A recent Nature editorial (https://www.nature.com/news/more-surgeons-must-start-doing-basic-science-1.21874) summarizes disturbing evidence that surgeons are becoming less involved in research. For example, from 2006-2014 the proportion of NIH funding to surgical departments at the top 25 academic medical centres fell from 3% to 2.3% and a 2016 survey of 1000 academic surgeons found that most surgeons thought that they did not have the time nor the resources for research.
Public science resources have become increasingly scarce over recent years, but surgery appears to be particularly hard hit because the clinical demands of surgeons have grown. To quote the editorial “US hospitals depend increasingly on the income that surgeons generate–and have little motivation for encouraging them to spend time on research.”
We have collaborated closely with neurosurgeons since 2011 to study epilepsy and the basic functional organization of the human brain. Neurosurgery provides a rare, invasive window on the human brain that has proved invaluable both for medical and scientific discovery, as demonstrated by great neurosurgeon-scientists like Wilder Penfield and George Ojemann. To make such research happen in the high-risk, complicated environment of hospitals absolutely requires the close collaboration and insight of neurosurgeons. Moreover, as mentioned in the editorial, keeping neurosurgeons involved in science improves their clinical practice by helping them stay up to date with medical research.
Now is a very exciting time for brain therapy innovation. Advances in computer vision (http://7dsurgical.com/), surgical neuronavigation systems (https://www.synaptivemedical.com/), and robotics (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043615/) are making neurosurgery increasingly precise and less risky. Moreover, implanted neuromodulatory devices are emerging as a powerful new therapy for brain disorders like Parkinson’s and epilepsy (http://www.neuropace.com/). To realize these valuable opportunities, academic hospitals and research funding agencies need to make it easier for surgeons to make science an integral part of their careers.