Dr Brendan Davis, FRACS, received the 2024 Queensland Younger Fellows Grant from the Royal Australasian College of Surgeons. The award enabled a 12-month Skull Base Fellowship at Addenbrooke’s Hospital in Cambridge, UK. The hospital is one of Europe’s most prestigious neurosurgical centres. Dr Davis returned to Queensland with refined skills and a commitment to improving patient care.

A lifelong fascination with the brain
“I’ve always had a passion for the neurosciences,” Dr Davis says. The interplay of anatomy, biology and psychology captivated him during his undergraduate degree. He remembers watching a deep brain stimulator implanted for Parkinson’s disease. “It was just breathtaking,” he recalls. That moment confirmed his path toward neurosurgery.

During training he developed a clear interest in the skull base. He describes the region as a place of complex anatomy that necessitated team-based decision making since treatment protocols are not always clear cut. The subspecialty demands collaboration with ENT surgeons and radiation oncologists, and he values this multidisciplinary style.

Pursuing high-volume international training
Australia offers limited high-volume exposure in skull base surgery, so he looked overseas. Addenbrookes serves all of East Anglia in England and from a population standpoint, "that's fairly similar to all of Queensland draining into this one hospital. With that high volume comes high complexity,” he says.

The Queensland Younger Fellows Grant appealed because it supports doctors who will return home. “It fits with my ethos,” he adds. He believes each generation should ease the path for the next.

At Addenbrooke’s, Dr Davis focused on microsurgical lateral skull base surgery and endonasal anterior skull base surgery including pituitary work. A highlight was participating in the unit’s first hearing-preservation acoustic neuroma operation and learning from highly gifted surgeons, the engaged registrars and residents, and the fantastic nurse practitioners.

He notes that volume and experience accelerated his operative judgment. “Identifying complex intraoperative decision points, when to be more courageous or conservative, to achieve optimal patient outcomes. These are essential learnings one gleans through experience.”

He stresses that skull base surgery carries major stakes since “You’re up against these critical neurovascular structures." He aims to guide patients through complex decisions with clarity and empathy.

The role of evolving technology
Dr Davis highlights microscopes, endoscopes, neuronavigation and radiosurgery as essential tools. He believes these technologies are adjuncts rather than replacements for clinical judgment. He foresees a future of improved imaging and possible augmented reality, though current systems have limited clinical application.

He has now returned to Brisbane contributing to the next generation of skull base neurosurgeons. He says Queensland has strong foundations, including a statewide Skull Base Unit and the Gamma Knife service. He aims to expand surgical volume, strengthen collaboration and support academic growth. 

At Cambridge he studied how the unit managed disruptions such as COVID-19 and the retirement of a senior surgeon. The research showed the value of structured mentorship and succession planning. 

Dr Davis used the grant to present his research at the European Skull Base Society meeting in Maastricht. The experience broadened his professional network and strengthened his desire to enhance mentorship opportunities in Queensland and support younger colleagues.

He encourages Trainees to choose high-volume Fellowships with strong mentorship. He also recommends overseas training to gain technical, professional and personal growth. He adds grant applicants should clearly outline their goals and fully immerse themselves in the experience.

When asked what he missed during his year abroad, he smiles. “The sunshine,” he says. Despite occasional storms, he is glad to be back contributing to Queensland’s neurosurgical community.