Dr Michael Stuart, a neurosurgeon, received the 2025 Bongiorno National Network Younger Fellows Travel Grant through RACS’ Scholarships and Grants Program.

The grant supports Younger Fellows undertaking overseas travel to advance their post Fellowship training and broaden their surgical experience. With this support, Dr Stuart is completing a Clinical Instructorship in open cerebrovascular neurosurgery at Stanford University.

At Stanford, Dr Stuart is focusing on complex extracranial-to-intracranial bypass surgery and the management of Moyamoya disease in both adults and children. “Stanford is in the middle of Silicon Valley, which is one of the most expensive places in the world to live,” he says. “Every little bit counts.” For him, the grant has provided essential financial support, helping make an otherwise inaccessible training opportunity viable.

Stanford’s program is world renowned. Dr Stuart describes it as the “Moyamoya centre of excellence for the English-speaking world.” Moyamoya is a rare, progressive disease that narrows the major arteries supplying the brain, depriving it of oxygen. The bypass procedure used to treat it is highly intricate, using either a scalp artery or a graft from the neck to re-establish blood flow. “It requires the smallest sutures we use.”

This level of expertise has been limited in Queensland. As a result, many patients who needed direct bypass surgery were sent interstate. “I’ll be returning to work at the Queensland Children’s Hospital,” he says. “We used to send many patients away, so hopefully we won’t have to do that anymore.”

Dr Stuart’s position at Stanford combines advanced surgical training with formal teaching duties. This dual role enables him to learn from internationally recognised experts, including Professor Gary Steinberg, while also teaching junior doctors and medical students. 

“As a junior doctor I found the best training came from people who were a year to five years ahead of me, and I gain the most from teaching people who are a year to five years junior.”

Training at a high volume centre has been essential, given the rarity of these conditions in Australia. Direct bypass surgery, for example, has not previously been performed in Queensland, whereas Stanford performs more than 100 operations each year. “It’s also a place where you can be involved in the whole journey of the patient—before surgery, during the operation and years afterwards.”

Beyond Moyamoya, the department manages complex intracranial aneurysms, arteriovenous malformations and cavernous malformations, many of which are located in the brainstem. These conditions demand both technical expertise and a deep understanding of the patient journey—from diagnosis to recovery. “There’s the challenge of selecting the right patients for surgery and caring for them afterwards, especially if complications arise or further procedures are needed.”

The position has also strengthened Dr Stuart’s research collaborations. He has partnered with colleagues at the Queensland Children’s Hospital on studies involving complex arteriovenous malformations, with work published in leading neurosurgical journals. He has also contributed a chapter to the widely used neurosurgical textbook Youmans and Winn. “For very rare diseases, academic collaboration is essential,” he says. “And any cerebrovascular condition in a child is a rare disease.”

Dr Stuart’s path to neurosurgery was not linear. He initially wanted to become a psychiatrist, but mentors at Brisbane’s Princess Alexandra Hospital encouraged him toward neurosurgery. Now, he looks forward to returning home to work alongside those same colleagues. After completing his time at Stanford, he plans to spend additional years in the US furthering his training before returning to Queensland.

Despite the intensity of the position, life in California has felt unexpectedly familiar. “California feels like home. It’s sunny most of the time, and people are cheerful and light hearted. They’re probably the most Australian Americans,” he says. When not in the operating theatre, he explores the Californian coastline or visits Yosemite National Park.

Ultimately, his overseas training has a clear purpose: building a comprehensive cerebrovascular service in Queensland. “Hopefully we’ll be able to offer a complete cerebrovascular service in Queensland. Then we won’t need to send patients interstate. We’ll be as mature as Sydney and Melbourne.”