From the Chair

Pediatric Neurosurgery Comes of Age

Rick Abbott, MD

In 1996, you honored me by first electing me to serve as a member at large on the Executive Committee of AANS/CNS Section on Pediatric Neurological Surgery. As I have moved through the offices of the Executive Committee, I have enjoyed watching our specialty come of age.

Over the past 10 years I have seen our section’s business mushroom, resulting in the need to create a chair-elect position and to split the office of secretary-treasurer into two separate offices, secretary and treasurer. Through Tom Luerssen’s leadership, the Pediatric Section stood behind the newly created American Board of Pediatric Neurological Surgery and the Accreditation Council for Pediatric Neurosurgery Fellowships as they blocked a threat to be rendered meaningless. Our annual meeting in December has become the must-attend meeting for pediatric neurosurgeons, not only for North Americans but now for those in Europe and the Far East. Our treasury has grown to more than $600,000, giving us the power to consider funding projects we could not even dream of a decade ago. All of this is a testament to your support for our specialty.

While we have much to be proud of, we still have much to accomplish. The creation of the Education Committee under the guidance of Paul Steinbok was done to revitalize our commitment to educating general neurosurgeons, neurosurgeons in training, other physicians and the general public about our field. Paul will need your support in this endeavor. Volunteers are needed to serve as faculty in instructional courses to be held both inside and outside North America. The Pediatric Section has committed to co-sponsoring a course in Colombia with FLANC, the neurosurgical society for Central and South America. We have also entered into an agreement with the International Society for Pediatric Neurosurgery to co-sponsor courses in emerging countries where there is minimal exposure to pediatric neurosurgery. The Pediatric Section is now receiving regular requests for manuscripts on pediatric neurosurgical topics. Doug Brockmeyer would welcome your support with manuscripts, and this is certainly a relatively easy way to become identified with a subject matter, not only by other neurosurgeons but also by physicians outside our field, such as pediatricians. It is also a good entry into the Educational Committee and its activities.

Our Greatest Challenge
Perhaps the greatest challenge currently facing us is the rate at which we are training our replacements. A graphic that demonstrates the problem is shown below. For nearly a decade, we have been certifying, on average, only seven to eight pediatric neurosurgeons per year.

We all have a sense that there is a manpower shortage, but we do not know to what degree and how it affects the care of children. We do not know what the needs are in North America for ABPNS-certified pediatric neurosurgeons. We do not know how many pediatric neurosurgery call rosters are filled out by non-pediatric neurosurgical specialists. We do not know how many vacancies currently exist. We do not know why fewer than half our fellowships fill each year, and why some years only three or four residents enter into a pediatric neurosurgery fellowship. We must get the answers to these questions so that we can respond to this low rate of fellowship enrollment.

The Pediatric Section is currently in discussion with the ASPN and the SONS of the American Academy of Pediatrics to fund a pediatric neurosurgery manpower study. This study should provide us with powerful knowledge that we will also be able to use to negotiate support for our programs and practices. The incoming leadership has the strength, experience and desire to meet these and other issues. They also have exciting new ideas. I look forward to this reenergizing of the Pediatric Section and to the accomplishments that are sure to come. Thank you for all your support.

I will end with a special thanks to Ann-Christine Duhaime, MD, for all of her efforts as secretary. It is the most difficult job in our section, and she has done a spectacular job.