The metamorphosis of neurological surgery and the reinvention of the neurosurgeon

SINCE ITS INCEPTION more than 12 000 years ago, neurosurgery has progressed through a number of phases, largely dictated by the available supporting bodies of information and technical adjuvants that allowed progress. The recent rapid escalation of technical progress related to surgery of the nervous system as well as global and regional climates have created diverse demands for the field and have challenged traditional methods of education for developing needed neurosurgical expertise. The creation of the "new neurosurgeon" is, in fact, the creation of many individuals and is dependent on objectives that are based on the needs directed toward the field. These needs are local, national, and international, and they are created by medical, scientific, economic, social, and political factors. Specific education should be directed toward these needs from early educational involvements at the premedical level but also should pervade the entire medical specialty exposure and postgraduate training. This communication discusses specific categories of needs and makes suggestions regarding programs and involvements that may address elements of the situation. General information and educational principles are discussed, along with recommendations for the fostering of a climate of innovation for the field.