This is just for brain storming, it is not intended to hurt anyones ego!

It has been the trend in medicine that research output and grants funding determines the reputation and ranking of residency programs. This was automatically reflected on surgical specialties as well, including neurosurgery. In the way that you see many programs that benefit from their undergrad or research reputation to hold the label "high tier" or competitive, despite low case volume. Examples are plenty, including Yale, Stanford, Columbia, and many others. 
That is the same reason why for a long time the minimum requirement for graduation was 400 cases and only recently was changed to 800! 
Kinda ridiculously low number! It is intuitive that you need much more than this to be a competent surgeon, and certainly taking 2 years off your senior years of residency for "protected research" is not helping, nor does having attendings who are great but very hands on! Otherwise more of the likes of Dr. Death will be out there. 

Associated with all of this is the arbitrary definition of "high tier" programs. What really is a high tier program ? How could one program define itself as high tier while their residents graduate with 1200-1500 cases, regardless on how many residents they take per year ?! This has lead to many stories of new graduates from some of those programs suffering at their new place of hire, and some of them were let go. They are great researchers, but not competent surgeons!

A better definition of surgical tiers should be the number of cases done (as senior or lead surgeon) at time of graduation and the associated level of autonomy, in a way that:

- High tier - >2000 cases with reputation of supervised autonomy
- Middle tier - 1500-2000 cases 
- Low tier - < 1500 cases 
Of course per the ACGME definition a senior or lead surgeon has to do more than just opening and closing the wound to be able to log the case.

Certainly if the residents' interest is more directed towards basic science research, then their choice of such institutions is ideal. However, the programs still should not enjoy the definition of high tier only because they are good at handling lab animals for 2 years. It's incredibly counterintuitive to being a "surgeon"!

God bless!

Louisiana has 3 programs: Tulane, LSU NO and LSU Shreveport. Looks like each one takes 2 per year. Anyone knows about their case volume and autonomy ?
I heard Shreveport is the busiest ?!

I’ve been looking for the best vascular fellowships (both endo and open) and was hoping this group could provide some insight. Also, when is the ideal time to start reaching out to programs?

The Fellowship page says call is shared with Cornell residents every 3/4th night and weekend. Is this general call? This seems like they’re taking advantage of the fellow. Does anyone have any info on this fellowship?

...there isn’t any sort of double standard, is there?

Is there a consensus on who are the best functional surgeons for epilepsy? I've seen that Philip Starr at UCSF is very well established, but he seems to focus on movement disorders.

Where did the residents at UNM and Detroit end up?

We are excited to announce our Virtual Sub-Internship program, starting August 17th @7pm MDT!

Each session will include a case presentation and discussion of neurosurgical approaches, highlighted by an interactive Q&A with our residents and faculty. We look forward to an engaging discussion with prospective applicants, current residents of all levels, and colleagues.

Upcoming dates and topics:

Peripheral Nerve: 8/17 - 19:00 MDT
Stereotactic & Functional: 8/24 - 16:00 MDT
Spine: 9/2 - 16:00 MDT
Tumor: 9/9 - 16:00 MDT
Pediatrics: 9/16 - 16:00 MDT
Endovascular: 9/23 - 16:00 MDT
Trauma: 9/30 - 16:00 MDT 
Leadership: 10/5 - 18:00 MDT
Virtual Happy Hour w/ Residents: 10/14 - 17:00 MDT

Twitter: @UofUNeurosurg
Facebook: @UofUNeurosurgery
Instagram: @UofUNeurosurgery
[/url][url=https://medicine.utah.edu/neurosurgery/residency/virtual-sub-internship.php]https://medicine.utah.edu/neurosurgery/residency/virtual-sub-internship.php

Assuming you have all of the other ingredients, is it okay if you only Pass OB, Peds, and FM? I would assume that students who otherwise have great Step, rsrch, and do well on away rotations shouldn't have any trouble

UNIVERSITY OF MARYLAND NEUROSURGERY MEET AND GREET

Join us August 25th, 6pm, for a meet and greet with Associate Program Director, Dr. Charles Sansur, and Residents.

-Learn about our curriculum, with an update on our new PGY-7 format
-Discover research opportunities available to residents, program benefits, and unique aspects of the Maryland experience
-Hear from residents who are graduating and who are beginning the program

-RSVP by using this link: https://forms.gle/XjYm4aKUtf3sZic6A
-Program Website: https://www.umms.org/ummc/pros/gme/resid...urosurgery
-Follow us on Twitter: @UMDNeurosurgery