For EPISODE 18 of the World’s Great Doctors, it is our great honor to have Prof. Veit Rohde as our distinguished guest, who is the Director of the Department of Neurosurgery of University Medical Center G?ttingen and the President of German Society of Neurosurgery (DGNC).

The Department of Neurosurgery of University Medical Center G?ttingen led by Prof. Rohde is one of the largest of its kind in Germany. With expertise, latest technical equipment and best care, Prof. Rohde and his dedicated team treat the entire spectrum of neurosurgical diseases with focus on preserving functions and consistently applying minimally invasive therapy principles.

Each year, 5000 outpatients and 2000 inpatients are treated there with about 3000 operations. In order to provide the best possible care for each individual patient, especially in the context of oncological diseases (cancer), G?ttingen University Hospital has an interdisciplinary University Cancer Centre (G-CCC). It also collaborates interdisciplinarily closely with other specialist departments.

Due to its high level of expertise and large numbers of cases, its many years of experience and the best medical results, the Neurosurgery Clinic led by Prof. Rohde is a certified centre of the German Society for Neurosurgery in the field of vascular diseases, especially brain haemorrhages ("bloody" strokes).

To guarantee individual and patient-oriented care, Prof. Rohde and his team work closely with rehabilitation centers to ensure the best possible therapy, including during postoperative periods.

1. Why did you decide to pursue a career in medicine and why, in particular, did you decide to specialize in neurosurgery?

That's a very difficult question. During my school time, I was highly interested in biology, but there was no clear plan to study medicine. As you know, if you have very good grades in Germany during school, you are allowed to study medicine and I had very good grades. Therefore, it was sort of preformed but it was not a very clear decision by myself. So I studied medicine and I soon recognized that this was a very good decision - It was very good and very interesting for me. But, again, the step to neurosurgery was also not so well structured or well planned before. During that time, there had been only two surgical disciplines in which it was not necessary to make general surgery in addition, and this had been cardiac surgery and neurosurgery. That's the reason why I ended up as a Chairman in neurosurgery.

2. Who have been your greatest influences? What have they taught you and how have they inspired you?

I would say my greatest influence had been made by two neurosurgeons which had helped me during my career.

It had been Prof. Hassler and Prof. Gilsbach. The first one was my senior in Tübingen. When I've started my career there, he pushed me a lot, he showed me the first operations and he also gave me the first insights into scientific work.

The other, as I said, was Prof. Gilsbach. I was with him eleven years in Aachen and I would say that he taught me everything which was necessary for a successful career in neurosurgery.

What they especially showed me is that you must have a very strong discipline if you like to be a good neurosurgeon and you must have a very clear mind about what to do when you're operating. They gave me insight and their thinking and thereby influenced me a lot.

3. You have been leading the Clinic for Neurosurgery at UMG for around twenty years. What was the biggest challenge during the last two decades? And as the Chief, what’s you plan for the following years?

I think there was no specific challenge, but it was an ongoing challenge during the whole time. This is that we have restrictions by the economy. We are, always dealing, as a neurosurgeon, with the aim of improving everything to have the latest technology to offer the newest operations, and on the other hand, you have the administration, who tries to to keep the budget low. This is, I would say, a tension, between those two points, which sometimes are quite hard to handle and which sometimes presented to challenge. Especially if the technology is moving very fast and you need to have a new machine or something else, and then you're discussing with the administration what's for and just to make clear that you're doing everything for the patient, which is not always seen in the same way by the administration.

(When it comes to my plan for the following years), I think it’s to be successful in this challenge, I just have mentioned. Second, I have to work, I think, eight years more, and I would have to hand over this department as one of the biggest in Germany with very good equipment and with highly trained neurosurgeons. This is my vision for the next upcoming years.

4. As a professor, a surgeon, a clinic director, how do you balance your personal life, administration, clinical practice, research activities and lecturing? How does the focus remain on the patients despite every other roles?

My daily activity is strongly focused on the clinical work, to make almost everything possible for the patients. The other focus is to stimulate research activity of young neurosurgeons. In my position, I do not intend to go to the lab personally, but to create new ideas, to create scientific questions, and gave these questions and ideas to your neurosurgeons which will do the research now.  I try to cut down the administrative work by putting on many shoulders in my team. By doing so I have a very strong focus on the patients and the well-being of the patients.

Concerning the personal life, well, it's also obviously a part of what I'm doing. I'm in a good position that my wife is also a neurosurgeon, so we are in a situation where we can discuss some professional issues while sitting at that table at home, which makes it easier sometimes to have more leisure time.

5. There are 30 certified Spine Center of Maximum Care by German Spine Society and UMG is the first and only certified center in Lower Saxony. What does this mean to the patients? How is multidisciplinary collaboration organized for spinal diseases between the neurosurgery clinic led by you and the orthopedics and trauma clinic led by Prof. Lehmann?

Prof. Lehmann and Prof. Veit Rohde

First of all, I'm very proud that we are one of the thirty centers and that we are the only one in Lower Saxony. To be acknowledged as one of the Spine Centers of Maximum Care, needs that you have a defined collaboration with the trauma surgeons and the orthopedic surgeons. By structuring this collaboration, I think, you offer a better care for the patients because we are able to deal also with the complex spine cases which are not so often seen in other spine centers which are not Spine Centers of Maximum Care.

The collaboration with the trauma and orthopedic surgeons in our hospital is very good. For the patients, as I said, it means that all the complex cases are discussed together and sometimes are operated together. If we're talking about easy spine cases, let's say, a lumbar disc herniation or a non complex fracture, the patient is treated either in neurosurgery or in orthopedic and trauma surgery, depending on through which door the patient enters our hospital, but for the complex cases and that's very important for the complex cases that we are working together, we are discussing together, and we are trying to provide the best care for the patient.

6. There is still gender disparity in the field of neurosurgery. In Germany, nearly 70% of medical students are female but only two of 36 university neurosurgical departments are headed by female. How well do you think German university hospitals are doing to encourage more women to pursue a career in neurosurgery, and how could this be improved?

That's a difficult question. You're right that there is a gender disparity. But on the level of the residents and also the younger staff members, I would say it's a 50/50 percentage. In this part, it's getting better and better. But you're right, it's still difficult to get one of the top positions in neurosurgery. I think that the German universities, since a few years ago, are doing a lot to facilitate the application of top female neurosurgeons, but we are still facing the fact that it's rarer for a woman to be on a shortlist of the last three applicants because sometimes universities fear that the female neurosurgeon, if she's not in the top position, might sue for getting the position. That's some sort of fear. I think if we are able to reduce the fear or eliminate the fear, the number of female neurosurgeons in top positions in Germany will go up.

7. Do you have suggestions on how to train the young generation (to the Chinese chiefs)? What advice would you give to the young neurosurgeons?

Again, a difficult question, especially because the situation between in China and in Germany or in Europe are a bit different, but there are some common points. One thing is that the hospitals or the chiefs should pick out the students with a very good theoretical basis, or let's say, the basic scientific background already must be available, because it's not possible to to give this knowledge completely to them during the residency. I'm a strong supporter of a very structured educational program, which should be implemented in a hospital. What I'm doing, this is a bit linked to the next question, as the President of German Society for Neurosurgery is to develop a structured educational program which might fit for most of the German hospitals so that the training is not so different between different hospitals.What I always push is that the residents take part in training courses. There are European training courses. There are also national training courses. It's a structured program always for four years. And during this four years, the whole field of neurosurgery is covered. I think we should support our residents to make this.

Now I'm coming to the difference between China and Europe. In Europe we have the problem that we have not enough operations for the young neurosurgeons and for training the neurosurgeons and therefore I also strongly support every attempt to take part in courses in which you're able to learn things, to get experience by working with models, or courses in anatomy. These are briefly the things how I think we can make the education better, but the most important thing is a very structured program for every hospital for six years of residency.

8. You have been the President of German Society for Neurosurgery since 2022. What does this mean to you? What’s the plan during your term of office? How important do you think the professional societies are to the field of neurosurgery and to the surgeons?

What does it mean for me? On the one hand, it showed that I've worked successfully in the field of, let's say, human surgery for a longer time and that I supported for a longer time the German Society for Neurosurgery. I think, I was elected as the President for a term for two years as some sort of award for this.

I already mentioned that one of my key work as the President is the improvement of the education of neurosurgeons on the level of residency, but also later to bring it to a higher level. This is very important for me.

Concerning the role of societies, I personally believe that societies are important. The German Society for Neurosurgery is a society which has a very strong focus on support of science and scientific work. And therefore, I think that societies can push research. On the other hand, it also has a role in dealing with changing political situation and trying to make our neurosurgical thinking clear to the politicians. The neurosurgical society is a quite small society. Therefore, I believe that our collaboration with the German Society of Surgeons is especially helpful for our political aims for improving the visibility of surgery and neurosurgery in the political field.

9. You enjoy a great international reputation. What is your proudest career achievement to date and why?

I think there is no one thing (which I am most proud of). I'm always proud if I'm going to conferences, to train courses, and to meetings, and the young neurosurgeons approach me and are saying to me that they had been influenced by what I've done or what I do in research for. These are the things which I'm happy about. It shows me that over the years, I, let's say, influenced a little bit the careers of  the future neurosurgeons. This is the thing which makes me proud.

10. What’s the most fascinating part of your profession as a medical doctor? And what would you have been if you had not been a medical doctor?

I would like to change a bit of the question to what’s the most fascinating part of your profession as a neurosurgeon, I would say. I don't want to be an internal doctor. I would like to be a neurosurgeon. There are two things which are fascinating. One thing is that if we are doing our job very well, we are really able to heal the patient. That’s the difference to the neurologist. We could really provide the patients with good expectation concerning their further life, with the few exceptions of the malignant brain tumors. This is fascinating for me that we could have big victories for sake of the patients, and sometimes we have no victories, but that's the other side of the medal.

The other thing which is fascinating as a neurosurgeon is that we are dealing with the newest technologies, many of the computer science early find the way into neurosurgery. We are always are confronted with the latest technology. That's also very fascinating. We are now exposed to artificial intelligence and I think it also will enter the field of neurosurgery. If you're always exposed to new ideas and new technologies. You're always on the pulse of time, and that's very fascinating for me.

And what I'd done if not having been a medical doctor, I really don't know. This decision of being a medical doctor was made more than thirty years ago. I know that I was thinking about Geology, but I'm not quite sure if I would have done it. I really don't know.

11. What are your hobbies during your leisure time?

Well, in former times during studies I've been a, let's say, semi-professional middle and long distance runner.I kept this hobby - I'm running two to three times a week, trying just to inhale good air and the impressions from the nature and to get rid of the daily work.