The cream will rise to the top
-- Macho man Randy Savage
^^^ Of course their are a few exceptions. But even those people are not very surgery-oriented in that they tend to see relatively few patients and have fellows/residents to do most of the work.
But by and large the research is done by PhDs and private companies. I would say the vast majority of functional people don't do relevant research, maybe like 1% of them do. But you are taking 1% and trying to paint a picture where the surgeons are doing all the research. I honestly don't know what you are trying to prove.
If you look at the research output for the vast majority of surgeons, its basically, "An unusual Case of XYZ: Case study and review of literature."
Excellent discussion here. Someone brought up a point about neuro-oncology. Over the past 3 decades what has changed in GBM research besides the Stupp protocol?
As far as functional goes, research that is practical is targeting new sites for more indications with DBS, focused ultrasound, LITT amygdalohippocampotomies.
PhDs lack clinical perspective. That's why MD-PhDs and the NIH program (and other bench research programs for MDs) are so important. I agree with the above posters that the vast majority of good basic work is done by PhDs. Go through any nsgy department's list of researchers and you'll see that PhDs are mostly doing basic work and MD PhDs are translating it (with exceptions, of course). This is partially why MDs and MD PhDs are over-represented among nobel laureates. Anyone who's spent serious time in academic research will have already seen this.
For any med students or younger interested in academics who read this thread, you need years of lab work to gain skills if this is something you want. You either pay for it before residency or later as you flounder in a post-doc trying to put together scraps for a K-award while your former co-residents make $$$ operating. Most neurosurgeons don't do this because it requires immense sacrifice and lab research is an acquired taste (we need more surgeons than scientists anyway).
All that being said, don't let anyone tell you that you can't do great research in functional, tumor or any field if that's what you want. MDs and MD/PhDs' careers aren't dependent on them keeping the lights on with boring R01's so they can take more moonshots. Look at Leuthardt at WashU, Lesniak at NW, or Chiocca at BWH. None of that work would ever attempted by a PhD. Ever. There are other examples as well and there's no smoother path to chairman than through the lab.
The amount of basic science and tech that could easily be translated to improvements in patient care is also staggering in nsgy so there's plenty of opportunity.
The concept of a neurosurgeon scientist is a myth.
Leuthardt, Lesniak, and Chiocca have not translated anything meaningfully to reach patients to date. Not to mention the dozens of others. Has Sampson gotten a cure to patients? Has Aghi made any impact even with all of his GBM tumor microenvironment?
The reality is that we're still operating with Stupp's protocol +/- Avastin for GBM.
As one of the more cynical posters on this thread, I still have to disagree with the above poster. All the innovations Leuthard is involved with are not easily tangible but I'd argue he has had quite an impact, especially with his pioneering work around LITT. Tumor ... yes, tumor. Are we gaining more insight, yes. Does this help patients, not yet. Not really. I wouldn't dismiss their efforts, however. You won't get to a cure without years of their work.
Lastly, care to explain why the surgeon-scientist is a myth? I think no PhD will crack the code without a clinician guiding them. And whether it's a surgeon or an internist, doesn't make a difference. You either round most of your day or you cut tumors out. We need the hybrids who constantly ask questions while treating patients and hire PhDs to answer these.
