Episode 18: Insights From a Lifetime of Training Residents and Neurosurgical Research. A Conversation with Dr. Haring Nauta

Dr. Maxwell Boakye
March 15, 2022

Few people have as long or as distinguished a career as Dr. Haring Nauta. On this episode, we discuss his observations about neurosurgical residency, neurosurgical training, and how to improve the quality of that experience. We also dive into his exciting work using the punctate myelotomy procedure to treat pain and current research topics.

You will want to hear this episode if you are interested in…

Diving into the current practice of Dr. Nauta [3:02]
What is a punctate midline myelotomy and how does it help neurosurgical pain? [10:03]
The logistics of a punctate myelotomy [26:00]
Dr. Nauta’s thoughts on the evolution of neurosurgical training [32:11]
Defining leadership and the qualities that make a good chief resident [38:48]
Fighting the resident burnout epidemic and the role of emotional intelligence [41:42]
Looking back at Dr. Nauta’s incredible career [46:05]
Dr. Nauta’s advice for young neurosurgeons striving for excellence [49:39]
Dr. Nauta answers the magic wand question [55:30]

The evolution of neurosurgical residency

One benefit to Dr. Nauta having a lifetime of experience teaching neurosurgery is that he’s seen the evolution of neurosurgical residency. He’s intimately acquainted with how it’s improved and where it should go next. He notes that one of the most welcome changes to residency is the culture as a whole. The formation of the Accreditation Council for Graduate Medical Education (ACGME) created a drastic reduction in the abuse experienced by residents at the hands of faculty. Gone are the days when scalpels could be thrown in frustration without accountability. Mediation is encouraged wherever there is conflict to promote a healthy learning environment. Dr. Nauta remains thankful for the overall increase in professionalism throughout neurosurgical graduate studies and looks forward to how that culture can further improve.

Lead by example

What makes a good leader? And as a good leader, what qualities do you try and instill in the leaders of the future? I love asking questions like that to doctors with experience like Dr. Nauta’s because their answers are always excellent. His answer was no exception…fairness. Fairness is a great leadership quality to Dr. Nauta because it is very hard to get others to follow you when you’re treating them unfairly. It seems so simple, yet many lead residents and faculty maintain militaristic control over those they are supposed to be teaching. Dr. Nauta shared the quote, “Leadership is the ability to inspire people to do what they otherwise would not do.” and quipped that if someone is already doing what they need to do, they don’t need leadership. He went on to say, “Leadership is the ability to inspire people to do something better. And largely, that involves them wanting to be like you a little bit, fair and competent.” It’s clear that Dr. Nauta is someone who leads by example.

People teaching people

When it comes to improving the training that neurosurgery residents receive, Dr. Nauta says that you can’t get away from the fact that it is people teaching each other. For him, the biggest factor in successful general neurosurgery training is the environment. Specifically, the learning that happens between residents. Dr. Nauta calls for a greater level of attention to encouraging a culture of resident to resident learning so that it’s easier for junior residents to accept non-faculty as the source of their information. Residents limit their education when they only take training from faculty or chairpersons because they are not always available. When residents train residents they get additional support and practice they would otherwise go without, decreasing the amount of time it takes to complete their program and increasing the overall quality of their experience. Listen to this episode for more insights from Dr. Nauta!