The AAMC (as part of our Specialty Perspectives series) recently sat down with Zayed Almadidy, MD (known as Dr. Z on social media), to learn more about his work. Dr. Almadidy is a fellowship-trained neurosurgeon specializing in spine surgery. He serves as an attending neurosurgeon at Advocate Lutheran General Hospital in the Chicago area. Learn more about Dr. Almadidy and his specialty below.
Can you describe your work as a neurosurgeon?
I am a fellowship-trained neurosurgeon specializing in spine surgery. My practice includes general neurosurgery, with a primary focus on spine pathology and spinal surgery.
What attracted you to neurosurgery?
During one of my courses in medical school, we would have doctors come each month to pitch their different specialties and why medical students should pursue them. One day, a neurosurgeon came to give a talk to my class, and he said, “I don’t think you should do neurosurgery.” He recommended that we find something else. But I was of the mentality where I didn’t like when someone would tell me that I couldn’t do something.
Later on, my dad ended up needing spine surgery. I called that neurosurgeon that gave the presentation to my class and asked if he could look at my dad’s leg, as he wasn’t able to move it. The neurosurgeon visited my dad at the hospital, performed surgery on him, and my dad was able to walk 45 minutes later. He was able to leave the hospital just a few hours after the one-hour surgery, which blew my mind!
The ability to restore someone’s functionality in minutes is an amazing skill that I wanted to have. So, I reached back out to that same neurosurgeon and said I wanted to learn more about neurosurgery, and he offered me the opportunity to shadow him. I accepted his offer and saw all the things neurosurgeons get to do in the operating room from trauma to elective procedures. Watching him work, I realized this was a specialty where every day in the operating room would be intellectually and technically demanding.
And it’s true! I have spent the last nine years training and working in neurosurgery through residency, fellowship, and independent practice, and there has not been a single day where the work has felt routine.
Can you describe a typical workday?
I have clinic days, operative (OR) days, and administrative days. On my clinic days, I wake up around 4 a.m. and exercise. Then I review my patient list and head to the clinic at 8 or 8:30 a.m., which is when I see my first patient. I continue seeing patients until 2 or 2:30 p.m., then I’ll perform my rounds on patients I’ve operated on in the hospital. My day typically ends between 4 and 5 p.m.
On operative days, which are typically two or three days out of the week, I still wake up very early and exercise. My workday starts at 7:30 a.m. when I have my first surgery. After surgery, I’ll see to any other cases I have for the day. Then I’ll perform rounds and ensure I see all my patients that have had surgery before heading home.
The thing about neurosurgery, though, is that you must always be available. It’s possible that I could go home and then get a phone call at 9 p.m. saying a patient isn’t doing well or there’s a trauma patient needing surgery and I need to head back to the hospital.
What parts of your job do you find most challenging? What parts do you find most rewarding?
The part that is most challenging is having to tell a patient a diagnosis that there is not a lot of treatment options for, because a lot of times, patients will come and seek help from me, and I am the final physician that can offer anything to them. So, if you don’t have a good answer for these patients and there’s nothing operative you can do to help them, that carries a significant emotional burden for both the patient and the physician.
The best part of my job is when I successfully perform a case and get to tell the family that the surgery was a success. The patient wakes up improved, which is when you know you have made a meaningful impact. It feels like I’ve changed someone’s life for the better.
What’s something that would surprise people about your day-to-day?
The intensity and duration of the work would likely surprise most people. Neurosurgery is among the most demanding specialties in medicine in terms of time commitment and call responsibility. It is not unusual for neurosurgeons to work extremely long hours doing cases or checking post-operative patients. But with all of these hours, attendings are still able to maintain a work-life balance, find time for their family, and do the things they enjoy.
How would you describe someone who would excel in a career in neurosurgery?
You have to have a great work ethic. In my opinion, you need to be the hardest working person in the room to consider specializing in neurosurgery.
When I was in residency, I was involved in evaluating neurosurgery residency applicants. One thing we looked for was a person’s work ethic. We were able to measure that by looking at how well they did on their sub-internship, the number of publications they had, and, most importantly, their letters of recommendation. The letters were a true testament of how well the applicant is doing according to a fellow neurosurgeon, and having a neurosurgeon vouch for you carries a lot of weight. Even if a person has mediocre scores or publications, a great letter of recommendation surpasses everything.
What advice would you share with students looking for mentors?
Premed students should just get their foot in the door with any physician regardless of specialty. Having a letter of recommendation from a physician will look great on medical school applications. When I was a premed, I would look online at local hospitals, find physicians’ emails, and cold email them. I would get maybe one reply for every 100 emails I sent, but that one response was my ticket in the door. Offer to help where you can, form relationships with other physicians, and see what connections the physician can help you with.
For neurosurgery residency, you establish relationships through research. The best way to do that is by contacting someone in the department who has conducted a lot of research and offer to help with data collection, manuscript preparation, and research coordination. The junior faculty at academic institutions are the ones that need the most help balancing all of their work, so I recommend reaching out to them.
Can you share a case you found especially rewarding?
I had a young patient that suffered from a spinal cord injury. With spinal cord injuries, there are different grades. If a patient comes in completely paralyzed, that’s called a complete spinal cord injury. This patient came in with a very high-grade spinal cord injury and I took them to the operating room immediately. I performed surgery on them, and just recently spoke with them and learned they were starting to walk again.
This case was so memorable because this person was very young and had their entire life ahead of them. The prognosis was not good for this patient, but I was able to do enough to restore their mobility.
Is there any advice you’d like to share with premeds?
If you are interested in neurosurgery, I recommend going into medical school with an open mind to other specialties, as well. I went into school thinking I wanted to be a cardiothoracic surgeon, and I later realized it wasn’t what I wanted to do at all.
It’s also important to be prepared to have a relentless residency for seven years if you specialize in neurosurgery. It is extremely challenging and will reshape you mentally and physically.
To learn more about Dr. Almadidy and his work, you can follow his educational content on Instagram.