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doi: 10.1227/NEU.0000000000000136
Special Article

Foundation for International Education in Neurological Surgery (FIENS) Global Health and Neurosurgical Volunteerism

Dempsey, Robert J. MD*; Nakaji, Peter MD

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*University of Wisconsin School of Medicine and Public Health, Department of Neurological Surgery, Madison, Wisconsin;

Barrow Neurological Institute, Phoenix, Arizona

Correspondence: Robert J. Dempsey, MD, FACS, University of Wisconsin School of Medicine and Public Health, Department of Neurological Surgery, 600 Highland Ave, K4/866, Madison, WI 53792. E-mail:

Received July 23, 2013

Accepted August 7, 2013

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This is a short prospectus about the Foundation for International Education in Neurological Surgery (FIENS). We would like to give general neurosurgery an idea about FIENS and the spirit of neurosurgical involvement in global health.

The Foundation for International Education in Neurological Surgery (FIENS), established in 1969, is dedicated to the provision of neurosurgical care in developing countries through the education of the founding neurosurgeons of those countries. As we enter a time of revolutionary change in health care, as well as communication, and education in neurosurgery, FIENS is transforming itself into a proactive agent of change in the healthcare of these countries. Currently involved in 21 sites around the world, FIENS volunteers are active in assessing the state of local care, tailoring curriculum and training to the needs of graduate neurosurgeons of the region, and supplying infrastructure and electronic education. FIENS has been assisting with providing equipment and instructing in its proper use and, most important, establishing training programs in the countries to ensure an ongoing supply of expertise in those lands. Neurosurgery has a long tradition of extremely altruistic volunteers who enter the specialty to serve and continue to do work globally. FIENS is working to coordinate these volunteer efforts toward a common educational goal by partnering with a wide variety of organizations: the World Federation of Neurological Societies, the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, the Society of Neurological Surgeons, ThinkFirst, the Africa 100 Program, and the Neurosurgery, Education and Development Foundation. The common philosophy is that building infrastructure and educational programs in a developing country is the best way to ensure that well-trained neurosurgeons of that country will succeed and benefit patients in their homelands. FIENS works to coordinate the multiple strengths of different organizations and to direct volunteer efforts to the sites with the most potential for growth and benefit.

The key ingredient to volunteerism is volunteers. We need you. For our part, FIENS seeks to make volunteering easier. Integral to the educational mission of FIENS is the Member Services Committee, which is an important asset to prospective volunteers. A toolkit provides important lessons learned from experienced volunteers. It contains information that explains the “nuts and bolts” of how to serve as a neurosurgical volunteer and is meant to facilitate participation. It assists a wide variety of volunteers and decreases the repetition of common mistakes. Resources include information on credentialing, health concerns, basic equipment needs, acquisition of equipment and supplies, and 2-way education—because volunteers quickly are reminded that they themselves are students as well.

FIENS is now establishing a Community Board with global expertise in a wide variety of important topics, including infrastructure, transportation, shipping, Internet-based education, and distribution of health care. This signifies a major change in emphasis and places neurosurgical care clearly in the context of the infrastructure of a growing health system. Our Communications Committee makes use of electronic media for the redesign of Web-based educational needs and draws extensively from organizations such as the Society of Neurological Surgeons for electronic curriculum design for initial education of trainees and milestones of educational accomplishments. As a result of working with the World Federation, an online educational curriculum has been designed that can pair residents in established programs with residents in developing countries. This allows real-time discussion and communication of the same cases among residents with faculty supervision. It enhances the possibility for exchange rotations and observerships to enhance their educational opportunities.

Most important, FIENS is an organization that believes firmly in ongoing support, both through a stream of volunteer educators and real-time communication electronically and through participation in regional and international educational offerings. Only through continued contact with the members of the program countries, open assessment of needs, and an ongoing commitment to the highest quality will we succeed. The mission here is clear. We wish to establish neurosurgery at a high level in developing countries. Initial reports1 have clearly shown that enhancing a highly visible program such as neurosurgery in developing countries can revolutionize trauma care, neonatal care, cancer care, anesthesia, critical care, imaging, and pathology, among other services. We focus on what we do well: neurosurgery. Realizing that it requires infrastructure to succeed, we are dedicated to developing that infrastructure to elevate the broader medical capacity of these underserved regions. This may serve to extend the reach of the healthcare system by providing neurosurgical care outside the capital of a developing country as graduates of these programs are sited and supported in a growing network or infrastructure. This is often critical in parts of the world where neurosurgical care otherwise would reach a tiny fraction of the population.

The work of FIENS is never finished. Neurosurgeons are, by their nature, altruistic and willing to volunteer. The efforts of all are much appreciated. You can participate through offering your expertise, volunteering, or donating much needed funds to help support the success of this program. To learn more, become a member, or to make a donation, please visit

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Dr Dempsey is chair of the board of FIENS and receives grant support from the National Institutes of Health. Dr Nakaji serves on the board of FIENS and receives grant support from the Barrow Neurological Foundation. Dr Nakaji receives honorarium/expenses reimbursement from Carl Zeiss, Inc; grant/research support from Aesculap, Inc, Carl Zeiss Meditec, Barrow Neurological Foundation, and National Institutes of Health; and consultant fees from Medtronic Navigation, Inc and Aesculap, Inc and is a major stockholder in Incubeon, Inc and GammaTile, LLC.

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1. Haglund M, Kiryabwire J, Parker S, et al.. Surgical capacity building in Uganda through twinning, technology, and training camps. World J Surg. 2011;35(6):1175–1182.


Curriculum; Education; FIENS; Mission; Training; Volunteerism

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