MY EXPERIENCE IN THE DEPARTMENT OF NEUROSURGERY UNIVERSITY HOSPITAL TÜBINGEN
WFNS-Aesculap Adult Neurosurgery Fellowship in Tübingen
July - September 2022

First of all, I will like to thank Aesculap, President WFNS, Professor Dr. Tatagiba and Professor Dr. Martin Schuhmann for giving me this opportunity. I am a Neurosurgeon in Karachi Pakistan. I work in a tertiary care hospital (Memon Medical Institute Hospital) in Pakistan. There is no dedicated Pediatric Neurosurgery Hospital in Pakistan and through this Fellowship I will do my best to setup a Pediatric Neurosurgery department in Pakistan.

After 4 years as Consultant Neurosurgeon, this fellowship was something different, a unique and most useful experience. I’ve had many questions and fortunately Professor Schuhmann is a great teacher, always willing to share his hardly gained expertise in practice and clinical research. Besides the medical part, also the human part of interacting with patients and colleagues was an example for me to follow. I have never seen him tired after daily 12h+ of work, always calm and enthusiastic, explaining, searching or providing therapeutic solutions.

I really want to thank Professor Schuhmann for allowing me to attend OPD especially craniofacial clinic and Ward rounds besides attending operating room elective and emergency both, which helped to learn how to do a complete patient care including pre and post-operative care . I observed around 100 cases in my fellowship tenure. Case based discussions with Professor Schuhmann. Assisting these surgeries, the indication-making and the follow-up, I have gained peerless experience. I also attended morning meetings, radiology and oncology board which helped me to enhance my knowledge.

It’s difficult to resume a short list of the most important lessons learned. For example the chronic over drainage consequences in hydrocephalus, surgical treatment of secondary Craniosynostosis, ICP monitoring and data interpretation, using the Dural patch for closure in spinal lipomas, improving the laminotomy technique, many of the ultrasound applications in neurosurgery, use of Robotic Arm, use of Laser in Endoscopic surgery, how to perform and interpret infusion test which in its own a unique procedure,the importance of multidisciplinary conferences and outpatient clinics, most complex tumor management and increasing the resection rate, the intraoperative assurance by proper neuromonitoring, the importance of having detailed patient files and a structured patient database,and so on.

I really admire Professor Schuhmann, his dedication and commitment are just commendable. His concern regarding patient care and that drive which keeps him doing major and difficult Pediatric Neurosurgical procedures. He is an Ocean of knowledge and is always there to teach and share his knowledge.

I have interacted with other team members like Dr. Adib, Professor Dr. Roder, Dr. Haas, Dr. Giese, Dr. Lee and Dr. Lörincz. All of them were very helpful and responsive, whenever I discussed any case they were always willing to answer my queries even though they were busy with their work.

In this kind of high-volume department, with daily interventions in 4 OR’s covering all the neurosurgical pathology, it is not easy for the staff members to always have around them visiting doctors or students, but in Tübingen, every one of them, depending on the interest, is very well integrated regardless of the language-barrier.I have had the possibility to observe also many adult surgeries as there was the possibility to move between the OR’s in order to watch the surgical steps of interest in concomitant surgeries. From the adult cases I was most interested observing some procedures I have only read about or have seen before only in presentations. I have also watched Professor Tatagiba operating some of the most complex oncological and vascular cases, always with calm and great precision as any neurosurgeon should aspire. I have tried to assimilate especially the technique of vestibular schwannoma resection with its origins in Hannover and perfectioned over the years. He was also very kind, he provided me with many information about the department and encouraged me to benefit the most from this experience and for the future.As part of the program I have had the unique opportunity to do a presentation in the hospital’s conference hall about my homeland and hospital.

I would like to thank Professor Schuhmann for arranging shunt valve training workshop with Miethke at Potsdam. I cannot express my gratitude towards Professor Tatagiba and Professor Schuhmann for giving me Neuro drill to develop a Pediatric Neurosurgery Department in Karachi.

Ms. Susanne Efferenn, was my first contact in Tübingen and has guided me through all this program and I am truly grateful for her kindness, enthusiasm and professionalism. All the international visiting doctors are very well received and informed by her throughout the period spent in the department.

When I will be back, I hope I will successfully use technical tips I have learned in Tübingen. I hope this fellowship turn out to be an extra engine for getting me to the next level in the Pediatric Neurosurgery career.

So, this is why I am thankful for this WFNS-Aesculap Pediatric Neurosurgery Fellowship at the University Hospital Tübingen. This is just a resume of what I have learned from Prof. Schuhmann, Prof. Tatagiba and from their department. I hope that many more like me will have the chance of attending this fellowship.

Further information:

WFNS-Aesculap Adult Fellowship in Tuebingen: https://www.wfns.org/training-centers/2/

WFNS-Aesculap Pediatric Fellowship in Tuebingen: https://www.wfns.org/training-centers/1/