Brain and Blade: The World of Neurosurgery

The University of Pittsburgh Department of Neurological Surgery hosts a pre-clinical annual elective course for interested second-year medical students that seeks to provide the most comprehensive exposure to neurosurgery available at any medical school. The course, titled Brain and Blade: The World of Neurosurgery, is the brainchild of Michael McDowell, MD, and consists of approximately 10 modules dedicated to exploring each subspecialty of neurosurgery. It runs from October through December of the academic calendar.

Past modules have included vascular, oncology, functional, spine, radiosurgery, endoscopy, plus a wide array of other topics. Each module consists of a one-hour lecture on the topic followed by an hour-long procedure workshop on cadavers during which students have the opportunity to attempt complex neurosurgical procedures such as spinal instrumentation and carotid endarterectomies.

The driving impetus of Brain and Blade is to fill the relatively limited exposure to neurosurgery that many students have prior to clinical years. A general understanding of neurosurgical topics is beneficial to all students and this course provides students with a career interest in surgery to engage with potential resident and attending mentors.

A substantial amount of literature has demonstrated that positive experiences with surgeons early in medical school increases the likelihood of specializing in surgery. The department has published its own experience [Impact of a Hands-on Pre-Clinical Neurosurgery Elective Course on Second-Year Medical Student Interest and Attitudes] in the Journal of Medical Education and Curricular Development on the topic, finding that exposure through the Brain and Blade elective significantly improved the perception and interest in neurosurgery in addition to resulting in a high level of content retention.

Since it's inception in 2015-16, the course has remained highly popular among students with surgical aspirations and was recognized with the 2020 Award for Outstanding Elective by the University of Pittsburgh School of Medicine student body. It continues to over-enroll annually. Inquiries may be directed to Dr. McDowell at

Brain and Blade demonstration

Table 1: Standard Course Modules

  • Introduction to Neurosurgery (Lumbar Punctures) 
  • Stereotactic Radiosurgery (Gamma Knife Planning)
  • Emergent Procedures (Hemicraniectomy and EVDs)
  • Pediatric (Supracerebellar Infratentorial Approach) 
  • Tumor (Interhemispheric Approach)
  • Skull Base(Orbitozygomatic Approach)
  • Spine (Cervicothoracic approach)
  • Spine (ACDF and Posterior Lumbar Fusion)
  • Vascular (Carotid Endarterectomy) 
  • Functional (Hemispherectomies)

2023 Modules

September 18: Michael McDowell, MD, Lumbar Punctures and Suturing
October 2: L. Dade Lunsford, MD, Gamma Knife Radiosurgery
October 16: Robert Friedlander, MD, CEA
October 30: Bradley Gross, MD, Hemicraniectomies and EVDs
November 1: Peter Gerszten, MD, ACDFs and PSFs
November 13: D. Kojo Hamilton, MD, Cervicothoracic Instrumentation
November 15: Georgios Zenonos, MD, OZ Approach
November 20: Stephanie Greene, MD, SCIT Approach
November 27: Taylor Abel, MD, Hemispherotomies
December 11: Costas Hadjipanayis, MD, PhD, Interhemispheric Approach with Exoscope