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One of the notable themes of the past decade has been the remarkable flattening of our global geopolitical landscape. The term “globalism” has set the tone for mankind's first decade in the twenty-first century. The combination of communication vehicles and ease of travel have made the world's population familiar at a level that is truly novel. And, our field of neurosurgery has experienced a remarkable metamorphosis. The era of the technical “virtuoso” has come to a closure. The number of neurosurgeons “trained” in sophisticated and predominately safe methods has expanded dramatically. Every continent now boasts sophisticated training centers and individuals offering superb levels of stewardship. Concurrently, the dominance of individual countries has ended as technical resources, economic shifts, and education have become more pervasive. The change has been dramatic as colleagues from every continent exchanged information freely in text, video streams and voice transmissions.
The uniformity and availability of “modern” treatment is now more evident than ever in man's history. However, there is not absolute uniformity and availability in optimized form. Much work is left to be done to completely flatten our neurosurgical world. Economical and political issues are at the heart of the matter. Social issues and language barriers add to hurdles that must be overcome.
Our next generation of neurosurgeons will be a different character than we have experienced in the past. Armed with technology and, in optimum circumstances, driven to ultimate specialization, they will have capabilities created by biological and hard sciences that seem unimaginable today.
The challenges will be created by the metamorphosis driven by science and the requirements to effect optimization of delivery of what is “modern” to all of the world's connected populations. All of us in neurosurgery should work toward optimizing these transitions and goals. There should be a unity of effort to advance, embrace the future, and create excellence in our available environments while contributing to the advancement of global uniformity in the best sense.