Residency in Neurosurgery
Residency is the most important stage of a multi-level structure of medical education. Residency is oriented to obtaining deepen current knowledge in the chosen specialty and also proficient practical skills.
Since 2020 the Federal Neurosurgical Center (Novosibirsk) is a setting for residents of the Novosibirsk State University and since 2021 – the setting for residents of the Novosibirsk State Medical University in “Neurosurgery” specialty.
When residents get into our Center, they are assigned to the divisions where they are provided with the opportunity to widen their knowledge in theory (approaches to patient’s managing) as well as in practice (participation in surgical procedures) under the leadership of a tutor-neurosurgeon.
During their trainings the residents take part in discussions of clinical cases that allow them obtaining experience. Apart from their activities in the divisions a particular attention is paid to self-education and residents’ training. Thus, from time to time future specialists present their reports on different spheres of neurosurgery; participate in discussions of current publications, etc.
The Federal Neurosurgical Center (Novosibirsk) is a setting for the residents of the Novosibirsk State University and Novosibirsk State Medical University. At present there are 9 second-year residents and 11 first-year residents study in our residency.
We have interviewed some of residents to understand why each of them had chosen neurosurgery, how they start their working day and what they could advise to specialists-to-be.
THE CHOICE
For some residents the choice of neurosurgery became random…
Irina Koroleva, the first-year resident (Novosibirsk State University): “Before choosing neurosurgery I have been sharpened my skills in abdominal surgery that was taught in our University for a long time. I took part in the Student’s Club meetings, I listened to lectures, I took duties, to be short, I followed my wishes and abilities. It happened that on the IIIrd course of my studying I got a chance to become a member of neurosurgical club where I had changed my mind and decided to be engaged in this specialty”.
Norayr Borisov, the first-year resident (Novosibirsk State Medical University): “During my school years I adored mathematics for its precision, consistence and subsequence. When I became a student, I understood that notions of precision and “correctness” are washed out and only surgery seemed evident and definite so that is why I was planning to deal exactly with it; during those times my ideas about neurosurgery were dimmed. Everything became settled by a chance… In February 2018 I visited the OR of the Federal Neurosurgical Center for the first time where neurosurgeons performed brain tumor removal surgery using the method of intraoperative awakening of a patient (so-called awake surgery). It was exactly the day when I understood that I was ready to be a neurosurgeon”.
The decision to become a neurosurgeon was taken by Taalay Turushbekov, the second-year resident (Novosibirsk State Medical University) during his attendance: “My way in medicine started from general surgery – I chose this sphere for my general development, to understand common principles and basic things of surgery. During one of my student attendances a patient with abdominal space and brain traumas was delivered to our department. I was fortunate to be an assistant during surgical procedure on craniocerebral injury. The work with a human’s brain impressed me greatly, I felt very high responsibility. After that interesting case I decided to become a neurosurgeon”.
Neurosurgery is a very challenging but not studied up to the end specialty for Anton Ivanov, the first-year resident (Novosibirsk State Medical University): “I have chosen neurosurgery because this profession if very complicated though it is relatively young. There are a lot of promising trends in neurosurgery and when you understand that you are just in the beginning of your way – this gives you strength and confidence in your choice”.
ABOUT DIFFICULTIES AND ADVANTAGES OF NEUROSURGERY
“There is a saying: one should love life not only for its amenities but also for its difficulties. I am sure this may also concern neurosurgery”, - comments Anton Ivanov.
“Neurosurgery is one of the most demanding specialties in the healthcare system, - notes Irina. – It’s a difficult profession. It demands persistence, high skills, precision in movements and balance, huge amount of theoretical knowledge on many related professions”.
Some residents note that a good result of their activities for them is increasing the life quality of patients, “…such result in neurosurgery will be when a patient moves without any problems, thinks / cogitates, lives a full life [Irina]… The most exciting moment is when a patient is awakening after a long and very serious surgical procedure, when a patients awakes mentally fit without additional neurological deficit [Taalay]”.
Summing up the replies of his colleagues, Norayr says that neurosurgery is a live-long art.
DAILY ROUTINE
Residents’ working days starts as so as the day of all specialists of our neurosurgical Center – it starts with a departmental meeting. As for its end – it’s always different. During his working day the resident has to examine newly presenting patients, to manage patients after surgery and those who are waiting for the surgery, to maintain medical documents.
A particular attention is paid to scientific activities: participation in academic seminars, lectures, conferences, etc.
Work in neurosurgical divisions takes much time so it is difficult enough to combine work and studies. Nevertheless, the residents are sure that it’s very important to make plans for the day correctly and set priorities properly in this situation. “Initially it’s difficult to do that but one should learn”, - states Anton Ivanov.
“I have experience with this, - says Norayr Borisov, - starting from the Vth course of studying I have been actively participating in clinical life of the spinal division of the Federal Neurosurgical Center. No, when I am a resident, this experience helps me greatly. I am really thankful to the staff of spinal division!”
ABOUT THE FUTURE
Irina Koroleva: “After graduation from the residency I would like to deal with pediatric neurosurgery”.
Norayr Borisov: “I would like to work, make progress and not to stop”.
Taalay Turushbekov: “As residency lasts for 2 years only, which is very little for neurosurgery, I would like to continue my postgraduate studying, to master more skills in a very difficult specialty”.
Anton Ivanov: “As any beginning specialist, I have huge plans for the future. But first of all I should graduate from the residency and then continue my postgraduate education. I’d like to work as a trainee and to present my reports on different scientific conferences”.
SUGGESTIONS FOR FUTURE SPECIALISTS
“I am not so experienced to give practical advice, - admits Taalay. - But if you have a great heart, tolerance and striving for saving human lives and not to be afraid to take responsibility, in this case this is your way”.
Anton and Norayr have similar opinions; the residents think that it’s necessary to start with general medicine. The entrants should know anatomy and neurology. Then they should work through general neurosurgery and only after that they could deal with neurosurgery. “One should not be afraid of make mistakes, at the same time one should not replicate them. It’s necessary to finish the job and not to look for excuses. The main thing is to remember that you should be a doctor not only in the OR but also outside of the hospital”, - says Norayr.
Here is suggestion from Irina: “The willingness is an engine of a progress. The person who really wants t do it, should work hard. Do your best and don’t be lazy. You will succeed for sure!”
