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In April 2025, we had the privilege of hosting the largest global neurosurgery symposium in Boston, with one clear goal: to improve access to care worldwide. The MGB Global Neurosurgery Symposium brought together over 500 impactful and dynamic leaders from all over the globe, each contributing their expertise to drive the conversation forward.

"Kindness isn't an act, it's a feeling you get when you see a person giving to another person without any expectations. When you see kindness like that, it reverberates, you can't help but spread it, it's what defines us as human beings - it's empathy." - Mohammad A. Aziz-Sultan, MD, MBA

Our speakers challenged us to think beyond the operating room. As Dr. Kee B. Park so powerfully put it, global neurosurgery is not just about performing surgery better, it’s about ensuring that everyone, everywhere, has timely, safe, and affordable access to care. The conversations sparked were a call to action, urging us to reimagine not only how we operate, but who we reach.

Defining Global Neurosurgery: "It is the clinical and public health practice of neurosurgery and there is a purpose behind it, to ensure timely, safe and affordable neurosurgical care to all who need it. What does that mean? It really is asking not only about how do we do surgery better, but should we also be asking the question how do we better deliver neurosurgical care to all who need it? And that's the challenge." - Kee B. Park, MD, MPH

"Often we think globally and apply locally, but we'd like to also propose the opposite, which is that one can experiment locally, and apply globally, and those shared experiences may look different in each one's homes, but we think and believe that there is some inkling and some element that one can learn from each other." - Wenya Linda Bi, MD, PhD

The event concluded with the Boston Declaration, signed by 100+ global health advocates, setting the stage for us to bring care to low- and middle-income communities. This is just the beginning of a larger movement as we have secured commitments from 90 major neurosurgical programs to bring care where it’s needed most. Thank you to all the wonderful leaders from around the glove that joined us for this special moment.

"Wars, poverty, malnutrition...how does that even fit with neurosurgery? How can someone have their aneurysm fixed if they don't have enough food in their belly? How can we talk about it even? this is broken. It doesn't make sense. But here we are, and we're attempting to do it." - Nirav J. Patel, MD

"It's really the together part that I want to highlight. It's the idea that each one of us can scale our impact to a much greater part when we work together, ultimately." - Brian Nahed, MD, MSC, FACS FAANS

A team of neurosurgeons and a neuroanesthesiologist from Mass General Brigham collaborated with Gambian neurosurgeon Dr. John Jabang to perform the first ever pituitary surgery in The Gambia's history. Dr. Jabang, one of only two neurosurgeons in the country, worked alongside Dr. Timothy Smith, Dr. Saksham Gupta, Dr. Ryan Chrenek, and Dr. Hinna Malik from Mass General Brigham to complete five complex pituitary and skull base surgeries. Their goal is to establish a sustainable practice for these procedures in The Gambia.

In addition to the surgeries, the MGB team donated over $20,000 worth of disposable supplies and drill sets to help Dr. Jabang enhance his capacity to perform future cases in The Gambia. Dr. Chrenek and Dr. Gupta also provided training to local medical students and resident trainees during the operations and through standalone lectures. Dr. Malik played a key role in teaching advanced techniques for maintaining hemodynamic stability during these large operations.

During their visit, the team also met with the U.S. Ambassador to The Gambia to discuss bilateral issues and how their partnership aligns with broader U.S. diplomacy initiatives in the region. Organized by Dr. Gupta and Dr. Jabang, the Mass General Brigham team aims to build of one of the continent's strongest neurosurgery centers and establish the first neurosurgery training program in The Gambia. This partnership was generously supported by Janet Thompson from Project CURE, Jay Dulka from Stryker, the Mass General Brigham Department of Neurosurgery, and the Brigham and Women’s Hospital Central Processing Department.

The Mass General Brigham team is looking forward to returning to The Gambia in June 2025 to continue the incredible work brought out by this partnership.

Mass General Brigham Neurosurgery Expands Global Footprint with Historic Return to The Gambia

A multidisciplinary team from Mass General Brigham (MGB) Neurosurgery recently returned to The Gambia for a high-impact medical mission, deepening a growing partnership with The Edward Francis Small Teaching Hospital and building on a shared vision: to transform neurosurgical care and education across the region.

This trip marked the second MGB-led mission to The Gambia, with returning team members Dr. Timothy Smith (pituitary neurosurgeon), Dr. Saksham Gupta (chief resident), and Dr. Hinna Malik (anesthesiologist) joined by first-time collaborators Dr. John Rolston (functional neurosurgeon), Karen Ruuska (surgical technologist), Zsombor Gal (Harvard medical student), and Maddie Ikeya (marketing and communications).

“We were excited not just to operate, but to help build a self-sustaining foundation for advanced neurosurgical care,” said Dr. Smith. “The need here is tremendous. When we first started last year, [Dr. Jabang] was one of the the only neurosurgeons in the country who was providing neurosurgery services to the entire population of 2.6 million people.”

The MGB team worked closely with Dr. John Jabang, head of neurosurgery at Edward Francis Small Teaching Hospital. Dr. Smith described him as “absolutely phenomenal” and “an incredible collaborator.” The seeds of the partnership were first planted when Drs. Gupta and Jabang met at a conference in Cape Town. “He really had a passion to want to build a training center,” said Dr. Smith. “So we really don’t want to come here and just do cases — what we are really trying to do is build an infrastructure and skill set so that when we leave here, they can continue on.”

Advancing Surgery: Pituitary and Epilepsy Milestones

On MGB’s first visit last year, the team performed the country’s first-ever pituitary surgery. This time, they returned to deepen that work and expand the Gambian team’s familiarity with techniques and tools — including the use of an endoscope gifted by Prosidio.

“We are excited to come back this time to continue our focus on pituitary surgery,” said Dr. Gupta. “With the goal that after this trip, Dr. Jabang and his team will perform these operations independently. Additionally, we’ve been gifted an endoscope from Prosidio, allowing us to perform the first endoscopic surgery.”

With Dr. John Rolston joining the team, the mission added a new focus: epilepsy. On June 11, he performed The Gambia’s first-ever epilepsy surgery, a corpus callosotomy, a procedure used to treat drop attacks caused by medication-resistant seizures.

“We have many patients who haven’t been helped with medications,” said Dr. Jabang. “Having another additional form of treatment, which is in the form of surgery, is really amazing for us.”

“When anti-epilepsy medications don’t work, surgery can,” said Dr. Rolston. “Surgery can help people. And now we are able to do that here in The Gambia.”

Performed in a packed OR full of residents and faculty, the surgery was both successful and instructive. “It’s a great surgery to start with and one that hopefully we can make part of the armamentarium here in The Gambia,” Rolston added.

Training Over Time: A Bid for Sustainable Impact

The mission’s core objective went far beyond the operating room. “We’re spending time meeting with the health minister, the dean of the medical school, the CMO of the hospital, and various surgical directors and heads,” said Dr. Smith, “all of which is to try to build enough political will and momentum to help invest capital into building this into a true emergency service center for neurosurgery and eventually helping them establish their own training program where they’re training their own residents.”

Dr. Gupta reflected, “I think you can be beneficial in a multidisciplinary way. Initially, I thought we would just be teaching neurosurgery and that’s that. But our partnership has evolved into so much more already.”

Residents on both sides emphasized the reciprocal nature of the learning. “I'm really learning so much operatively and in terms of my management skills by seeing how things are done in a different country and different part of the world,” said Dr. Luiselli. “So I think as much as we’ve tried to give them, they’re giving us even more back.”

For Gambian resident Dr. Manneh, the mission reinforced his own aspirations for the future of neurosurgery in the country. “The more you go, the more you see, the more you realize where you’re supposed to be. So I’m looking at getting neurosurgery here to the highest it can get to. So the care that someone in the richest of countries can get – I want to ensure that people here have access to that standard of neurosurgical care.”

“In the partnership we have with the Brigham team, I am positive that with time, even when they aren’t around, we’ll be able to do the procedures. That’s where I want us to get to” he added.

Research and Technology: Piloting a Clinical Study with OpenAI

In tandem with the clinical work, the team is piloting a first-of-its-kind research study in collaboration with OpenAI, using ChatGPT to support clinical decision-making in low-resource environments. The study is designed to evaluate the potential of large language models in improving care where neurosurgical expertise may be limited.

“We’ve been very fortunate to have interest from OpenAI in working with us and providing funding for this project,” said Gal. “Additionally, they’re gifted every participant in this study a free Pro account, which normally costs quite a bit. This gives us the ability to use some of the most powerful base models that ChatGPT has to offer.”

Dr. Luiselli described the study’s aim: “This will be a really impactful study where we’re using ChatGPT to improve clinical care in a setting where typically there aren’t a lot of neurosurgery residents or staff around. Oftentimes, the clinicians taking care of the patients aren’t neurosurgery trained. So our hope is that using ChatGPT to educate them about patient care and post-operative care, we can help improve patient care in countries where neurosurgery care isn’t readily available.”

The study will include a structured pre- and post-presentation model: clinicians give initial rounds-based presentations on neurosurgical patients, then receive curated AI-generated output from ChatGPT, and re-present with that guidance in mind. The goal is to evaluate whether the AI improves the clarity and accuracy of care recommendations.

“The thing we’re really interested in, first and foremost, is: is the ChatGPT output safe?” Gal explained. “Is it telling us things that are medically accurate recommendations? So we have a team of physicians who will be evaluating the output every single day to make sure these are actually safe recommendations and that they can be used in a clinical setting. Having this sort of prospective study is really important.”

Early findings from preliminary testing are already proving meaningful. On day two of piloting the study, ChatGPT identified an omission in a patient’s postoperative plan.

“Unfortunately the post-op patient wasn’t prescribed a medication he was supposed to be taking,” said Gambian medical student Jay Touray. “When the nurse was presenting all the medications the patient was on, they didn’t mention the antibiotic. ChatGPT noted that the patient should be on an antibiotic and the patient hadn’t received it. This was an oversight, but they corrected it with the help of this study, which is really good.”

“Catching that clinical error was huge,” added Gal. “Because that patient’s entire post-op course would’ve been affected in a negative sense had that error not been caught.”

Gal and Luiselli will remain in The Gambia throughout the month to prepare for the study ahead. “What we expect to find is that ChatGPT will be a useful tool for not only clinical practice but clinical education,” said Gal. “And if we can demonstrate its safety and efficacy, that will mean a lot for medical practice in resource-limited settings.”

Looking Ahead

With positive outcomes and deepening relationships, the MGB team views this mission as part of a long-term investment.

“This is one of the best parts of my medical education,” said Dr. Gupta. “You become a better clinician when you practice in an environment like this. Dr. Rolston added, “I think it’s important for us as a global community to always collaborate and teach each other as much as we can. It’s a great way to make new friends and colleagues across the world.”

The mission was made possible entirely by donations. Dr. Gupta and Dr. Jabang expressed gratitude: “We are very lucky and thankful to our many sponsors — MGB, OpenAI, Prosidio who was kind enough to provide us a fully functioning endoscope system for pituitary surgery, and KLS Martin and Scanlan, who have some of the highest-quality microinstruments. We’re thankful they provided those instruments for our trip here as well.”