Neurosurgery elective, Royal North Shore Hospital, Sydney

I completed my elective between second and third year of medical school under the supervision of Dr Nazih Assaad at RNSH in North Ryde, Sydney. It was a fantastic, albeit daunting, experience.

I knew this was going to be a full-on rotation and that Dr Assaad would have high expectations for his team and students. Fortunately, I was the only student present on the team, which afforded me many opportunities in theatre and on the wards.

Rounds started at 6AM, and we were in theatre from 8AM to 6PM daily, with a paper round after. On days where there were less exciting (or those I had seen several of) surgeries I helped the team on the wards look after roughly 40 patients. There were several days that I didn’t go home, choosing to participate in the on-call work with one of the registrars who was happy to teach a student and have their ‘help’ (as much as a student can help, anyway!).

Dr Assaad allowed me to scrub in and participate in all surgeries. I was fortunate to see a variety of conditions, including elective, non-elective and trauma procedures. These ranged from simple lumbar laminectomies and anterior cervical discectomies, to brain cyst removal, tumour excision and arteriovenous malformation surgery, to decompressive hemi-craniectomies with neurological salvage following severe (sometimes fatal) trauma.

The team were fantastic and taught me many procedural techniques to use on the wards, effective time management and prioritisation, and included me in research. During my time with Dr Assaad, I became involved in two research projects of which I am the primary author. One is under review (as of January 2019), and the other is in a data collection phase as a prospective cohort trial.

A final note: the very nature of neurosurgery is confronting. While it may seem a magnificent and ‘noble’ specialty, the harsh reality is that most patients never make a full recovery, and the procedures carry a high risk of inflicting further trauma to the central nervous system. I may have been rather ignorant of this, and completing this elective opened my eyes to an aspect of neurosurgery (and many other surgical specialties) that I had previously chosen not to consider.

As a high-quality institute for neurosurgery, I would recommend this elective to any student with an interest in neurosurgery. It allows both exposure to and experience in neurosurgery while presenting students with the opportunity to become involved in research with a feasible end goal.