Medical students gain confidence and experience through neurosurgery mentorship

By Grace McOmber
School of Medicine

Konstantinos "Dino" Oikonomou has always been drawn to surgery. He enjoys working with his hands and started medical school in 2023 with an interest in procedure-heavy fields. Now a second-year medical student at Virginia Commonwealth University and still months away from his first clinical rotation, Oikonomou has found meaningful research, personalized guidance and a potential career path with a leader in one of medicine's most competitive specialties - neurosurgery.

Oikonomou is one of four medical students working in the lab of David Limbrick, M.D., Ph.D., in the Department of Neurosurgery. Limbrick, a pediatric neurosurgeon who completed the VCU School of Medicine's M.D.-Ph.D. program in 2001, returned to the MCV Campus in 2023 as the James W. and Frances G. McGlothlin Chair, a role supported by a philanthropic endowment.

On top of his responsibilities as a physician, researcher and administrator, Limbrick dedicates time to be a mentor. He goes out of his way to create a welcoming and supportive environment within a field that can be intimidating to students and makes himself available to his mentees both in and out of the lab.

"We instantly hit it off," said Oikonomou, who met Limbrick as a first-year student at a McGlothlin Scholars luncheon last fall. "Working with Dr. Limbrick has opened my eyes to the field and made me seriously consider it in the future."

Paying it forward

If he decides to go into neurosurgery, it will be nearly another decade before Oikonomou is an attending physician. Factoring in the rest of medical school, a seven-year residency and one to two years of fellowship training if he wants to subspecialize, it's a daunting prospect - but Oikonomou said the career path feels more approachable with Limbrick's mentorship.

Limbrick wants students interested in neurosurgery to know that they aren't alone in being overwhelmed, and freely admits to his own imposter syndrome and feelings of inadequacy when he started out. His mentors within the field helped him overcome those feelings of doubt when he was an M.D.-Ph.D. student at VCU, and now, he wants to pay that forward.

"One small amount of interest and attention can have an enormous impact on someone's career," Limbrick said. "Mentorship is about building confidence and opening up possibilities for people. And, personally, it's a tremendous amount of fun."

In recent years, including at his previous institution, Washington University in St. Louis, Limbrick has sought funding to support his mentorship priorities - this allows him to bring students like Oikonomou into the lab for invaluable hands-on research experience. Oikonomou is helping him design a study on how irregular connections of arteries and veins in the brain's protective tissue present in children, one of several projects Limbrick has invited students to join.

"These four students make up a great cohort and they all come from different backgrounds with different interests," Limbrick said. "But they're all linked by the overall mission of improving neurosurgical care for children with disorders."

'Shattering the stereotypes'

There's more to being a mentor than providing academic and professional guidance, and multiple students described Limbrick as someone they feel comfortable talking to about anything, neurosurgery-related or otherwise. Marie Michenková, an M.D.-Ph.D. student from the Czech Republic who couldn't return home during the holidays last year, was struck by Limbrick's kindness when he invited her to spend Thanksgiving Day with him and his family.

Like Oikonomou, Michenková has always been interested in surgical specialties. She has a master's degree in biomedical and health informatics and a bachelor's in neuroscience, but only truly began considering neurosurgery as a career choice after meeting Limbrick at last year's M.D.-Ph.D. program retreat. Like many students, she was discouraged by its competitive nature and unsure of how welcoming it would be - during the 2023-2024 match cycle, only 68% of M.D. applicants matched into neurosurgery programs. It's also one of the most male-dominated medical fields, with women making up less than 10% of practicing neurosurgeons in the U.S., according to a 2024 report.

Michenková has found a passion for the subject matter, and with Limbrick as her mentor, she's reframing her perception of the specialty.

"You can tell by the number of mentees he has that he's just trying to help so many people be successful," she said. "I think his legacy at VCU, besides the actual clinical and basic science work that he does, will be shattering the stereotypes about neurosurgery."

Now in her graduate phase of the Medical Science Training Program, Michenková is working alongside Limbrick to identify nonsurgical treatments for children with hydrocephalus. She will resume her M.D. training as a third-year medical student after completing her Ph.D. in a few years. The combined program allows her to "stay in touch with both sides," she said, and having an advisor who straddles the basic science and clinical worlds is helping her visualize that balance in her own career.

"I think it's wonderful to be able to improve medicine through research and improve research through medicine," Michenková said. "I don't think I can say I want to do it the way he does, because in a year or two I might say I want more clinical time, or more basic science. But right now, I'm just happy I have that person I can watch and see how it's done."

A dual approach

Fellow graduate student Habeebah Vohra, who's working alongside Michenková in the lab, decided during her second year in the M.D. program to also pursue a Ph.D. She met Limbrick that year and said it was his encouragement that gave her the confidence to change course.

"Getting a Ph.D. has been an aspiration of mine for a while, but I've kind of pushed it away," Vohra said. "When we first talked, he told me about how he also had doubts, especially during his residency. It was nice to hear that from someone who seems to have it all figured out."

Vohra plans to work as a pediatric neurosurgeon in communities with inadequate access to health care, which she said Limbrick considered when introducing her to his hydrocephalus studies that align with her goals of "working on solutions that will help children in low-resource settings.

"A surgeon impacts the people they operate on, but a researcher's work can impact millions," Vohra said. "Dr. Limbrick is able to bring perspectives to the lab that someone without clinical experience wouldn't have. I really like that dual approach, and that's where I want to get to."

'I fit in here'

Thérèse "Tess" Weidenkopf, a leader in VCU's student chapter of the American Association of Neurological Surgeons (AANS), is working with Limbrick on a study of the health-related quality of life for post-operative patients with Chiari Malformation, a condition where the lower part of the brain pushes through an opening of the skull, and syringomyelia, a fluid-filled cyst in the spinal cord. She met Limbrick through the AANS as a second-year medical student and vividly remembers their first sit-down in his office.

"He offered me a Kind bar and I thought, 'This guy knows how to get through to medical students; always offer snacks,'" Weidenkopf said. "We had a wonderful meeting and discussed my interest in the field, how I see my career unfolding and potential projects I could get involved in."

Now in her third year of medical school, Weidenkopf is learning to balance her interest in research with the demands of clinical rotations. After some recent anxiety around finding time to work on the project during her surgery block, she said Limbrick immediately helped her manage her schedule and her stress levels.

Weidenkopf has been encouraged to keep an open mind as she explores the full spectrum of medicine, and she said she is also enjoying other brain-related fields, such as psychiatry and neurology. But in Limbrick's lab, alongside her neurosurgery-curious peers, Weidenkopf has found a specialty that is challenging, rewarding and welcoming.

"I feel that the more experience and exposure I get with neurosurgery and mentorship within the field, the more drawn to it I become," Weidenkopf said. "It makes me feel like I fit in and I'm meant to be here."

This article originally was published on the VCU School of Medicine website.

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