Brain Tumor Center: Neurosurgery Clinical Fellow, Dr. Brad Elder

Pictured: Philip Gutin Dr. Philip Gutin, one of five Sloan Kettering neurosurgeons Dr. Elder interacted with on a daily basis.

Dr. Brad Elder traveled nearly 3,000 miles to spend this past year at Memorial Sloan Kettering Cancer Center as a Neurosurgery Clinical Fellow. But, for him, it was like coming home.

Prior to his neurosurgery residency at the University of Southern California in Los Angeles, Dr. Elder had gone to medical school at Columbia University in New York City.

Of course, the pull back east was more than just his med school ties and familiarity with the city. “I felt most comfortable and at home at Sloan Kettering,” he says of his decision. “The fact that it was in New York City was a bonus.

Born in Norman, Oklahoma, Dr. Elder went to college at the Massachusetts Institute of Technology in Cambridge before continuing down the ivy-laden path to New York. It was at Columbia that his interest in neurosurgical oncology was born. He took a one-year hiatus from school to conduct research in a brain tumor lab. After graduation, he swapped coasts to delve further into the field at USC.

Brad arrived with excellent surgical skills,” says Dr. Philip Gutin, one of five Sloan Kettering neurosurgeons Dr. Elder interacted with on a daily basis. “With the large numbers of cases that he participated in during his year with us, he was able to hone these skills and increase his confidence and sense of independence as he heads out to the excellent academic job he secured.

His job hunt was made easier, I am certain,” he added, “by having the Memorial Sloan Kettering fellowship credential.

Later this summer, Dr. Elder will leave New York for an academic position in the Department of Neurosurgery at The Ohio State University.

We recently sat down with Dr. Elder to get some insights into his time as a Neurosurgery Clinical Fellow, what brought him to Sloan Kettering, life in New York City and how he thinks the past year will impact his future goals.

Why did you choose Sloan Kettering for your fellowship?

When considering a fellowship, it's important to know who you're going to work with and what you're going to get out of it. I knew I wanted to see how world-renown neurosurgical oncologists work. I also knew I wanted to interact with both neurologists and radiologists, at a place where a multidisciplinary team approach is used for each patient. If that is your goal, you'd be really hard-pressed to find a better place.

The neurosurgical oncologists at Sloan Kettering are at the forefront of the field. The chairman, Dr. Gutin, has had an enormous amount of experience. Dr. Holland has very few peers, in terms of his contributions to literature and basic science research. Dr. Bilsky has been at the forefront of advancing surgical and radiation treatments for spine tumors for years. And those are just three of the many physicians I have worked closely with. It's people like that who you want to learn from and model your career after.

Not only are their reputations solid, but they have great personalities too. Everyone genuinely likes them.

How does this fellowship year compare to residency?

During residency, you usually work with an attending physician. But once residency ends, you're on your own whether you go on to private practice or an academic setting.

This fellowship year helps you to take the next step in terms of being independent, specifically in the neurosurgical management of cancer. It's nice to have a transition in which responsibilities are gradually placed on you, yet you still have somebody that you can go to with a question and get advice. And if it's someone like Dr. Gutin or Dr. Bilsky, then there's no comparison.

What kind of research opportunities did you have as a fellow?

There's an endless wealth of data to look at here. Only at big cancer centers are you going to find so much data and so many people thinking about the same things as you. So it is not a stretch to go up to somebody with an idea and say, “I want to look at this type of radiation for this type of cancer.” A lot of places may have seen a few such cases, but not enough to discover a trend or make a worthwhile contribution to the literature. If the cancer exists, there have been tons of people treated here. So you can look at it, see the trends and responses to different kinds of therapy, and then you can write it up. The data are just sitting here waiting.

Part of what comes with being at a place like this, where you have access to a lot of different patients and areas of research, is that you are sort of obliged to forward medical knowledge on a topic. We have either in press or in review, three or four peer-reviewed papers and three book chapters from this last year. Our first paper appeared last month in Journal of Neurosurgery Spine. It'll probably be a year and a half before my name associated with Sloan Kettering stops appearing. There are also two main national conferences in neurosurgery, and I went to both.

What else does Sloan Kettering offer that is unique?

When you are at a big cancer center like this, it draws in people who want to reach the kind of an audience that this institution has. For example, academic talks are always going on here — nearly every day, as opposed to once or twice a month. And they are not necessarily all neurooncology. For instance, we had a clinician from Kentucky give a talk on pediatric brain tumors; and then the next one was on head trauma.

Again, the multidisciplinary approach is unique here. The Brain Tumor Center, for example, houses over 70 MDs and PhDs working together, including computational biologists and engineers.

One of the nice things at Sloan Kettering is that you can be busy with clinical cases, writing research papers, or going to talks if they interest you. There is always stuff happening that can supplement your existing knowledge.

How is life in New York City?

I had lived in New York City before, so it wasn't the scariest thing for me when I arrived. But the transition for people who haven't lived here is still pretty smooth. All of the housing is taken care of. You really don't have very much to worry about. You just need a couple days to get settled before you start, and then you can hit the ground running.

Most people live only a few blocks away, so you can take home call and never have to sleep in the hospital. And Sloan Kettering's location on the Upper East Side of Manhattan is in a nice part of town. It's not the suburbs, but it's also not like living downtown. Plus, housing comes out of your paycheck before they tax you, so you save a little bit of money. Sure, you're not going to show up and get a 3-bedroom house with a yard, but I think all the other advantages outweigh that.

New York City shouldn't need any selling. If you can imagine it, you can do it here 24 hours a day. And, hands-down, it has the best restaurants and food you can get in the country.

What if someone were coming to the city with kids?

I don't have any kids, but contrary to what some people may think, it is possible to raise kids in NYC. My co-fellow has a 2-year-old son. He has daycare in his building, Central Park is within walking distance, and there is a huge play ground across the street from the hospital. There are tons of young couples with kids here, and they've all figured out how to do it and they enjoy being in the city.

Do fellows have a social life?

In this department, an effort is made to do stuff with the fellows. Dr. Gutin always wants to go to Georgio's wine bar, Patsy's pizza or do something in the Hamptons. There's at least one night every week where Memorial Sloan Kettering fellows and staff can attend a happy hour with free wine or beer.

There is an orientation session that really helps too. When you first get here, there are different tables set up and you can stop at each one depending on your interests. There is an exercise club, a ski club and several parent groups, among others. You can even sign up for a cheap gym membership or a nanny share program.

Another key here is that you can get away on weekends. We do power weekends, which means a weekend of call and then three weekends in a row where you don't even have to sniff the hospital. You can always arrange to get away and have someone else cover too, which helps when you're interviewing for jobs, going to conferences, or taking a vacation.

How will your time at Sloan Kettering stick with you?

I will still be publishing papers from this year for a while. And anyone senior in the field that I meet will undoubtedly say, “Oh, you worked with Dr. Gutin?” or “You know Dr. Holland?” People truly respect them, so having been around them makes you look better in their eyes.