?
Trauma and spine will always be there. Neurosurgery isn't going anywhere. If anything, we'll be working better hours because of it.
I am a senior yet youngish attending at a major academic center and I mostly agree with this assessment. I really enjoyed my open vascular training and experience but saw the writing on the wall 10 years ago and chose to be a spine surgeon instead. Endovascular may be fun if you are a neurologist, but if you are a surgeon firing in screws and cages is way more fun. I do not do many brain tumors any more but I think theres always going to be a role for taking out skull base meningiomas etc, but the volume is limited. Maybe self-driving cars will do away with trauma but there will still be elderly patients who fall down and get subdurals and central cords.
Finally, you should know there are ongoing discussions of spinning off spine as a separate residency. as much as i take pride in calling myself a neurosurgeon, i think this may happen and perhaps may be a good thing.
good luck to you all...
I wouldn't mind spending all day picking away a GBM. I came into this field to remove brain tumors. Sucks to think that it may be dwindling down. Would suck to do 4 more years of residency and then tumor dies.
(05-25-2017, 06:57 AM)Guest Wrote: I wouldn't mind spending all day picking away a GBM. I came into this field to remove brain tumors. Sucks to think that it may be dwindling down. Would suck to do 4 more years of residency and then tumor dies.
meningiomas are where it's at, bro. they'll always be there to take out, and they're awesome cases. very satisfying and patient is happy and doesn't die a year down the road.
rad onc can have all the gbm and mets. I'd be perfectly happy throwing screws and taking out the occasional meningioma. add some trauma in there and you got a pretty sweet gig.
(05-25-2017, 02:37 AM)Guest Wrote: (05-24-2017, 10:50 PM)Guest Wrote: Cerebrovascular is done. No idea why all these people are people are freaking out to be trained at these institutions that clip everything. Five years down the road, you are going to be considered a hazardous dinosaur. Endovascular is (unfortunately) the future.
Spine will always be there.
Tumor will always be there, too...but rad onc is taking away more and more, which in my opinion is a good thing. Who honestly wants to spend all day picking away GBM?
Trauma and spine will always be there. Neurosurgery isn't going anywhere. If anything, we'll be working better hours because of it.
I am a senior yet youngish attending at a major academic center and I mostly agree with this assessment. I really enjoyed my open vascular training and experience but saw the writing on the wall 10 years ago and chose to be a spine surgeon instead. Endovascular may be fun if you are a neurologist, but if you are a surgeon firing in screws and cages is way more fun. I do not do many brain tumors any more but I think theres always going to be a role for taking out skull base meningiomas etc, but the volume is limited. Maybe self-driving cars will do away with trauma but there will still be elderly patients who fall down and get subdurals and central cords.
Finally, you should know there are ongoing discussions of spinning off spine as a separate residency. as much as i take pride in calling myself a neurosurgeon, i think this may happen and perhaps may be a good thing.
good luck to you all...
I hope spine doesn't spin off. We don't want to go the way of gen surg fractionating into a bunch of different fields
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