Integrity
Adherence to moral and ethical principles; soundness of moral character; honesty.
Retractions of neurosurgical publications are increasing significantly, mostly due to issues of academic integrity, including duplicate publishing and plagiarism. Implementation of more transparent data sharing repositories, a thorough screening of data prior to manuscript submission, as well as additional educational programs for new researchers, may help mitigate these issues moving forward 1).
Excellence in surgical work should be measured comprehensively and over long follow-up, periods using tools such as functional outcome, and quality of life instruments besides morbidity and mortality. For excellence in neurosurgical research, one can use the help of indices such as the h index and i10-index. No single measure, whether for surgical excellence or excellence in research, however, incorporates a measure of qualities such as empathy, integrity and mentorship. These intangible qualities should be an integral part of the assessment of a neurosurgeon and his/her work. Cushing's attributes of meticulous record-keeping, attention to detail, and maximal utilization of opportunities should guide us in our pursuit of excellence. In recent years, it has been suggested that excellence is not the result of innate talent but can be aspired to by anyone willing to adopt a work ethic that involves several hours of “deliberate practice,” feedback and passion. Neurosurgeons should continue to pursue the legacy of Cushing especially in present times when medical professionals are frequently depicted as being driven more by avarice than by Hippocratic principles 2).