I got 15+ interviews last year, this year only 4. ( idk if signaling has anything to do with it in addition to being a reapplicant). Doing a pre-lim year right now ( no neurosurgery program). dont think i will match again. what should I do? just pursue gen surg? IR? i really want to be a neurosurgeon. any reapplicants want to share their success stories?

MS3 with 40 pubs, P USMLE, one high pass but the rest honors on rotations. Honestly I feel like I need to take a year off and work on my CV it’s so killer out there nowadays. If anyone has advice please let me know. Also top 50 med school for reference.

Dear members of the Neurosurgery Hub community, 

I am a biomedical engineer, working on a NIH R01 proposal and with a long-standing interest in neurosurgery simulation, emphasizing the skull base. I have a clinical collaborator, but I would like to complement his input with that of other neurosurgeons, to make the proposal, and the simulator if funded, as clinically useful as possible. 

I have a background in medical image analysis (including meshing), haptics, neurosurgery navigation, and various other areas of computer-assisted medicine (also collaborating on geriatric fall injury mitigation and breast surgery applications). I did my PhD in neurosurgical brain shift estimation at Montreal Neurological Institute and also had some early patents in neuronavigation. My group has published papers on minimally supervised identification of cranial nerves in T2-weighted MRI  
https://pubmed.ncbi.nlm.nih.gov/28422682 https://pubmed.ncbi.nlm.nih.gov/31236805, 
and I'm also interested in doing the same with DTI data. I have papers in other related areas: haptics, meshing, etc.. 

We are emphasizing skull base tumor resection because I believe that this is where there is the most important need, in terms of simulation-assisted improvement of surgical skill, while minimizing risks to patients. I am collaborating with Kitware, which has developed the open-source Interactive Medical Simulation Toolkit (imstk.org). Also working with a haptics company that will customize for surgery low-cost, high-fidelity haptic device with 6/7 degrees-of-freedom. We plan on emphasizing 1 or 2 specific approaches; I'm thinking transsphenoidal/transnasal and pterional, but open to suggestions. Knowing the approach ahead of time means knowing the surgical corridor, and modeling in detail only the anatomy along this corridor, leaving the rest as sparse as possible for an interactive computational response.

So, with those details out of the way, here are some questions... 
1) What's hard about neurosurgery where simulation can provide an improvement in surgical performance and in patient outcomes, by ramping up these skills with no risk to the patient? 
2) Is there a glaring omission in terms of the approaches that we should start with, vs transphenoidal and pterional?
3) Conversely to 1, what improves over time for a neurosurgeon, which could be accelerated with simulation-based training? (e.g. better force control on instruments, better understanding of neuroanatomy, better identification of intraop pitfalls, better damage control in on-going complications?)
4) What are the complications in skull base surgery that occur where (well-designed) simulation-based training can have an impact? (e.g.: CSF leak, hypophyseal or hypothalamic injuries, blindness/double vision, palsies of CN III, IV, VI, cerebral infarct, carotid artery injuries, meningitis...)
5) Any clinical papers to recommend, especially review papers, that could suggest which complications to key on? 
6) Is there something that I should know, to complete the picture, where a neurosurgeon reviewer might say: "What about...?" ?  

Thanks for your kind consideration and support. Best wishes,

MichelODU
Michel Audette, Ph.D.
Old Dominion University

Dear Medical Students,
Dr. Peter G. Passias is inviting highly motivated medical students to apply for a Research Fellowship with the New York University Division of Spine Surgery/New York Spine Institute. This fellowship is intended for 3rd or 4th-year medical students who are interested in gaining additional exposure to the field and enhancing their residency application. The research fellowship is a paid, one-year or two-year position. During this time, you will work closely with Dr. Passias on a multitude of ongoing prospective and retrospective studies. Most research focuses on adult spinal deformity (ASD) and adult cervical deformity (ACD), though the lab also conducts studies on other spinal pathologies. Current projects include single-institution studies, national database research, and joint projects with the prestigious International Spine Study Group (ISSG).
Responsibilities include all aspects of clinical research:
·        Patient enrollment and collection of clinical data
·        Developing research hypotheses
·        Performing statistical analyses
·        Writing and submitting publications
You will have the opportunity to participate in weekly grand rounds, monthly meetings with the current spine fellows, and a lecture series on sagittal spinal alignment hosted by the Hospital for Special Surgery.
Previous fellows have been successful in presenting their research at several neurosurgery, orthopedic and spine-specific national and international conferences as well as authoring multiple manuscripts.
Applicants will be selected based on their academic record, previous research experience, interpersonal and organizational skills, and a video or in-person interview (depending on location). Research fellows should preferably commit to a start date in May 2023 (flexibility considered).
Interested candidates should fill out the following form by March 31st, 2023: 

https://docs.google.com/forms/d/e/1FAIpQ...&w=1&flr=0

For any questions please email researchfellows@nyspine.com.

like the subject says lol

Anyone hear back about late breaking abstracts? Were supposed to be out last Friday

I'm an Asian American who has basically spent his entire life in California (high school, undergrad, med school). As I enter my last year of medical school, I'll likely be applying to residency programs in the Midwest. However, I am concerned about what it would be like for an Asian American to live/practice medicine in a predominately white area. If there are any Asian Americans on this forum who have done their residency/medical school in the Midwest, I was curious if you be open to sharing your experiences being a resident in these areas? I understand that racism exists everywhere. I've even encountered racism in my pretty liberal city (primarily at the VA). However, I'm concerned it would be amplified if I entered more conservative parts of the US.

As a resident logging cases near the end of my training at a large academic program, does anyone else feel like there is an overemphasis of spine in our residency training? Almost half of the cases are spine, and the minimum requirements favor spine over open vascular, tumor, functional, peripheral nerve, epilepsy, hydrocephalus, and trauma combined. Why is this? Most medical students entering neurosurgery  are not seeking to become spine surgeons (admittedly many do switch). What value is there to having senior residents do round after round of ALIF, XLIF, T10-Pelvis, and corpectomies they will never do again? This seems like a total misallocation of our training hours in the OR for those not pursuing spine.

MGH just started a spine fellowship. In general is a fellowship at MGH a good idea? Heard from many different people that their volume is low so curious about what to expect in terms of operative experience as a fellow. Does MGH have low volume in every sub specialty?

To paint a broad picture of myself, I go to a top med school with a top home neurosurgery program. I have 20+ publications and great board scores. 

My sub-Is will likely be scheduled for September and October of this year (unfortunately can't do it any earlier because of how my school's 4th year is set up which sucks). I understand that I'll need 3 LORs by September 28 which is when PDs can begin reviewing applications. My current plan regarding the 3rd letter is to ask for a letter during the early 3rd week of my first away neurosurgery sub-I and hope that it's on time. However, if I can't get this 3rd letter by the 28 deadline, I'll likely have to submit a 3rd home letter. Therefore, I was wondering if it's okay if 3 LORs come from my home program and then a 4th letter submitted in early October from my first away program. I'm not sure how I'll get a letter from my 4th sub-I, but the earliest I can probably get that letter is late October. Does anyone have any advice on what to do? I feel confidently about my overall application with the exception of this situation. Thank you.