A Year in Perspective

A Year in Perspective: PGY-6

by S. Hassan Akbari, MD

S. Hassan Akbari, MD

Last year, as senior residents in Washington University’s neurosurgical training program, we were primarily responsible for our own services with limited chief resident oversight, which improves resident autonomy. While on the “Cranial Service” or “Spine Service,” we had the privilege of independently developing plans for our patients from pre-op to post-op while taking more responsibility in the OR from skin incision to closure. While at St. Louis Children’s Hospital, we managed the entire pediatric neurosurgery census with a second- or third-year resident, which allowed us to not only advance our surgical technique but also enabled us to take a more active role in junior resident training. Thanks to a high case volume at Children’s, the opportunity to learn from our fellow and attending is profound.

As a result of the complexity of cases on each of the three senior services, my operative skills have grown tremendously in a short time. Meanwhile, the busy census has allowed me to become more efficient and precise in the development of preoperative and postoperative management. In many ways, fourth year has been the cornerstone of my neurosurgical training.

In addition to the emphasis placed on surgical and nonsurgical patient care, a significant amount of senior residents’ time is spent on developing a research project that will carry them through their fifth and sixth years. Thanks in large part to a vast network of clinical and translational mentors available through the department as well as the School of Medicine as a whole, there is no limit to the research opportunities available. Additionally, more residents are pursuing degrees during their research time, from an MBA to an MSCI.

This past year year, I have been involved in a variety of exciting pediatric surgeries at Children’s Hospital. In particular, I was able to perform the vast majority of a Chiari decompression with my attending serving primarily as the assistant surgeon. Through this case, we discussed the nuances of a bone-only versus dural augmentation approach and the subtleties of the pathophysiology of the disease. On a separate occasion, I was able to care for multiple patients with craniosynostosis, utilizing both open and endovascular methods to treat the disease. As a result of these experiences, I have developed interests in Chiari and craniosynostosis, which I hope to carry with me as I further my career.

With its impressive history, the Washington University experience for neurosurgical training is unparalleled. The department respects its roots while embracing the future, placing an emphasis not only on work ethic, efficiency and diligence, but also on innovation, discovery and research. As a result, the department provides for its residents a well-rounded training experience in cranial, spinal and pediatric neurosurgery.

Fun interests: Sports (Blackhawks, Cubs, Bulls, Bears), movies/TV, video games, travel