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The Responsibilities of Excellence

Third Harvey Cushing Oration

William H. Stewart

of the neurological and related sciences, and most appropriately so. What I am suggesting is that you measure this advancement, not only upward along the axis of science, but outward along the axis of meeting public need. These are by no means incompatible, far from it. They are inseparable. Second, you have a responsibility to the oncoming generations of physicians. Many of you are directly involved in their preparation through your association with academic medicine. All of you are involved as models, as preceptors whom the young will seem to emulate. In this

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Perspective on Neurosurgery

Presidential Address

Eben Alexander Jr.

trained well, largely without federal support. This is obviously a strength of our own specialty. There have been funds available, as in all areas of surgery, for research and for the training of some men who will devote their time to laboratory investigation for a year or more, with the hope that such men will be attracted into academic fields. The need in neurosurgery and in academic medicine in the next ten years will be for men highly trained in the research areas as well as in the skills of neurosurgery, and increasing support is being given to neurological

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Edward F. Macnichol Jr.

became apparent that although practicing neurosurgeons were not in the short supply evident in many other medical disciplines, there was an urgent need for the skilled neurosurgeon with the additional preparation required for a career in research and academic medicine. Once convinced of this need, the national societies strongly and actively encouraged the development of this aspect of neurosurgical training. As a result, applications for support were submitted to the NINDS, and a substantial number of training grant programs have been established during the

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Paul C. Bucy

. Bailey began his work at Chicago with great anticipation. Here was a new school with new ideas. Not only did it have the first completely full-time, fully salaried faculty, but it developed an unusual curriculum. The course of study for its students was founded upon several important pillars. The student body was unusual. They were selected because of their apparent interest in investigation and academic medicine. Many of them already had Ph.D.'s in various areas. Many were members of faculties in other institutions in the basic sciences. The faculty had their offices

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Harry A. Kaplan

to academic medicine in 1970 as professor of neurosurgery at the College of Medicine of New Jersey at Newark. Dr. Browder was a Diplomate of the American Board of Neurosurgery and president of this group in 1958. He also was highly respected by his colleagues in neurology and they elected him president of both the Brooklyn and the New York Neurological Societies, president of the Association for Research in Nervous and Mental Diseases, and vice-president of the American Neurological Association. He was a member of most of the leading surgical, neurosurgical, and

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clinical practice as well as the surgeon who entered academic medicine. It is only fair to add, however, that academic credentials do not, by definition, confer a degree in professional excellence or irreproachable professional behavior. I feel very strongly that there is no rational basis for the mistrust and hostility in our profession. If the past provided a basis for antagonism, it is high time that these wounds be healed. Academic neurosurgeons and neurosurgeons in private practice in the community each fulfill important roles that are truly complementary and not

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Darell D. Bigner

American Academy of Neurology for outstanding research in brain tumors. And finally, because he was a loyal supporter of his alma mater, the University of North Carolina at Charlotte, he was extremely pleased when he received the Distinguished Alumnus Award in 1986, was elected to their Alumni Hall of Fame in 1991, and was given the Distinguished Service Award in 1991. M. Stephen Mahaley, Jr., M.D., Ph.D., 1932–1992 Steve rose rapidly through the ranks of academic medicine at Duke from Assistant Professor to Associate Professor of Neurosurgery. At the time

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academic health centers. Admittedly, to cover the expenses of medical education, research, and care of indigents, some cost shifting was used, but this “Robin Hood” practice worked to everyone's advantage, and also felt noble. Unfortunately, with the failed attempts at national health care reform, numerous forces were unleashed, many of which were driven by profit and none of which were primarily concerned with medical education and/or academic health centers. A storm is approaching, with the potential not only to stifle but to destroy excellence in academic medicine

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Eben Alexander Jr.

physicians in planning for the casualties of World War II. One of the more surprising things was the influence of Eli Ginzberg as Director of the Resource/Analysis Division of the Army Medical Corps. During that time he was an intimate advisor to Colonel Michael DeBakey, Deputy Head of the Consultant Division under General Bliss, and was accompanied by Brigadier General Hugh Morton for medicine and Brigadier General William C. Menninger for psychiatry. These individuals, as summarized in an article by Ginzberg published in Academic Medicine , 5 had a large influence in

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William B. Borden and Rafael J. Tamargo

Cincinnati and contributed significantly by revamping the department of surgery and creating the third postgraduate surgical education program in the United States, joining The Johns Hopkins Hospital and the Peter Bent Brigham Hospital in this endeavor. 9 Heuer's accomplishments in Cincinnati became known throughout academic medicine. Thus, when the Board of Governors of the New York Hospital decided to create residencies on all services for the opening of their new hospital in 1932, they contacted Heuer to be chief of surgery and to establish the form of training that