Neurosurgery May Die

Abstract The promise and excitement that once permeated neurosurgery have yielded too often to an easy acceptance of the status quo that can be traced to a poorly ordered system of neurosurgical education. Current neurosurgical training programs contain 662 trainees, of whom 22 per cent are sponsored by the Educational Council for Foreign Medical Graduates. Most trainees are later capable of generalized practice at a standardized level; few are directed into neurosurgical subspecialties or neurosurgical research which will lead to neurosurgical progress. The development of 95 training programs can be linked in part to the service needs of the teaching institutions rather than to the eventual clinical needs of society. Although neurosurgeons in the United States perform "a total of five to six major operations a month," training programs have failed to limit the number of trainees. Neurosurgical educators — supported by medical schools, educational councils and surgical societies —must develop new systems of neurosurgical education. (N Engl J Med 288:1043–1046, 1973)