Money, or lack of it, is but one, albeit very important, threat to academic neurosurgery. This review has rambled over some of the other minefields and self-inflicted hurdles. The path of academic progress is long and tortuous. Time has to be found in neurosurgery to examine critically the opportunities and threats posed by a changing world to our goals of establishing standards of patient care, research, and the flexible training of the next generation.
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