During the pandemic, united by a shared love of Neurosurgery and the Russian language

May 7, 2020

By Gail Rosseau, MD, Clinical Professor of Neurosurgery, George Washington University of Medicine and Health Sciences, Washington, D.C.

During the pandemic, virtual meetings have become commonplace and have even allowed medical trainees in remote parts of the world to share how the pandemic has affected their training.  In this brief interview, two future neurosurgeons connect over their shared interest in Neurosurgery and Russian language.

Nathan Shlobin (nathan.shlobin@northwestern.edu)is a first year medical student at Feinberg School of Medicine, Northwestern University, Chicago, Illinois.  His interest in neurosurgery started when he realized that he wanted to pursue his interest in neuroscience while being engaged in operative care. He learned Russian as a first language, as his grandparents and parents immigrated to the United States from Ukraine and Belarus.

Manuel De Jesus Encarnacion Ramirez (dr.encarnacionramirez@gmail.com) is a second year resident in Neurosurgery at Peoples’ Friendship University of Russia, Moscow, Russia.  His interest in neurosurgery started in his native Dominican Republic, and led him to pursue a neurosurgery residency in Caracas, Venezuela.  When political instability threatened his hospital, he moved to Moscow to pursue his training. He learned Russian while learning neurosurgery, and is learning to appreciate the Russian language and culture through his Russian wife and young daughter.

They were recently interviewed by Dr. Rosseau (gailrosseaumd@gmail.com)of the World Federation of Neurosurgical Societies Global Neurosurgery Committee.

Gail Rosseau, MD, Clinical Professor of Neurosurgery, George Washington University of Medicine and Health Sciences, Washington D.C., USA

Nathan Shlobin, first year medical student at Feinberg School of Medicine, Northwestern University, Chicago, USA

Manuel de Jesus Encarnación Ramírez, second year resident in neurosurgery at Peoples’ Friendship University of Russia, Moscow, Russia

Gail: These are challenging times. The COVID-19 pandemic has necessarily focused the attention of medical professionals on the clinical care of patients, hospital workers and communities. This scourge has also disrupted medical education and residency training throughout the world.

How has the current situation affected your schooling / training?

Manuel: Our academic program has been reduced, and we only go to the hospital 3 days/ week for on-call duty,only we attend emergency surgery

Nathan: While our lectures have been moved to an online platform, we also have a reduced and incomplete academic program. Sessions for our longitudinal care care clinics were moved to telemedicine visits, which has limited my ability to practice the clinical exam. Clinical skills sessions were postponed to at least June.

What has been the largest limiting factor on your education due to the social distancing requirements?

Manuel: Suspension of all the scheduled surgeries means I am not learning how to perform elective surgery. Only emergency surgeries, such as neurotrauma(fractures,subdural and epidural hematoma, etc.) are performed. The hospital provides us with personal protective equipment

Nathan: A lack of on-site clinical exposure has limited my ability to practice skills at a young stage in my education.

What have you done to manage limitations on your education during this time?

Manuel: I am using my time to improve my neurosurgical didactic education, with online educational courses ( Neurosurgicaltv, Skullbase week. neurocirurgia.online and PNS Webinar) and increased the reading of neurosurgical texts and journals.

Nathan: I have watched the online lectures created by professors at my medical school, thought about how I would conduct patient visits, and continued to engage with my professors and classmates via the online platform. Engaging with my professors and peers has helped bring some semblance of normalcy.

What attitude are you taking to:

Manuel: Receiving online classes everyday also and increase the reading time, At the same time, every day I go to the hospital I have to be more careful, without letting fear and stress prevent me from doing my job in the best possible way, and after I leave the hospital I must go home very carefully.

Nathan: I feel fortunate that I am able to continue my education during this time because events such as these show how important physicians are. Purely online classes have not been too much of an adjustment because a lot of the curriculum was already online. I do not think that the time I have spent on school work has increased.  My class schedule has changed a bit, but that has not been too much of a problem. The most difficult part of this has been engaging with my classmates in an online setting. It is easier and more natural to work together on problems or discuss cases face-to-face, but the online platform has still allowed those discussions to continue to occur.

Have you felt stress? If so, how has this changed your education?

Manuel: Yes. I feel that I must increase my hours of reading about neurosurgical topics, as well as learn everything I can about COVID-19.But also information overload creates more stress and uncertainty.

Nathan: It was a bit difficult to maintain focus at the beginning of the pandemic due to the stress of hearing about the number of people affected, and I continue to worry about loved ones. Unfortunately, this has become the new normal. We have to continue what we are doing now for the sake of our current or future patients.

What are your expectations about how this will change your education post-quarantine? 

Manuel: The academic year will be prolonged.  We don’t know if students and residents will graduate on time.  There will be a  post-quarantine period of uncertainty in health care and education.

Nathan: In the short term, the start and end dates of our academic year might get shifted. In the long term, it is difficult to say. Many of my classes were already pre-recorded and placed online or placed online after lecture prior to quarantine.

Gail: You both have said that you expect that your training will continue to include much more virtual learning in the future. Medical educators are predicting significant changes to medical school and residency curricula that will reflect lessons learned from the profound increase in online learning necessitated by social distancing.

What are your suggestions for  other trainees during this time?

Manuel: I have found online educational resources to be very useful.  For residents who have operating  loupes,  they can practice microsurgical techniques, like suturing, at home.

Nathan: It is particularly important that you continue your education, perhaps now more than ever. Stay connected with your friends and family. Even though we cannot be with some of them in person, it is important to support each other. And if you are struggling mentally, that is ok. There are resources to help us get through this safely, with our physical and mental health intact. It is a difficult time, and we are united to help each other through this.

What can faculty do to support you?

Manuel: A suggested reading list or other learning guides from faculty would be helpful, as well as continuing departmental educational conferences via online platforms.

Nathan: Instructors should assess our needs and work closely with us. Fortunately, administrators in the office of medical education at my medical school have been very helpful. They send out a weekly email detailing any updates they have to share with us and have been responsive to student concerns.

Map of path from Chicago to Moscow