In 2020, Edward Chang became UCSF's seventh Chair of Neurological Surgery. Here he talks about what it means to lead one of the top neurosurgery programs in the nation and what will shape the future of the field.
Having trained as both a medical student and resident at UCSF, how does it feel now to be appointed the Chair of the Department of Neurological Surgery?
I am honored. As someone who attended both med school and residency here, I’ve seen how special UCSF is. At each stage of my career, I’ve been fortunate to have opportunities to move, but every time I’ve considered it, it was clear to me that UCSF is the very top program for academic neurosurgery. This is reflected in our national rankings, but more importantly, in the major impacts and leadership that our faculty have contributed to medicine and science. I was very fortunate to be able to develop my career here, and one of my main goals is to attract and develop the very best future neurosurgery leaders. I am excited and honored to take on this role.
How has your experience as a surgeon-scientist with a thriving research program shaped your vision for the Department moving forward?
In my own career, clinical care and research have been inseparable. There is a seamless interface between our pioneering brain mapping approaches and my research studying language and emotion. It’s hard for me to imagine one without the other.
While we have learned a lot about how the brain works, our field is in its infancy. As we continue to learn more about brain circuit function, we will have opportunities to intervene in new ways for emerging indications. For example, if we better understand the circuits underlying severe neuropsychiatric conditions, like major depression, we may be able to very precisely modulate them more safely and effectively than what we can currently offer.
In other areas, for example, new tools in gene editing, immunotherapy, and drug delivery have the potential to dramatically change outcomes for patients with brain cancer or neurodegenerative disease. Ultimately, we will invest more and find even deeper synergies between the clinical and research realms. Our goal will be to foster collaborations between basic scientists and clinicians in ways that we’ve never done before, fostering broader communities with scientists in other fields in order to tackle big challenges.
I have loved every minute of being a surgeon–scientist — even though sometimes it's like having two jobs — and I intend for us to continue to attract the best surgeon-scientists to our program.
Since you began training as a neurosurgeon, what have you observed to be the biggest changes in the field?
In the last couple of decades, we have been approaching some fundamental limits of what we, as surgeons, can do with our hands and minds. We have furthered our abilities through microscopes and endoscopes, but the future is about pushing beyond those limitations. How can we better predict outcomes before the surgery happens? How can we do surgeries that require dexterity beyond human limits? There will always be more to do with our current tools, but I also realize that we are at new boundaries. To make the next big strides we have to bring in more technology and engineering — machine learning/AI, robots, synthetic biology — to enhance our ability to take care of patients. Through all of this, our compassion will always be central.
Another big change we are seeing in neurosurgery is a cultural one. The image of what a neurosurgeon looks like will change dramatically in the next decade. My priority is to lead towards building an inclusive community, one that takes advantage of the diversity that is coming out of our medical schools. New perspectives will make us better doctors and will allow us to have a bigger impact on our communities. Again, our core values will not change; hard work, compassion, and excellence will all remain essential. But tapping into a bigger talent pool will bring us new ideas and I’m looking forward to seeing that change.
Has the challenge of the COVID-19 pandemic altered your plans for the Department in any way?
This pandemic has re-affirmed the resilience and commitment of our team. Despite being on the front-line every day, we remain focused on our missions. I am very proud of our people and to be part of this team effort.
Our excellence in the setting of the pandemic has inspired me to think carefully about our strategy. It is accelerating changes that will define what neurosurgery looks like in the next 5 to 10 years. We have found new ways to connect with patients via telehealth, for example, which is allowing us to expand our reach and help more people. Through this experience we are getting a keen understanding about what things are truly important to our mission and what things are not.
