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Forbes
a day ago
- Health
- Forbes
Neurosurgery Awareness Month: So How Do You Become A Neurosurgeon?
Neurosurgeons perform intricate surgeries on the brain, spine, and the different peripheral nerves as they course throughout the body. They meticulously open a patient's skull to stop bleeding vessels, remove tumors with precision measured in millimeters and strategically reshape the spine to correct conditions like scoliosis, restoring alignment and enhancing the patient's quality of life. In essence, neurosurgeons transform lives through their expertise. But how do they achieve such mastery? How are neurosurgeons made? Step 1: Get Into Medical School Each medical school has variations in its prerequisites, but all require a strong foundation in the sciences. This includes courses such as the notoriously recondite organic chemistry as well as biology, general chemistry, and physics. These courses must not only be completed but mastered, as applicants need to distinguish themselves among peers pursuing the same rigorous curriculum, all with the same goal. Competition for medical school acceptance can be stiff. My alma mater, Georgetown University School of Medicine, for example had 14,480 applicants in 2024 for a class of around 200, with an acceptance rate of 2.89%. The average GPA was 3.76, achieved while tackling the most demanding courses. Grades serve as only the baseline hurdle. In addition to academic excellence, applicants must distinguish themselves outside the classroom through leadership, extracurricular activities, and meaningful exposure to clinical medicine. These accomplishments are essential for standing out in the highly competitive medical school admissions process. Step 2: Do Well In Medical School And Match In A Neurosurgery Residency Medical school spans four years, with the first two years focused primarily on classroom-based learning and the latter two emphasizing clinical, patient-centered training. Upon graduation, students earn the title of medical doctor but lack any specialization. Each student's unique interests and strengths guide their choice of specialty, with subsequent training varying significantly. Residency provides the specialized training in a chosen field of medicine. Residencies range from three years for some specialties to five years for others, with neurosurgery requiring the longest commitment—a grueling seven-year program known for its intensity. Aspiring neurosurgeons must excel in their preclinical years, perform exceptionally during clinical rotations, and achieve high scores on national exams. Research is also critical, as is participation in audition rotations—commonly called "away rotations"—at other university hospitals. To secure a neurosurgery residency, students need compelling letters of recommendation from neurosurgeons at their home institution and from others across the country. Ultimately, neurosurgery faculty evaluate candidates by asking critical questions: Is this individual someone we want to train as a neurosurgeon? Can they handle the demands? Most importantly, can we trust them to care for a vulnerable patient population? As a nod to a familiar saying, the person who graduates last in their medical school class may be called "doctor," but they are highly unlikely to be called anyone's neurosurgeon. Step 3: Survive And Thrive In Neurosurgery Residency Neurosurgery residency is a remarkable yet formidable endeavor. The cases are often lengthier than those in other specialties, with exceptionally high stakes. This makes the hours long. Residents learn to care for critically ill patients, a process that demands intensive hours, extensive study outside of work to prepare for cases, and the emotional resilience to confront life-and-death situations daily. Neurosurgery offers the extraordinary power to save and transform lives, but it carries the sobering reality of the potential to cause harm. It's also very busy; it is not uncommon for a junior resident to oversee the care of 40 to 70 patients during a single night shift, underscoring the intense and demanding nature of neurosurgery training. Attrition rates reflect this intensity, varying from 2.6% in recent years to 10.98% between 2005 and 2010. The first year, known as the internship, serves as an introductory training period, historically focused on responsibilities outside the operating room. As training progresses, residents undertake junior and then senior rotations as well as dedicated research periods. The culminating year, called chief residency, is when neurosurgery trainees tackle the more complex cases and assume significant leadership roles in managing the neurosurgery service, ensuring they develop into safe, competent surgeons. All neurosurgeons receive comprehensive training in the large variety of neurosurgery including pediatric neurosurgery, tumors, spine, stroke and vascular neurosurgery, equipping them to handle the field's diverse challenges. Step 4: Become An Expert, Fellowship Training Upon completing residency, a surgeon is deemed a board-eligible neurosurgeon, qualified to practice independently and perform surgeries. However, some pursue additional fellowship training, typically lasting one year, or in rare cases, two years, extending their post-medical school training to eight or nine years, respectively. These fellowships allow surgeons to master the most challenging cases or develop advanced research expertise in a specific sub-specialty, such as pediatric neurosurgery, vascular neurosurgery, trauma neurosurgery, functional neurosurgery, complex spine surgery, minimally invasive spine surgery, or tumor and skull base neurosurgery. Surgeons seeking to advance the field through academic practice frequently pursue specialized fellowship training. For instance, I am fellowship-trained in complex spinal deformity, equipping me to handle difficult, long-duration spine reconstruction surgeries. My partners, who perform most other spine surgeries, refer these complex cases to me. And, my practice is actively engaged in several spine research projects. Similarly, while I manage brain tumor surgeries when on call, my partner, who is fellowship-trained in complex tumor surgery, specializes in meticulous microscopic procedures for challenging tumors in high-risk brain regions. I refer those difficult cases to him. This pattern extends to my colleague in pediatric neurosurgery and so on. Step 5: Pass The Neurosurgery Boards And Become A Board-Certified Neurosurgeon The certification process begins during residency, where prospective neurosurgeons must pass a written examination. Then, completing residency renders them board-eligible. After a few years in practice, neurosurgeons sit for the neurosurgery boards, marking the culmination of their training and education—and the definitive affirmation of their expertise as safe neurosurgical practitioners. Upon passing, they become board-certified and diplomats of the American Board of Neurological Surgery (ABNS). It typically takes three to four years in practice for neurosurgeons to undertake the oral board process. This rigorous evaluation involves masters of the field guiding the candidate through cases step by step, incorporating clinical scenarios, MRIs, X-rays, CT scans, and occasionally anatomical models. In essence, they are assessing: did the surgeon know what to do? Did he or she understand the differential diagnosis? Was he proficient in the anatomy? Did he know when to operate? Could he articulate the surgical procedure? How could he manage a hypothetical complication? Even more critically, candidates submit their actual performed cases, including clinical notes and pre- and post-operative imaging for over a hundred sequential cases. This serves as a quality and safety audit: are the candidates delivering safe and effective care? The process is fair yet demanding, as it must be to uphold the profession's standards. Step 6: Develop The Mindset Of Mastery: Continuous Learning in Neurosurgery Neurosurgery is a field shaped by new research and data-driven techniques. To succeed and be safe, a neurosurgeon must be a dedicated learner, consistently engaging with the latest journals and attending conferences to stay current. Equally vital is the capacity to shed ego and engage in daily, introspective reflection on the successes and shortcomings of their practice. This disciplined self-examination is the foundation for refining skills and advancing toward mastery. I frequently advise our trainees that the moment they believe they've executed a flawless surgery is when they are on the pathway to becoming dangerous. Progress in this exacting specialty demands humility and an unwavering commitment to self-improvement. The most exceptional neurosurgeons are those who maintain a rigorous, yet constructive, self-critical mindset, perpetually seeking ways to elevate their calling. The emotional weight of neurosurgery also imposes a formidable challenge. Complications, setbacks, and the daily reality of facing mortality rigorously test any surgeon's resilience. Yet, this resilience enables them to process these profound experiences, draw insights from adversity, and return home to their families with renewed clarity. It is not that uncommon, for example, for a neurosurgeon to inform a patient's spouse at 6:40 p.m. that his or her husband or wife will not survive a traumatic accident, only to embrace one's own spouse hours later. I have been summoned on an idle Sunday from moments of play with my four-year-old to perform urgent surgery on another family's young child. Navigating this emotional intensity alongside personal life requires a steadfast support system and a capacity to find purpose amid hardship. Step 7: Express Gratitude Neurosurgery is an extraordinary profession, it requires profound sacrifice, steadfast support, and an unwavering commitment to personal and professional growth. Our patients are truly inspiring. It is, undeniably, a calling. As Arthur Brooks articulates, a happy life hinges on three core elements: enjoyment, satisfaction, and purpose. Neurosurgery offers these in abundance.
Health Line
21-06-2025
- Health
- Health Line
What Is Lumbar Spondylitis?
Lumbar spondylitis is a general term for degenerative changes causing pain in the lower spine. It's a progressive condition that can lead to a limited range of motion in your back. Lumbar spondylitis, also called lumbar spondylolysis, can lead to a limited range of motion in the back and problems with other joints, such as the ribs, shoulders, or hips. Symptoms typically develop in early adulthood, but they can also develop in teens or children. Back trauma, chronic repetitive loading, or hyperextension of the back can cause lumbar spondylitis. Ankylosi ng spondylitis is a type of arthritis that can also cause this condition. Ankylosing spondylitis most commonly affects the lower spine. When it involves your lower back, it's sometimes called lumbar spondylitis. This term can also refer to any degenerative changes in your lower spine, such as those caused by osteoarthritis. Symptoms of lumbar spondylitis Lumbar spondylitis symptoms can vary between people. They tend to onset slowly over months to years. The main symptoms are lower back pain and stiffness. Your upper back or neck may also be affected as the condition progresses. Your pain may: get better with exercise, but stay the same or get worse with rest be worse in the morning and evening wake you up at night be felt around your buttocks improve with warmth, such as in a warm shower Pain can range from mild to debilitating. Symptoms tend to flare up and then go through periods where they're reduced or disappear altogether. Other symptoms Other potential symptoms include: pain, stiffness, and warmth in joints, such as the: ribs, which may cause problems with deep breathing shoulders knees hips enthesitis, pain where a bone connects to a tendon abdominal pain and diarrhea loss of appetite weight loss fatigue uveitis, which can cause: vision changes eye pain light sensitivity Lumbar spondylitis causes and risk factors Researchers do not fully understand why some people develop lumbar spondylitis. It's thought that genetic and environmental factors both play a role. People who have the HLA-B27 gene seem to be at an increased risk. More than 90% of people with lumbar spondylitis have this gene. However, most people with this gene never develop lumbar spondylosis. Other risk factors for lumbar spondylitis include: family history age, with most people developing symptoms before age 45 having Crohn's disease being assigned male at birth, occurring about two times more often in males (however, it's believed that AS has been under-recognized and under-diagnosed in biological females) Lumbar spondylitis complications Lumbar spondylitis can compress your spinal cord and lead to neurological symptoms like chronic lower back or leg: pain numbness tingling weakness In rare cases, it can also cause loss of bowel control or loss of bladder control. Other complications can include: reduced joint mobility increased fracture risk increased risk of cardiovascular disease How is lumbar spondylitis treated? Lumbar spondylitis does not have a cure, but a combination of natural remedies, medications, and sometimes surgery can help you slow its progress. Natural remedies and lifestyle modifications Natural remedies or lifestyle modifications that may help you manage your symptoms include: physical therapy, which may include: posture exercises strengthening exercises stretches and mobility work massage exercising regularly focusing on having good posture using assistive devices like walkers or canes minimizing your stress levels eating a nutritious, balanced diet that includes foods like fruits, vegetables, whole grains, and lean protein quitting smoking (this can be difficult, but a doctor can build a cessation plan that works for you) or not starting Medications A doctor may recommend or prescribe the following types of medications: nonsteroidal anti-inflammatory drugs like ibuprofen or celecoxib biologic medications like TNF inhibitors to modify immune system activity janus kinase inhibitors if your condition does not respond to other treatments corticosteroids to decrease inflammation and help with pain (these are used sparingly due to their cumulative side effects) Surgery Because of potential complications, surgery is performed infrequently. Your doctor may recommend surgery if you have trouble with daily activities or neurological complications. Some of the most commonly performed surgeries include: Laminectomy: A laminectomy involves removing a part of the vertebra called the lamina to decompress your spine. Spinal osteotomy: A spinal osteotomy is a procedure used to correct structural abnormalities in your spine. Spinal fusion: Spinal fusion is a procedure where two or more of your vertebrae are permanently fused together. Hip joint replacement: A hip joint replacement involves replacing the ball, socket, or ball and socket of your hip joint with an artificial replacement. When to contact a doctor It's a good idea to contact your primary healthcare professional if you have persistent symptoms that may be a sign of lumbar spondylitis. If your doctor suspects ankylosing spondylitis, they may refer you to a doctor called a rheumatologist who specializes in joints for further evaluation. It's also a good idea to visit your doctor if you've previously been diagnosed with ankylosing spondylitis and you notice a change in your symptoms. How is lumbar spondylitis diagnosed? Lumbar spondylitis can be difficult to diagnose. Doctors will typically consider your personal and family medical history, conduct tests, and order a number of tests to help them make a diagnosis, including: performing a physical exam, which might include: examining your joints watching your movement checking for rib stiffness by having you breathe deeply blood tests to check for inflammation and to see if you have the HLA-B27 gene imaging, such as: X-rays magnetic resonance imaging (MRI) ultrasound You may receive an ankylosing spondylitis diagnosis if you have inflammation in the joints between your lower back and pelvis and at least one of the following symptoms: lower back pain that improves with exercise and gets worse with rest limited movement in your lower back limited ability to expand your chest compared to what would be expected for your age and sex What is the outlook for people with lumbar spondylitis? Lumbar spondylitis generally has a good outlook. There's no cure, and symptoms tend to progress, but in most instances, the condition responds to conservative treatment. Your doctor may recommend surgery if you have neurological complications.
Forbes
20-06-2025
- Health
- Forbes
Clarity, Not Volume, Drives Trust In Pain Management Messaging
Christy Saia-Owenby is the Founder & CEO of MOXY Company, focused on strategic growth for medtech, healthcare brands and physician leaders. getty In today's spine and pain management landscape, the only thing more overwhelming than the condition itself is the sheer volume of competing messages claiming to provide relief. For potential patients, this information overload—and the social baggage that comes with it—often creates more confusion than clarity. But it's not just patients who are caught in the noise. For healthcare organizations, medical technology companies and physicians, the spine and pain space presents one of the most complex communication challenges in medicine today. Having worked extensively in this space, I have seen firsthand how complexity is often underestimated. When agencies or partners claim they can effectively market pain products, procedures or providers without a true understanding of the clinical, emotional and social dimensions of pain, it raises a necessary question: Are they advancing care, or simply chasing attention? Pain is deeply personal, often invisible and difficult to define. So is the messaging around it. Crafting communication that is clear, credible and collaborative requires more than marketing tactics—or inflated vanity metrics designed to make generic messaging appear effective. It demands empathy, precision and a deep understanding of both the science and the stigma surrounding pain. In a market saturated with bold promises and competing voices, the question for healthcare communicators becomes urgent: How do we break through the noise—without adding to it—and build trust in a space where trust is often the first casualty? One of the most common mistakes in spine and pain communication is casting too wide a net with a generic message in an attempt to capture the attention of the millions of people living with pain. While the potential audience is expansive—with nearly 21% of U.S. adults living with chronic pain—seeking mass appeal should never come at the expense of relevance. In an effort to seem inclusive, many medtech brand strategies end up overly generalized, lacking the nuance needed to truly connect. Ironically, this often alienates the very patients they hope to engage and help. This challenge is amplified by the realities of information overload. Studies show that an excess of digital content can significantly impair decision making, productivity and well-being, illustrating why focused positioning is critical for impact. The fundamental role of a healthcare brand strategist is not to promote everything to everyone; it is to deeply understand a specific pain point and deliver a clear, confident solution—your solution. In the spine and pain management space, a strong communication strategy isn't just good branding; it's a public service. Specificity is the antidote to overload. While pain may be physical, how individuals experience it and seek help is intrinsically emotional and cultural. When healthcare communicators neglect to acknowledge this critical facet of care, campaigns miss the opportunity to connect with patients on a core level. Research shows that shame can act as a silencer, with many reporting that feelings of embarrassment or unworthiness prevent them from seeking care or sharing their despair. This stigma is often exacerbated for those with chronic pain conditions where symptoms manifest in intimate or invisible ways. As a result, many patients internalize the belief that their suffering is exaggerated or illegitimate, creating uncertainty around when and how to chart a pain-free path forward. As communicators, we must understand the social context in which we operate. It's not enough to promote a product—we need to validate the pain journey. That means highlighting the full treatment trajectory—not just the treatment itself—and honoring the emotional realities that come with it. Compassionate and candid campaigns that emphasize empathy and care build trust. And trust is the bridge between despair and repair. In today's fractured care landscape and increasingly crowded digital space, patients aren't just searching for a service—they're seeking guidance. They need trusted sources to help them navigate information overload, form informed opinions and chart a clear path forward. That's where strategic healthcare communication becomes invaluable—not by saying the most or shouting the loudest, but by communicating with clarity, calm and purpose. The most impactful messaging positions itself thoughtfully within the care continuum, defining a clear niche while acknowledging the complexity of available treatment options. A strong brand strategy doesn't just promote—it provides context. It demonstrates an understanding of the social, emotional, physical and financial barriers patients face, while staying grounded in the specific solutions you offer. When healthcare communicators do this well—offering insight, not just persuasion—they are no longer seen as promoters. They become trusted guides. In a space as personal and high-stakes as pain care, that shift isn't just good strategy—it's a public service. Pain management requires collaboration, not competition. The future of healthcare communication lies in uniting disciplines, honoring lived experiences and crafting clear, evidence-based messaging that rises above the digital noise. When you move beyond simply promoting services or new medtech—and start genuinely connecting with people, their challenges, their passions and their goals—you stop being just another provider or product. You become part of their story. That's how brands, hospitals, surgeons and the entire healthcare industry can stand out—not by shouting louder, but by mattering more. As brand strategists and communicators, our role is not just to amplify, but to advocate. We must continually ask: How can our messaging make patients feel more seen? How can it reduce fear, silence shame and open the door to trust? When patients feel seen, they are not only more likely to seek care; they are also more likely to believe in the care they receive. At the end of the day, clarity isn't just a smart strategy. It's good medicine. Forbes Agency Council is an invitation-only community for executives in successful public relations, media strategy, creative and advertising agencies. Do I qualify?
Daily Mail
04-06-2025
- General
- Daily Mail
People left terrified to sneeze after shocking simulation reveals how woman was left paralysed
Social media users have been left terrified to sneeze, after a video showing how a woman was left paralysed from the involuntary reflex went viral. A sneeze is the body's natural defense against anything that irritates the nose, and can be triggered by anything from germs, allergens and even sudden exposure to bright light. But, in extreme cases, the daily phenomenon can do more harm than good. The simulation clip, posted to X (formerly twitter) has so far been viewed over 331,000 times, leaving viewers 'scared to ever sneeze again'. The video, made by Zack D Films, aims to offer a visual explanation as to how a solicitor spent almost a year paralysed after she ruptured a disc in her spine from sneezing. 'As she sneezed, it ruptured a disc in her spine, and when it collapsed, a nerve got trapped between her two vertebrae,' the voiceover says. 'Suddenly, she couldn't move and even though she had three separate operations, she still suffered extreme pain.' The woman in question is Victoria Kenny, who suffered the extremely rare complication in 2007, after a sneeze disloged a disc in her spine, trapping her sciatic nerve between two vertebrae. She said: 'When I sneezed I felt a searing pain down my spine. 'I didn't understand what was happening. I couldn't stand or move my limbs. It was terrifying. My first fear was that I was paralysed', she added. The video goes on to say: 'For the next two years, she was bedridden needing painkillers so strong she would hallucinate.' The mother-of-three recalled that the morphine she had been prescribed to manage the pain was so strong that she 'saw people literally melting in front of [her]'. The pain was likely caused by a condition known as sciatica, which occurs when the sciatic nerve—which runs from the lower back to the feet—is irritated or compressed. This can be caused by a slipped disc, when the soft cushion of tissue between the bones in the spine pushes outwards. However, despite three operations on her spine, doctors were unable to resolve the problem, leaving Ms Kenny bedridden. 'Being in that kind of pain day after day, I eventually got to the point where I just didn't want to live. The pain took over every part of my life', she said. But after going private, surgeons inserted a hollow plastic cage containing a bone graft into her spine to prevent the vertebrae from rubbing together and the disc from collapsing again. Within a week of the operation, Ms Kenny was up and walking and shortly after, she returned to work. 'The relief was immediate after the operation and I was discharged from hospital the next day,' she recalled. However, she is still 'terrified of sneezing' and pinches her nose every time she feels a sneeze coming on. In response to the simulation, viewers shared similar concerns, with one user saying: 'Now I have another reason to worry about my mom's sneezing. She pretty much shouts it.' Another user commented on the video: 'New fear unlocked'. According to experts, sneezing is a protective reflex, involving an expulsion of air from the lungs through the nose and mouth—most commonly caused by irritants. Whilst unavoidable, and a common reaction to environmental stressors, such as dust and pollen, sneezing can cause a range of terrifying and gruesome injuries. Ian Applegate, from Santa Cruz, was sitting in the car when he suffered a sneezing attack which tore through the inner lining of an artery in his neck, resulting in a stroke. According to Professor Adam Taylor, an anatomy expert from Lancaster University, a sneeze is powerful enough to break ribs, burst lungs and even tear delicate brain tissue. This comes shortly after a fit and healthy young father almost died after sneezing so hard it caused him to suffer a stroke. Ian Applegate, 35, was in the car with his wife Jennifer and their four-year-old son Jon when he suffered a series of explosive sneezes. After the third sneeze, the young dad experienced a sudden blinding headache and dizziness, followed by pins and needles on his left side. Unbeknown to him, the 'violent' sneeze attack had torn through the inner lining of an artery in his neck — a condition known as a vertebral artery dissection (VAD). This tear then caused a blood clot to develop which restricted life-giving oxygen to his brain, triggering the stroke. The 35-year-old was rushed to hospital where doctors gave him blood-thinning medication—known as anticoagulants—to prevent further blood clots. He is now undergoing rehabilitative therapy to help retrain his muscles, after the stroke left him unable to swallow.
