The Medical Directors Section of the CSNS was formed to engage neurosurgeons acting as medical directors to share their leadership experience with the CSNS, AANS and CNS members and, through these organizations, to enhance the educational opportunities for leadership development. A recent survey was completed about the role that Neurosurgeons as Medical Directors play in community and academic medical centers and the specifics of their contracting and responsibilities. The goal is to use our collective knowledge to enhance the preparedness of leaders in neurosurgery and to support them with informed and valuable advice as they take on new leadership roles. Shared knowledge about hospital and academic contracting can prepare leaders facing negotiations for resources, program development, staffing and compensation. The section also serves as a platform for advocacy of Neurosurgical Medical Directors through the CSNS to address issues that are important for our patients and practicing neurosurgeons, such as instances of insurance company obstacles to care for our patients and private equity incursion into healthcare. We welcome all CSNS members to attend our committee meeting.