Sharing the directorship will be John Engstrom, and Daryl Gress, who have known each other since the early 1980s, when they went through an internship and residency together at Johns Hopkins Hospital in Baltimore.

Regarding the dual directorship, Engstrom said, "It's a big job, and both of us want to continue to have a clinical presence. Although we've focused on different areas of clinical practice, we Š already have built a strong basis of mutual respect. In planning and problem solving, it's often a good idea to have multiple perspectives."

Engstrom, an associate professor of clinical neurology at UCSF, received his medical degree in 1981 from Stanford. After the residency in internal medicine at Hopkins, he went to UCSF to complete a residency and chief residency in neurology. A UCSF faculty member since 1994, Engstrom is vice-chair of the Department of Neurology and director of the Spine and Nerve Clinic, the Neurology Outpatient Service and the Neurology Residency Program.

Gress, an assistant professor of clinical neurology and neurosurgery since 1994, earned his medical degree in 1982 from Washington University before serving as the Osler Intern and Resident in Medicine at Hopkins. He went on to Massachusetts General Hospital to complete a residency and chief residency in neurology, followed by clinical, research and ICU fellowships in neurology and neurosurgery there.

"These two talented young physicians have made a terrific impact on the department at UCSF. I believe their enthusiasm and intellect will benefit the service line," said Stanford professor and chair of neurology William Mobley, who was a member of UCSF's neurology department before coming to Stanford last year.

"We are extremely fortunate to have recruited Drs. Gress and Engstrom for this position," said Gary Steinberg, professor and chair of neurosurgery and co-director of the Stanford Stroke Center. "Together they possess the clinical expertise, intelligence and familiarity with current health economics to help lead the adult neurosciences service line. Under their guidance, it's likely that neurosciences at Stanford and UCSF will achieve unprecedented levels of clinical integration and growth."

The multidisciplinary approach inherent in the service-line concept is already well developed in the area of stroke treatment and neurocritical care, Gress said. "Not only stroke, but also programs such as epilepsy, brain tumor and aneurysm/AVM, have utilized a multidisciplinary approach for some time. It is not uncommon for the same patient to experience more than one type of treatment," he said.

The greater challenge, in his view, is that of creating clinical integration between the two campuses. "We need to find ways to practice side by side and learn from each other," said Gress.

Toward that end, both Gress and Engstrom plan to serve as teaching attendings at Stanford in the coming year, Wintroub said.

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