Neurosurgeon:Scientist Pathway in
Pediatric Neurosurgery
14th AACNS Meeting, Jeju Island, Korea
James T Rutka, MD, PhD, FRCSC
Division of Neurosurgery,
The University of Toronto
Neurosurgeon:Scientists
Around the World
Can Paediatric Neurosurgeons Be
Productive and Competitive Scientists?
Excellence in Neurosurgical Research
The Next Generation!
Abhaya Kulkarni MD,PhD
Clinical Epidemiology
Clinical Trials Design
Gamma Knife in Ped NS
JAMA, J Pediatr, Lancet
Peter Dirks MD,PhD
Vascular Neurosurgery
Stem Cells in Brain Tumors
Canada’s Top 40 under 40
Nature, Cell, Cancer
Research
Michael Taylor MD,PhD
Molecular Biology of
Pediatric Brain Tumors
Canada’s Top 40 under 40
Nature Genetics, Cancer
Research, Cancer Cell
How Did These Neurosurgeons
Achieve Excellence in the Lab?
1) They are Neurosurgeons!
2) They devoted substantial time to their
research efforts.
3) They published their seminal work in high
impact scientific journals.
4) Their clinical areas of interest meshed
with their research interests.
5) They are innately interested in doing
better for their patients.
Excellence in Neurosurgical Research
Advice to Paediatric Neurosurgeons
• Adequate training in the lab (2 - 5 years)
• Focused area of research interest
• Research tied to main clinical area of interest
• PROTECTED TIME!
• Adequate infrastructure, team relationships
• Sweat equity
• Dogged determination
Excellence in Neurosurgical Research:
Advice to Residents
• Dedicated time in the lab
• Timing of lab rotation
• Unencumbered by significant call responsibilities
• Ideal if research rotation counts towards a
higher degree
• Best if research is done in a productive lab with
infrastructure and good mentors
Neurosurgeon:Scientist Pathway:
A Practice Sharing Scheme
Dr James Drake
Clinical Trials
Hydrocephalus
2 weeks clinical service
Covers Dr Rutka’s patients
2 weeks in lab
Runs weekly clinic
Formed a partnership:
One large clinical
neurosurgery practice
Busy 2 weeks clinical
Protected time research
(50%)
Dr James Rutka
Brain Tumors
2 weeks in lab
Runs weekly clinic
2 weeks clinical service
Covers Dr Drake’s patients
Glioblastoma Multiforme
Hallmarks of a Feared Cancer
• Nuclear and cytoplasmic pleomorphism
• High mitotic index
• Vascular endothelial proliferation
• Pseudopalisading around Necrosis
• Lymphocytic cuffing
• Invasion into regions of normal brain
Astrocytoma Invasion
Building a Model of Astrocytoma Invasion
NEJM Dec 2010
BIOCOMPATIBLE
BIODEGRADABLE
NANOPARTICLE
INCORPORATION
INTRACELLULAR
DELIVERY
REPRODUCIBLE
SYNTHESIS
TARGETING
Nanoparticle Delivery Across the BBB with
MR-Guided Focused Ultrasound
The Future of Nanomedicine and Neurosurgery
Establishing the Infrastructure for Neuro-Oncology Research
The Arthur and Sonia Labatt Brain Tumour Research Centre
James T. Rutka MD, PhD, FRCSC
Division of Neurosurgery,
Hospital for Sick Children,
University of Toronto
Sick Kids Brain Tumour Research Centre Now!
On September 26th, 2013
A move to the new Peter Gilgan
Research Tower at Sick Kids Hospital!
Principal
Investigators
Annie Huang
James Rutka
Peter Dirks
Jane McGlade
Cynthia Hawkins
Uri Tabori
Michael Taylor
Gelareh Zadeh
Todd Mainprize, Sid Croul, Sunit Das
Recent Publications
Nature Reviews Neurology 2012
Continental Collaboration!
Annual Report of Activities
The Neurosurgeon:Scientist Pathway
• Paediatric neurosurgeons must continue to do
neurosurgical research
• Paediatric neurosurgeons have led the field in neurooncology research
• Residents must be encouraged to pursue careers in
neurosurgery and science with appropriate support
• To do research, there is no substitute for protected
time
• As faculty, we should lead by example
Acknowledgements
Arthur and Sonia Labatt
Brain Tumour Research Centre
The University of Toronto
Bodour Salhia
Hojun Seol
Adrienne Weeks
Christian Smith
Shoichi Nagai
Orlando Moreno
Betty Kim
Warren Chan
Kullervo Hynynen
Arnold Etame
Roberto Diaz
Korean – Sick Kids Alumni Reunion
WFNS World Congress Meeting
Seoul, Sept 2013