History of Neurosurgery
The neurosurgical service continued to grow, and by 1940, when the American Board of Neurological Surgery was incorporated, the Yale program had trained five more neurosurgeons. Within the next few years, the American Board of Neurological Surgery defined what constituted an accredited residency program and a 3-year training residency was established at New Haven Hospital. As the program grew, German received recognition for his clinical and academic accomplishments. He became Secretary-Treasurer of the American Board of Neurological Surgery and President of the Harvey Cushing Society (now the American Association of Neurological Surgeons) and was chosen as honored guest by the Congress of Neurological Surgeons. Neurosurgery remained in the Department of Surgery but became a separate section with its own clinics, inpatient ward, and operating room. The Yale training program was combined with Hartford Hospital in the 1940s. Under the direction of Drs. William Scoville and Benjamin Whitcomb, Yale residents gained extensive experience with all forms of spinal surgery.
During the 1940s, a sufficient number of surgeons specialized in the practice of neurosurgery to support a publication devoted to this emerging subspecialty. The concept of a journal devoted to neurosurgery was initiated by Dr. John Fulton, a neurophysiologist at Yale, who in collaboration with Spurling, McKenzie, Craig, and Horrax, published the Journal of Neurosurgery in 1944. Eisenhardt became the journal's first Managing Editor, a position that she held until 1965.
The medical community in New Haven grew significantly during this time. To accommodate the need for additional hospital beds, construction of the Memorial Unit, a dedicated community physician inpatient facility within Yale-New Haven Medical Center, was completed in 1951. The clinical neurosurgery service at Yale solicited expertise from community neurosurgeons committed to neurosurgical resident training. These individuals continue to provide important clinical training. Dr. Lycurgus Davey (Clinical Professor) devoted his entire career to clinical teaching and resident education at the Yale program.
In 1967, German retired and his successor, Dr. William Collins, was appointed as Cushing Professor of Surgery Neurosurgery and Chief of Neurosurgery. The New Haven Hospital was now formally affiliated with Yale Medical School and renamed the Yale-New Haven Hospital. Under the direction of Collins, the residency training program took a different direction with the development of programs that were designed to permit neurosurgical residents to prepare for a career not only in clinical neurosurgery but also in original basic investigation in neuroscience related to neurosurgery. The concept was based on the development of subspecialty areas in neurosurgery with integrated programmatic laboratory investigation. The first program was an integrated laboratory and clinical program for the study of chronic pain. The investigative aspects of that program began with Collins' seminal work on C fibers, and it remains in the Section of Neurosurgery to the present. The next program was devoted to neuroendocrine study that focused on pituitary tumors. During this time, collaborative research was developed with the Section of Endocrinology and the Department of Obstetrics and Gynecology. A joint pituitary tumor clinic was organized, and a considerable portion of the investigative research was developed in combination with the laboratory staff of the three departments. The principles of collaborative research between Neurosurgery and other clinical and research departments within the University was started by Collins and continues to be a fundamental method for maintaining the high standards for resident education and academic growth.
In 1968, it was apparent that the volume of cases at Yale-New Haven Hospital, including spinal surgery, was more than adequate for a residency training program and with the development of the Medical School at the University of Connecticut, plans were made to separate the two programs with Hartford Hospital affiliated with the University of Connecticut and the Yale program affiliated with the Yale-New Haven and West Haven Veterans Administration Hospital. Residents from both the Yale and Hartford programs shared rotations until 1978, when the two became separate programs. In 1973, a dedicated Neurosurgery Intensive Care Unit was opened at Yale-New Haven Hospital for critical care management of patients with neurological disease and trauma. This unit, in part, was organized to develop the next two subspecialty programs, surgery for epilepsy and acute management of traumatic spinal cord injury. During this time, pediatric neurosurgery was developed at Yale under the direction of Dr. Joan Venes, and the National Acute Spinal Cord Injury Study was established under the direction of Collins and Dr. Michael Bracken (Professor of Epidemiology and Public Health).
Dr. Dennis Spencer was appointed acting and then Chief of the Section of Neurosurgery in 1987. Under Spencer's leadership, the Section of Neurosurgery continued with the development of programs in epilepsy surgery, neuro-oncology, neurovascular surgery, pediatric neurosurgery, and functional/stereotactic neurosurgery. In December of 1996, the Section of Neurosurgery was granted Departmental status and in January of 1997 Dr. Dennis Spencer was appointed the first Chairman of the Department of Neurosurgery.