First European Lecture: A European looks at neurosurgery in America-personal observation on clinical practice, training, and research.

After five years experience each in the U.K. and the United States of America, the author comments on clinical practice, training and research in neurosurgery in America and draws some conclusions which may be relevant to the future of neurosurgery in Europe. Of particular importance is the need to avoid over-supply of neurosurgeons, dilution of experience and dispersion of facilities. The work of a NIH Clinical Research Centre in the United States of America is described. The potential role of the EANS in promoting multi-centre neurosurgical research in Europe is stressed.