Content Credits: Aditi Abburu, Adish Joshi
Design Credits: Bhavya Jain
1. What inspired you to become a neurosurgeon? Do you have any advice for medical students looking to choose the field?
From my medical school days, I was fascinated with the anatomy of the nervous system and the brain, and as the years rolled by, I became more inquisitive and curious to explore the unknown realms of the brain. Brain surgery is considered one of the most challenging feat a surgeon can master, and my love for taking challenges was perhaps instrumental to some extent. Having said that, there is a great need for neurosurgeons in our society to manage complex patients and that drove me to pursue this speciality. During my surgical residency tenure, when I got the opportunity to work in neurosurgery for the first time, I was hooked for life. At that time, I was quite naïve and did not know what it takes to be a neurosurgeon and had a vague idea about what the practice of neurosurgery looks like. However, as I was nearing the end of my surgical residency, I had made up my mind to become a neurosurgeon and did everything to get into a neurosurgical residency program. Fortunately, I got selected in one of the best medical teaching institutes, PGIMER Chandigarh for MCH neurosurgery, where I got the opportunity to train with the best surgeons. To the young medical students who are looking to choose this field and are inclined towards neurosurgery, I would say that it is a rewarding but extremely challenging journey. Neurosurgery demands dedication for life, and the health and safety of your patient is always above and beyond anything else. You should be prepared for working at odd hours; you might not have enough time for your friends and family and your patients will need you more than anyone else. So, if you are passionate, dedicated and want a speciality where there are new challenges every day, only then venture out in this speciality.
2. How do you handle the emotional aspects of working with patients who may be facing life-altering neurological conditions?
The practice of neurosurgery is extremely challenging -physically, mentally, and emotionally. Often there are conditions, where the outcome is expected to be poor, especially dealing with paediatric patients and traumatic brain and spinal injury patients. A neurosurgeon has to be emotionally strong and not let the emotions cloud the clinical judgement and prevent him from doing what is scientifically, ethically and morally right. Having a stable mindset, support of family and friends and debriefing with your colleagues and peers goes a long way in keeping your emotional health intact.
3. What role do you see artificial intelligence playing in the future of neurosurgery?
Well, artificial intelligence will influence the practice of neurosurgery as it would affect every aspect of human life. With rapid scientific advancements, it is becoming a challenge to keep pace with the evolving technology. As in any other medical field, I believe the AI would revolutionise the way we practice and manage our patients in terms of providing better diagnostic capabilities, surgical navigation and the ability to use the power of AI to deliver better patient outcomes.
4. What is your perspective on balance between innovation and proven surgical techniques?
Modern Neurosurgery is a relatively new speciality and only in the recent decades we have moved from primitive neuro-surgical procedures towards advanced modern day surgical protocols. There are advancements in neurosurgical technology, equipment such as operating microscopes, drills, image-guided navigation and lasers that have immensely helped surgeons to strive for, and achieve better surgical outcomes. Neurosurgical conditions which were once considered untreatable and inoperable are now routinely operated with quick recovery, short hospital stay and good surgical outcomes. The use of new technology in routine surgical practice would translate into better patient care by leaps and bounds and I believe the existing surgical techniques and the evolving techniques would collaborate to achieve the best possible evidence-based patient care.
5. Can you provide insights into the differences and potential advantages of pursuing neurosurgery fellowships in countries abroad versus in india, and how these experiences may shape one’s career in the field?
Neurosurgery fellowship requires passionate, dedicated and driven fellows who are responsible and accountable for their actions. No matter where you get the fellowship from – Fellows must display strong work ethics, attention to details, perseverance, and the desire to learn. It is a brutal and unforgiving battlefield without these qualities.
Neurosurgical fellowship in India has many advantages including the access to an immense range of challenging and rare neurosurgical conditions with a variety of surgical options, huge population base, free surgical hand in teaching hospitals to hone the surgical skills and serving the underprivileged community. I believe training in India gives you an exposure to, and opportunity to learn from the best surgeons of the world and an unlimited exposure to the population and a quick accession to perform neurosurgical procedures independently.
Fellowships abroad are more structured and standardised with specific management protocols, training requirements that have strict entry criteria and are quite competitive. Often one will require to be licenced in a country where you intend to pursue the fellowship practice. Often, there is a requirement for initial research work prior to undergoing neurosurgical training. There are more post fellowship opportunities available in collaboration with neuroscientists.
6. What are some upcoming developments you see in the field of pain medicine in the next 10 years?
Pain medicine and neurosurgery are quite closely linked and interrelated. I have the opportunity to work both neurosurgery and pain medicine having attained another fellowship in Australia. Often the procedure work in pain medicine relates to the neurosurgery skills and training. Some of the recent developments in the field of pain medicine such as deep brain
stimulation, spinal cord stimulation neuromodulation has evolved from neurosurgery and
have given tools like never seen before to improve the quality of life of our patients.