Global Neurosurgery at the University of Toronto: Past and Present Efforts, and a Charter for the Future

Abstract

Kenneth McKenzie arrived in Toronto in 1923, bringing the legacy of being the first neurosurgeon in Canada. Since then, Toronto has established itself as the hub of Canadian neurosurgery, in both volumes of cases, the strength of trainees, and research output (1). As one of the most extensive training programs in North America (2), Toronto has had ongoing international connections, chiefly through the fellowship programs within our division. The earliest instance in which Toronto demonstrated a concerted work efford in global neurosurgery was through the persistent and continued struggle of Ab Guha (1957-2009), who amongst many philanthropic activities, establish the National Neuroscience Institute in Calcutta (India), his city of birth, as his goal. Since then, interest in global neurosurgery has remained strong within our division, with multiple continued and consistent collaboration areas. These include Mark Bernstein’s travels within Africa and SouthEast Asia, expanding the reach of awake craniotomies; James Rutka’s efforts to strengthen local surgeons throughout Ukraine; George Ibrahim’s collaborations in Haiti to expand the surgical treatment of pediatric neurosurgical conditions; and Mojgan Hodaie’s work on structured curricula for neurosurgery residents. Simultaneously, Toronto neurosurgery has focused on encouraging fellows from low- and middle-income countries (LMIC’s) to join our center, in many cases funded by the first Chair in International Neurosurgery (3).

As a result of these activities, several clinical fellows who trained in Toronto and returned to bring their expertise to their local sites must be highlighted, including Grace Mutango (pediatric neurosurgery, Uganda), Nilesh Mohan (neuro-oncology, Kenya), Claire Karakezi (neuro-oncology, Rwanda), Selfy Oswari (Indonesia), and a substantial number of short-term visitors from a breadth of international sites.