The British Student Doctor Journal (BSDJ) is the only peer-reviewed and open-access international journal uniquely managed by medical students and resident doctors. As the official journal of the Academy of Medical Educators (AoME), it is primarily aimed at a readership of medical students and resident doctors in the UK. We publish original research and systematic reviews, and we also provide a platform to medical students to express original thought and reflections on clinical practice, student life and medical education. All of our content is fully open access, available without subscription and with no authorship charges. All articles published in The British Student Doctor Journal go through a rigorous peer-review process, led by our Editorial Board. The governance of the journal is overseen by our Faculty Advisory Board. We are published by Cardiff University Press and funded by the Academy of Medical Educators and Cardiff University School of Medicine. For more information, please visit our homepage at www.bsdj.org.uk.
Copyright for articles published in the journal is held by The British Student Doctor Journal. Authors are required to complete a copyright assignment form, available here. The form specifies that authors must seek to obtain permission for publication of any content for which they do not already own the copyright, before submission of the manuscript. The content of The British Student Doctor Journal is usually made available under a CC-BY-NC-ND 4.0 International (Attribution-NonCommercial-NoDerivatives) licence from Creative Commons. The licence lets others distribute the work in its original form as long as they credit the author(s) of the work. Authors of articles in The British Student Doctor Journal may request that their work is published under a CC-BY 4.0 (Attribution) licence instead. If this is the case, then please contact the Editor-in-Chief (editorinchief@thesdj.org.uk) at the time of acceptance. For further information about the licences, please visit https://creativecommons.org/licenses/. For full details of our open access and copyright policies, then please visit our website.
Doctors as Agents of Health Equity: The Future of Medicine Is in Our Hands
The British Student Doctor Journal (BSDJ) has launched its 2026 issue with an editorial from our Editor-in-Chief, exploring why doctors should be agents of health equity and their moral obligation to advance this work through both clinical practice and broader advocacy. It also highlights the importance for trainees to recognise the powerful agency inherent in academic freedom, and to use the research and advocacy published in scholarly journals to help drive change at a scalable, system-wide level.
Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0
Have We Lost the Human Connection in Medicine?
This editorial explores the experiences of an early-career resident doctor with end-of-life care and the importance of restoring human connection in medicine amidst an evolving future of clinical practice.
Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0
Chimeric Antigen Receptor T-cell Therapy in Multiple Myeloma: Potential Benefits and Key Challenges to Becoming a Standard Treatment
Background: Multiple myeloma (MM) remains an incurable haematological malignancy, with most patients experiencing relapse owing to drug resistance despite advances in proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, and autologous or allogeneic stem cell transplantation. Chimeric Antigen Receptor T-cell (CAR-T cell) therapy has emerged as a highly promising immunotherapeutic agent, particularly when targeting B-cell maturation antigen (BCMA). Methods: A narrative literature review was conducted using PubMed, MEDLINE, and Embase to identify relevant studies published between 2013 and 2025. Search terms included ‘CAR-T’, ‘multiple myeloma’, ‘BCMA’, ‘idecabtagene vicleucel’, and ‘ciltacabtagene autoleucel’. Additional grey literature was obtained from regulatory agencies (FDA, NICE) and cancer statistics (SEER). Eligible studies included phase I-III clinical trials, systematic reviews, meta-analyses, review articles, and policy documents in English. Case reports, non-peer-reviewed conference abstracts, and non-English studies were excluded. Results: FDA-approved, BCMA-directed CAR-T cell therapies such as idecabtagene vicleucel and ciltacabtagene autoleucel have shown unprecedented response rates in patients with relapsed/refractory MM, with overall response rates of 73% and 98% respectively. However, challenges such as antigen escape, CAR-T cell exhaustion, high manufacturing costs and accessibility challenges have limited their widespread use. Adverse effects such as cytokine release syndrome, neurotoxicity, and prolonged immunosuppression further complicate its integration into clinical practice. Discussion: CAR-T cell therapy represents potential for tangible improvement in the relapsed/refractory treatment landscape. Compared to conventional therapies, CAR-T cell therapy offers durable remission, particularly in heavily pretreated patients, and more precise targeting of tumour cells. Future research should focus on optimising CAR-T cell persistence, exploring dual- or multi-antigen targeting and developing more efficient, decentralised manufacturing processes. Bridging the gap between innovation and accessibility is critical for the feasible implementation of CAR-T cell therapy as a standard treatment for MM. Broader integration into treatment algorithms requires addressing financial and ethical barriers to ensure equitable access.
A New Lens: Reflections on My Ophthalmology Elective in Sydney
You Belong Here: Combating The Imposter Phenomenon in Health Professional Education
<p class="p1" style="margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-size-adjust: none; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-variant-position: normal; font-variant-emoji: normal; font-stretch: normal; font-size: 10px; line-height: normal; font-family: Helvetica; color: #000000;">Our Co-Editor-in-Chief shares her perspective on the discourse surrounding the imposter phenomenon in health professional education.
Performative Wellbeing Provisions in UK Medical Schools
Letter to the Editor by Ria Bansal and Akshata Valsangkar.
Equal Standards: Should Faculty Be Held to the Same 48-Hour Email Response Policy as Medical Students?
Email response policies in medical education shape communication expectations for students and faculty. 48-hour email response policies for medical students are typical at many UK medical schools, with University College London, Glasgow Medical School, and Queen Mary University of London formalising these expectations through signed agreements. However, the absence of similar standards for faculty members raises questions about equity, professionalism, and the hidden curriculum in medical education. This article explores the implications of asymmetric email response policies, focusing on their impact on power dynamics, student-faculty relationships, and professional identity formation. We propose four recommendations to improve professionalism and the collaborative culture essential for future healthcare practitioners, ensuring that communication policies reflect the values they aim to instil.
Is Now the Time to Introduce a National Prostate Screening Programme in the UK?
Prostate cancer is the most diagnosed cancer in men across the UK and a leading cause of male cancer mortality, raising a crucial question: Why has national prostate screening not yet been established? Evidence highlights the significance of early detection to improve prostate cancer prognosis, yet the current PSA-based opportunistic testing strategy fails to address inequities in diagnosis and, crucially, there is no evidence of improvements in prostate cancer mortality following the PSA test. Consequently, UK-based and international research into the development of new screening tools for prostate cancer diagnosis are advancing. For instance, recent biomarker technologies aim to offer more accurate and less invasive screening options, reducing unnecessary biopsies and over-diagnosis. A national prostate cancer screening programme targeted towards high-risk groups could emulate the successes of breast and bowel cancer initiatives, which have demonstrated significant mortality reductions. Beyond cancer detection, national screening could act as a gateway to addressing broader men’s health issues, including cardiovascular and mental health, while leveraging AI-driven tools and societal role models to improve health education and engagement. This discussion explores the challenges associated with the implementation of a national prostate cancer screening programme in the UK, despite its transformative potential to save lives, reduce health inequities, and redefine male healthcare.
Will pharmacotherapy soon replace bariatric surgery as the gold standard treatment for obesity?
Background: Obesity remains a substantial and growing global health issue, contributing significantly to comorbidities such as type 2 diabetes, cardiovascular disease, and reduced quality of life. As the prevalence of obesity continues to rise, clinicians must help people living with obesity to navigate the increasing range of treatment options. Bariatric surgery has been regarded as the gold standard treatment for severe obesity, due to its consistent and substantial weight loss outcomes. However, recent advancements in pharmacotherapies targeting appetite regulation and metabolic pathways, particularly GLP-1 receptor agonists, have prompted renewed interest in medical management as a potentially effective and more accessible alternative. Methods: A narrative review was conducted using PubMed, Cochrane, and NICE guideline databases covering studies from 2000 to 2024. Inclusion criteria encompassed clinical trials, meta-analyses, and national health policy reports. Exclusion criteria included non-English sources and case studies with <10 participants. Search terms included “bariatric surgery”, “GLP-1”, “obesity pharmacotherapy”, and “obesity management UK”. Data were analysed for treatment efficacy, safety, cost-effectiveness, accessibility, and long-term outcomes. Bias risk and funding sources were noted where applicable. Results: Evidence indicates that bariatric surgery achieves greater and more sustained weight loss (up to 70% excess weight loss) and improved long-term comorbidity remission, but carries surgical risks and access barriers. New pharmacotherapies such as semaglutide and tirzepatide achieve 15-25% total body weight loss with favourable safety profiles, however long-term outcomes and accessibility remain concerns. Conclusion: While pharmacotherapy shows promise, especially for less severe obesity or surgery-ineligible patients, it is unlikely to fully replace bariatric surgery in the near future. A combined, patient-centred approach may be the future standard. For clinicians, especially those in training, understanding both approaches is essential for offering tailored treatment strategies based on individual needs and preferences, in order to improve outcomes in obesity management.
Physician-Assisted Dying: History, Changes in Law and Ethical Dilemmas
Summary: Physician-assisted dying is an act where a patient can end their life by ingesting a medicine or any form of medication that has been prescribed to them by a medical practitioner. At the moment, all forms of assisted dying in the UK are illegal under Section 2 of the 1961 Suicide Act. However, the recent ‘Terminally ill adults (End of Life) Bill’ was backed by MPs which could result in assisted dying being made legal in the UK, provided that both Houses of Parliament approve it. This article analyses the history of physician assisted dying in the UK, the recent changes in law and its ethical dilemmas. Relevance: The new developments surrounding assisted dying, which are currently being discussed in parliament, will alter the way medical students perceive physician roles. In medicine, there is a great emphasis placed on the Hippocratic Oath and the ethical pillar of non-maleficence but physician-assisted dying questions these teachings and how they should apply to modern clinical practice. Medical students must be aware of the evolving changes in law and its implications so that they can assist patients to make well-informed decisions about their own life when they graduate as doctors. Take Home Messages: Physician-assisted dying could trigger the slippery slope and could put vulnerable members of society at risk due to mala fide intentions. There are limited statistics to support this as physician-assisted dying has never been legal in the UK but there are indications from other countries that laws could gradually change over time until a wide range of individuals, not just the terminally ill, are able to seek assisted dying to end their life. In addition, certain duties of a doctor could be deemed to be out-of-date and may need to be refined in the context of physician-assisted dying.
Terminally Ill Adults (End of Life) Bill
Looking Ahead – How Will the Climate Crisis Impact Eyecare?
Summary The Royal College of Ophthalmologists has warned that the ongoing climate crisis poses a ‘threat to eye health’. Currently, one in five of us will experience sight loss in our lifetime, but with numerous growing threats, sight loss is set to double by 2050. So, how much of this increase can be attributed to climate change? This article explores the mechanisms by which climate change contributes to ocular disease burden and argues that the medical community can act to stop its impact from materialising; whether it may be reducing single-use plastics to decrease global incidence of conjunctivitis, educating patients to result in fewer cataract cases or recycling equipment to reduce glaucoma prevalence. Relevance The doctors of the future will be managing the health implications of the climate crisis and also be the ones attempting to stop it. Knowing the ocular diseases which will become more clinically relevant and knowing how to practice sustainably should make better, more prepared clinicians. Additionally, by understanding the effects of the climate, they can advise patients on how they can protect their eyes from its effects, to slow the rising of sight loss in the UK. Take home messages The climate crisis results in ocular diseases ranging from uveitis to conjunctivitis to acute and open angle glaucoma via. multiple mechanisms. Patients can preserve their eye health, for example through the use of UV-protective sunglasses, or by consumption of an antioxidant-rich diet. Healthcare results in 5% of the Earth’s carbon footprint, making sustainable practise a necessity. Individually, we can prescribe dry powder rather than metered dose inhalers to have 10x less the carbon footprint and wear washable scrub hats to reduce unnecessary waste. On a wider scale, hospitals can change policy, minimise single-use plastic equipment usage and encourage telemedicine to cut emissions by greater amounts.
The 2025 Issue Editorial written by the Editors-in-Chief of the British Student Doctor Journal.
Copyright (c) 2024 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0
A perspective on financial hardship among medical students and its impact on wellbeing
Summary: The escalating cost of medical education in the UK, set against austerity and financial crises, poses significant challenges for medical students. This paper examines financial pressures, increased living costs, and inadequate support schemes. It highlights the impact on students' mental well-being, academic performance, and the necessity of part-time employment, whilst critiquing widening participation schemes and financial uncertainties during clinical placements. Relevance: Understanding the financial pressures on medical students is crucial for policymakers, educational institutions, and support organisations. This commentary offers insights into these challenges, examining the inadequacies of support schemes and their impact on students' wellbeing and performance. It underscores the need for effective support systems and financial strategies to support students throughout their education. Take-home message: A more transparent and supportive financial structure is needed to ensure medical students can succeed in their education.
Longitudinal Integrated Clerkships: The Good, the Bad, and the Fixable
Longitudinal Integrated Clerkships (LIC) have gained popularity as an alternative to traditional block rotations in health professions education. LICs are defined by three core characteristics: students participate in the comprehensive care of patients over time, build ongoing learning relationships with these patients’ clinicians, and achieve the majority of their core clinical competencies across multiple disciplines simultaneously through these experiences. This model offers continuity in patient care and long-term mentor-student relationships, enhancing student engagement and clinical competence. Research shows that LIC students often outperform peers in assessments and demonstrate a stronger professional identity. However, the approach faces challenges, including supervision gaps, inequitable learning opportunities, and student disengagement from clinical duties in favour of self-directed learning. Assessments in LIC, such as mini-Clinical Evaluation Exercises (mini-CEX) and Objective Structured Clinical Examinations (OSCE), are effective but not without limitations. Mini-CEX may lack reliability in undergraduate settings, while OSCEs can feel inauthentic due to their fragmented structure. To bridge the gap between the intended and experienced curriculum, this article suggests four improvements: strengthening curriculum mapping, fostering community and continuity in practice, advocating for "assessment for learning," and conducting regular audits to ensure quality. Implementing these changes could ensure that LIC better supports students in achieving core competencies, preparing them for successful foundation years while promoting critical reflection and lifelong learning.
Cutting Deep: Why Knife Crime is a Public Health Emergency in the UK
Summary: Knife crime is the leading cause of teenage homicides, reaching the UK’s highest figures in history. Stemming from deeply ingrained social determinants—including poverty, school exclusion, adverse childhood events, and geographical disparities—this crisis highlights the limitations of a law enforcement-first approach. This article explores the UK’s knife crime epidemic, its impact on our healthcare system, and the transformative potential of addressing the issue through a public health lens, focusing on its social dimensions and preventative strategies. Relevance: Young adults at risk of or already involved in knife crime often come into contact with the healthcare system; be it through external agencies (e.g., schools, youth justice services, or the social care sector) flagging up adverse behaviours, their need for support, or presenting with physical injuries. As medical students and practising physicians, it is crucial to understand the risk factors contributing to an individual’s involvement in knife crime, and to be familiar with the aid systems (e.g., charities or youth crime prevention programmes) available in your community. By doing so, you not only enhance your professional ability to support your patients but foster a more compassionate approach through a deeper understanding of their social context. Take home message: Current evidence indicates that both family and school based strategies are most effective at deterring individuals from engaging in knife crime, despite the limited data on the true efficacy of combining these interventions. Predictive studies are also scarce regarding the social benefits of broader family and support systems for victims, as well as the cost-effectiveness when considering early prevention initiatives—both of which would provide valuable insights for shaping future policies and programs. What remains clear is clinicians can have a crucial role in flagging early at-risk behaviours, and deterring crime to protect our future generations.
Sports and exercise medicine: a Cinderella specialty?
Summary: Sports and Exercise Medicine (SEM) is an emerging specialty that integrates clinical care, public health, and lifestyle medicine. Despite its growing importance in managing musculoskeletal conditions and promoting physical activity, SEM remains underrepresented in UK medical curricula. This article examines the barriers to SEM integration, including limited curricular exposure, financial constraints, and a lack of structured training pathways. It also explores international models and policy initiatives that have successfully incorporated SEM into medical education. Recommendations are provided to enhance SEM's presence in medical training, aiming to better prepare future doctors for holistic patient care. Relevance: As the prevalence of chronic diseases and sedentary lifestyles increases, SEM offers essential skills in prevention, rehabilitation, and health promotion. However, many medical students graduate without adequate exposure to SEM, limiting their preparedness to address these challenges. Integrating SEM into medical education is crucial for developing a workforce capable of delivering comprehensive care that includes physical activity as a key component of treatment and prevention strategies. Take home message: SEM is a vital specialty that addresses the intersection of physical activity, injury prevention, and chronic disease management. Medical curricula should incorporate SEM through core modules, electives, and clinical placements to provide students with practical experience. International examples demonstrate that structured SEM education can be successfully implemented, offering a blueprint for UK medical schools. Enhancing SEM training will equip future doctors with the necessary tools to promote physical activity and manage related health conditions effectively.
Medical students’ experiences of gender discrimination and sexual harassment at a UK medical school
Background Gender discrimination (GD) and sexual harassment (SH) continue to be significant issues within Medicine and Medical Education globally. This study examined student experiences of GD and SH at a UK medical school, as well as exploring student perspectives around interventions that might be helpful in reducing GD and SH and supporting students. Method An anonymous online self-report questionnaire was developed and distributed to participants who were recruited via social media, medical student societies, student learning platforms and teaching sessions. Participants were undergraduate medical students at a single UK medical school. Data were collected about students’ experiences of SH and GD during medical school, the impact of such experiences, reporting of these experiences and student perspectives around what medical schools could do to reduce rates of SH and GD and support students effectively. Results Of the 43 students who completed the questionnaire, 12 students (28%) reported experiencing SH whilst at medical school, of which 42% felt that this had significantly impacted their wellbeing. 19 students (44%) reported experiencing GD, of which 63% felt this impacted on their wellbeing. 2 of these 19 students reported their experience of GD to the medical school, with no students reporting their experiences of SH. 15 students (35%) reported having witnessed SH or GD during their time at medical school. Students felt that GD and SH were normalised and seen as societal issues, rather than issues within medical education. Students described how these these experiences impact negatively both on their wellbeing and their learning opportunities. Discussion SH and GD continue to be prevalent within undergraduate medical education, particularly among students who identify as female. Such experiences impact on student learning and wellbeing, however students are unlikely to report these experiences and often do not access support.
Medical Student Perspectives on the Recommended Considerations for Interacting With ChatGPT as Part of Learning and Working With Patients
ChatGPT, an artificial intelligence chatbot developed by OpenAI, has prompted significant interest in medical education. Its ability to generate fast, context-specific responses can improve efficiency in learning, but concerns about over-reliance, misinformation, and privacy risks remain. While educators have begun examining the impact of ChatGPT, there has been less exploration of the learner perspective. This piece reflects on the authors’ experiences as medical students and proposes a Code of Practice to guide the responsible use of ChatGPT in both education and patient-facing contexts. With clear guidelines, AI tools like ChatGPT could be safely integrated into the medical curriculum and clinical training.
The Looming Past of Lobotomies: A Dive into the Exploitation of Women
In the Edwardian era, psychiatrists birthed the "Lobotomy", a groundbreaking yet haunting medical intervention. This essay scrutinises the gender bias inherent in lobotomy procedures and its profound implications. Lobotomy, prevalent in the 1930s, involved severing brain lobe nerves. Despite male predominance in schizophrenia, the majority of lobotomies worldwide targeted women. This bias, rooted in societal perceptions and patriarchal influences, is evident in specific cases like Rosemary Kennedy and Helen Mortensen, showcasing the distressing consequences for women. Ethically, lobotomies raise concerns about informed consent, patient autonomy, and disregard of empirical evidence. Post-lobotomy, women faced enduring disabilities and societal stigmas and lacked vital support systems. The shift from lobotomies to psychopharmacology underscores the need for evidence-based, holistic mental healthcare. In conclusion, understanding lobotomy's historical legacy underscores the call for ethical oversight, evidence-based interventions, and gender-equitable healthcare. By embracing these principles, we pave the way for compassionate, evidence-driven healthcare.
Future application of Artificial Intelligence in Urology: an update for future clinicians
Artificial Intelligence (AI) is becoming an increasingly prevalent tool across medical and surgical disciplines, with numerous specialities looking to implement this powerful technology in day-to-day clinical practice. Current and future medical students will begin to frequently encounter AI in their careers, and here we analyse the potential role of AI in urology. With growing pressures on urology departments globally, could AI be the solution to managing urological diseases in a growing population with increasing comorbidities? With a number of clinical applications, this work identifies several key domains where AI can make a substantive difference to urology. Working symbiotically with urologists, AI can be harnessed to improve the surgical outcomes of patients, while also enhancing surgical education and decision-making. From increased clinician productivity to enhanced anatomical training, embracing AI will modernise the practice of urology. Research has already been undertaken to demonstrate AI’s value in urology, and further attention must be given to integrate this powerful tool into the urologist’s arsenal.
Assessing Gastro-Protective Medication Co-Prescription with NSAIDs, Anticoagulants, and Antiplatelets in Primary Care: An audit
Introduction: Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), antiplatelets and anticoagulants, are ulcerogenic drugs associated with gastrointestinal (GI) bleeding, increased hospitalisation risks and straining healthcare resources. Co-prescribing gastroprotective medications (GPMs) can mitigate these effects. Methodology: Searches were conducted on electronic health record system ‘SystmOne’ to identify patients in a Northampton primary care setting from 02/01/2023 to 07/07/2023. Eligible patients were identified according to Medicine Safety 01- Medicine Safety 03 under the NHS Investment and Impact Fund Guidance to PCNs 2020/21: Over 65 and on NSAIDs, over 18 on anticoagulants and antiplatelets, over 18 on aspirin and another antiplatelet. Patient medication lists were anonymised and recorded. This data was used to produce descriptive statistics and for analysis against prior audit data from 01/10/2019 to 12/11/2020. Results: 81 patients were identified, with 66 patients above 65 and on NSAIDs, 4 patients above 18 on anticoagulants and antiplatelets and 11 patients above 18 on aspirin and another antiplatelet. 92.6% (75 out of 81) of patients were prescribed GPMs, a 18.7% relative increase, or a 14.6 percentage point improvement, from the 01/10/2019 to 12/11/2020 period. Discussion: Rational prescribing requires regular evaluation. Proton pump inhibitors (PPIs) are preferred gastroprotective medications and warrant supervision when co-prescribed with ulcerogenic drugs. GI bleeding has multiple aetiologies, each mandating its own treatments. By involving a multi-disciplinary team, implementing clinical education and conducting systematic auditing, hospitalisation numbers can be reduced. Conclusion: GPM prescriptions with NSAIDs, anticoagulants and antiplatelets in line with aforementioned guidelines have improved in the primary healthcare setting between the two audited time periods. This serves as a good reflection for healthcare practices, offering actionable insights to enhance appropriate drug use while supporting the development and implementation of effective policies.
Climate change and mental health: what can we do about the impending pandemic?
Mental health sequelae of the changing climate arise through various pathways -- direct and indirect, acute and chronic. As the consequences of the climate emergency become more frequent and severe, these pathways may align to impair wellbeing and increase the risk of psychopathology in populations across the globe, especially in vulnerable and underprivileged communities, leading to a mental health epidemic of unprecedented proportions. The healthcare community should thus do all it can to prepare for the coming crisis before it arrives. I propose four ways we can all act within clinical practice to begin mitigate the effects of climate change: (1) become environmentalists and work with sustainability groups at our Trusts; (2) conduct more research to address the understudied areas of climate-triggered mental disease; (3) be involved in teaching and outreach about global heating and its consequences; (4) address our own cognitive biases that climate change will never impact us.
What is the most important innovation in neurosurgical practice that will emerge in the next 10 years?
Brain computer interfaces BCIs are automated neurostimulators that analyse brain signals and translate them into output. They aim to allow modulation of neurological functioning at cellular and network levels without the need for clinician-performed adjustments. BCIs are beginning to progress from the research and development phase to their introduction into clinical neurosurgery. Some anticipated applications include advanced treatment of cerebral palsy and stroke, aiming to restore function to these patients. In time, they will become one of the most significant innovations in neurosurgery. Provided here is a review of BCI research to date and their implementation into clinical neuroscience, aiming to highlight the importance of BCIs as a developing treatment modality in neurosurgery in the next decade. A review of the literature was performed using Pubmed as the primary database. BCI applications, recent technological advancements and current challenges facing these devices were reviewed. Trends in research and development were considered and are discussed. It was found that significant developments have been made in manufacturing BCIs that can interpret cortical processes with adequate spatial and temporal resolution. It was shown that the number of procedures to implant neuromodulators taking place in the UK each year is increasing, with more funding provided for BCI research each year. Further to this, a review of publication data found that neuromodulation devices placed among the top new patent categories in neurosurgery in recent years, a large portion of which were BCIs. These results highlight the continually growing interest in BCI research and their application in neurosurgery. In conclusion, BCIs will become an increasingly important area of innovation in neurosurgery. Advances in translational neuroscience, imaging technologies and signal analysis will provide clearer insights into disease processes, allowing increasingly complex devices to address current limitations in the treatment of these conditions.
What has been the most important advancement in neurosurgical practice over the last 10 years?
Neurosurgery is considered one of the oldest specialties, with evidence of surgical intervention being observed in skull specimens dating back to pre-history. Yet, the modern idea of neurosurgery is a very recent concept. Increasingly sophisticated technology has revolutionised the field, but arguably the greatest impact on patient outcomes has come from an only seemingly less exciting reform, which has transformed the structure of the service. Over the last decade, efforts have been made to redefine the relationship between patients and healthcare practitioners, in favour of a more holistic and collaborative approach with the patient being placed at the centre of their own care. This shift has particularly impacted specialities like neurosurgery, where meticulous care planning frequently involves input from several other experts and healthcare professionals. Furthermore, advancements in the field of neurosurgery tend to stem from the process of optimisation of techniques, or tool kits, that were actually devised decades ago. True paradigm shifts simply do not occur as frequently, and they are the result of new ways of understanding disease, or new ways of working. The work towards multidisciplinary approaches, patient centred care and social care constitutes the most significant advancement for patient outcomes and satisfaction in the field of neurosurgery over the last decade.