Subspecialty certification

The 2016 AANS Presidential Address: Leading the way

This AANS presidential address focuses on enduring values of the neurosurgical profession that transcend the current political climate. The address was delivered by Dr. Batjer during a US presidential election year, but the authors have intentionally avoided discussing the current chaos of the American health care system in the knowledge that many pressing issues will change depending on the outcome of the 2016 elections. Instead, they have chosen to focus on clarifying what neurosurgeons, and the American Association of Neurological Surgeons, in particular, stand for; identifying important challenges to these fundamental principles and values; and proposing specific actions to address these challenges. The authors cite "de-professionalism" and commoditization of medicine as foremost among the threats that confront medicine and surgery today and suggest concrete action that can be taken to reverse these trends as well as steps that can be taken to address other significant challenges. They emphasize the importance of embracing exceptionalism and never compromising the standards that have characterized the profession of neurosurgery since its inception.

The impact of subspecialization on postgraduate medical education in neurosurgery

Medical subspecialization is a response to rapidly expanding technology and knowledge. Although beneficial to patient care, it poses a challenge to the current infrastructure of resident education. This article analyzes the advent of subspecialization, the current template of postgraduate neurosurgical education, the impact of subspecialization on postgraduate neurosurgical education, and, finally, suggests strategies to optimize professional education in the face of an increasingly subspecialized field.