Specialty in Neurosurgery

 

Neurosurgery encompasses the diagnosis, assessment and surgical management of disorders of the nervous system. Although being practiced from 5000 years ago and in ancient Egypt and Persia, the specialty was established in nineteenth century and developed in the first half of the twentieth century through the treatment of cranial trauma and intracranial mass lesions. Subsequent advances in innovating angiography, CT scan, MRI, microsurgical techniques, non-invasive imaging, neuroanaesthesia, intensive care, image-guided surgery, and the introduction of sophisticated radio-oncological and interventional treatments have changed and widened the scope of neurosurgical practice. Ancient excavations reveal that simple neurosurgical surgical procedures were performed in ancient Iran (Persia) dating back to 5000 years ago. Centuries later, Avicenna described trigeminal neuralgia meticulously and in a detailed manner.

 

Modern neurosurgery was established in 1951 in Iran and in Tehran University of medical sciences (TUMS).

 

Philosophy (Beliefs & Values)

• Effective cooperation with other colleagues and specialties
• Professionalism (empathy, respect, confidentiality, excellence, and honesty)
• Lifelong learning
• Evidence based medicine

 

Expected outcomes

At the end of the course trainees should be able to:

• Correctly obtain history, perform physical examination, order paraclinical assessments, analyze the data and diagnose the disease or problem through clinical judgement.
• Select and plan the proper treatment and management approach
• Give proper and effective consultation to the others
• Perform all the related surgeries (brain, spinal cord, peripheral nervous system (PNS), and spinal column surgeries along with micro procedures, sympathectomy, pain management, brachytherapy, endoscopic surgeries, etc.)
• Gather the medical data and statistics in the region of education
• Properly design, perform and evaluate researches in the field of neurosurgery
• Manage the wards and centers of neurosurgical practice
• Educate patients and specific populations (in society or in the University)

 

Expected Competencies & Procedural Skills

The expected competencies for the trainees in this field are:

• Communication
• Fluently speak English and the ability to write, listen and use English articles, references, and manuscripts.
• Obtaining history and performing physical examination (in Persian)
• Ordering paraclinical assessments
• Ordering medication
• Team working
• Counseling & consulting
• Managing the relevant units
• Patient management
• Education and research
• Paper writing
• Proper use of computer, internet and routine programs and software

 

Procedural skills (diagnostic and management)

 

Diagnostic procedures

• Biopsy (brain, vascular system, skull, spinal column, spinal cord, and PNS)
• Lumbar puncture

 

Management and continuous evaluation of patients in intensive care unit

 

Neurosurgical procedures

Emergent procedures

• Decompressions (spinal and brain)
• Fixing fractures (skull and spine)
• Evacuation of hematomas
• Tractions

 

Elective procedures

• Treatment of congenital diseases and problems
• Treatment of degenerative diseases and problems
• Treatment of infectious diseases and problems
• Treatment of tumoral diseases and problems
• Treatment of functional diseases and problems
• Treatment of vascular diseases and problems

 

Teaching & Learning Method

• Lecturing and Speech
• Self-study
• Participation in mini groups
• Participation in theoretic educational plans such as symposia, scientific congresses, conferences within the wards or hospital or between the hospitals, etc.
• Clinical educational plans: morning reports, rounds, grand rounds, clinical practice and education, mortality and morbidity sessions, tumor boards, and journal clubs
• Electronic and virtual educational methods
• Practical trainings in related topics