Op-Med is a collection of original articles contributed by Doximity members.
Name: Jonathan Rasouli, MD
Education: Mount Sinai School of Medicine, Albert Einstein College of Medicine of Yeshiva University, Virginia Commonwealth University
Areas of Expertise: Spine surgery, Adult spinal deformity, Spine trauma, Complex spine surgery, Stereotactic and Functional Neurosurgery, Glioblastoma
Current Position: Chief Resident at Mount Sinai
1. Why did you choose neurosurgery?
Neurosurgery is a challenging field that is centered on the diagnosis and treatment of patients with complex conditions of the central and peripheral nervous systems. I chose to specialize in neurosurgery because of my desire to help patients with neurologic disorders and work with some of the most intelligent, altruistic, hardworking, honest, and caring individuals I have ever met. A neurosurgery operating room is intense and methodical, but also full of education and excitement. In my opinion, people who have a high attention to detail and thrive in high-stress environments make for successful neurosurgeons. In addition, I found that my personal value system was very much in-line with my neurosurgery colleagues, so it was literally a no-brainer!
2. What area of neurosurgery is changing most rapidly?
Neurosurgery, as a whole, has drastically changed since I started as an intern in 2012. Virtually every sub-specialty of neurosurgery has adopted elements of advanced intraoperative imaging, ultra-precise robotic stereotactic surgical devices, and high-resolution functional tractography. Vascular neurosurgery, in particular, has risen to the forefront of endovascular stroke treatment with advancements in mechanical thrombectomy. Fluorescence-guided brain tumor resections will become commonplace with the recent FDA approval of 5-ALA. Advancements in computer-guided intraoperative navigation have allowed spine surgeons to place pedicle screws with more ease and precision than ever before. Needless to say, it’s an exciting time to be in neurosurgery!
3. What is the last journal article or piece of research that significantly changed your practice?
The latest CDC guidelines on prescribing opioids for chronic pain were quite eye-opening, to say the least. Opioid addiction has reached epidemic proportions in the United States. The financial costs on our country have been staggering. Over $78.5 billion annual loss to our economy in the form of missed earnings and unemployment. As physicians, it is our duty to prevent this epidemic from getting worse. At Mount Sinai, our department has moved towards limiting opioid prescriptions for post-operative pain and prescribing them less frequently. Although it’s a small step, we all need to get into the mindset of prescribing far less opioids. Personally, I try to limit my prescription of opioid medications whenever possible. The published CDC guidelines are a solid step in the right direction to combating this devastating public health crisis.
4. What are your research interests?
My research interests include deep brain stimulation, traumatic brain injury, blockchain technology in healthcare, adult spinal deformity, surgical wound healing, and surgical infection prophylaxis. It’s certainly a diverse list! You can read some of my latest publications on Pubmed.
5. Outside of your daily practice, do you have any personal or professional projects that you’re passionate about?
Outside of the hospital, I am quite passionate about personal investment, finance, and portfolio management. Amazingly, nobody teaches us about these important topics at any point during our medical school or residency careers. I am perpetually amazed at the number of medical professionals who live on the brink of financial ruin, despite making relatively decent incomes. In fact, I recently published an article on Doximity’s Op-Med about different financial strategies residents can utilize to earn additional income. You can read my article here.
6. How do you unwind after a challenging day?
After a challenging day in clinic or the operating room, I like to unwind by spending time with my friends and family in a social setting. In terms of my extracurricular hobbies, I enjoy playing guitar, working out at the gym, and on occasion, a good Cuban cigar and glass of scotch! Music also plays a large role in helping me relax, you can listen to my intraoperative Spotify playlist here.
7. Who are your mentors?
My dad, hands down. Before he retired several years ago, my dad was very active in business and real estate. He has always given me no nonsense, common sense advice throughout my entire life. I highly value his perspective because he is a man who emigrated to the United States in the 1970s and was able to become a successful entrepreneur, despite numerous economic, political, and social hardships. Not only is he my mentor, but also one of my best friends. One of our favorite past times on the weekends is having a cigar together at a local cigar bar. It’s a great father-son bonding activity.
8. What is a common misconception that other clinicians have about neurosurgeons?
In my opinion, the most common misconception of neurosurgeons is that we are a mostly homogenous group of egotistical men. I could not disagree more with this idea. From my experience working with my neurosurgical colleagues and travelling to neurosurgery conferences around the nation, I have found that neurosurgeons are some of the most humble, down-to-earth, self-sacrificing, and diverse group of medical professionals with whom I have ever worked. One does not have to search very hard to find some truly incredible and talented men and women in neurosurgery, both past and present. It is an honor to be able to join their ranks.
9. What’s the best advice you’ve ever received?
Trust, but verify.
10. What has been your most gratifying moment of being a clinician?
One of my most gratifying moments as a clinician is being able to inspire, educate, and watch my junior residents grow into independent and capable neurosurgeons. One of the best aspects of senior residency is being able to pass the knowledge I’ve gained from my attendings and past seniors onto my junior residents. Instilling a sense of camaraderie and discipline in the juniors keeps a busy neurosurgery service running smoothly, safely, and efficiently. I’m always proud to see them incorporate my personal tips and tricks into their own repertoires of skill and knowledge.
11. How do you motivate patients to do what’s best for their health?
Healthy behavior change is one of the most difficult tasks for patients to accomplish in terms of taking charge of their health. In the realm of neurosurgery, I have found the best advice we can give our patients is to diet, maintain healthy body weight, exercise regularly, and avoid taking pain medications unless absolutely necessary. Unfortunately, in most cases this is easier said than done.
12. What is the biggest challenge or obstacle in neurosurgery?
In my opinion, the biggest challenge we face in neurosurgery is the ability to adequately educate and train residents in a medical environment that is becoming increasingly risk-averse and bureaucratic. The main difference between today’s neurosurgery training and that of years past is the gradual disappearance of operative autonomy. Although residents still have the ability to operate on their own; these opportunities are becoming increasingly rare. Unfortunately, unless concrete steps are taken to preserve resident operative education, I only imagine this problem getting worse over time.
My favorite Doximity features are DocNews and the Career Navigator. They consolidate a ton of useful information into a concise, clean, and easy to use graphical user interface. I also like the Residency Navigator, as it is pretty much the only search tool out there for medical students to find information about residency programs. The information is up-to-date and easy to obtain, which is also a good feature. You can read my article about Doximity’s Residency Navigator here.