Breaking barriers in brain surgery

Last summer, St. Michael’s Hospital proudly welcomed Dr. Saira Alli as the newest member of the neurosurgery team.

Dr. Alli, the Martine Irman Research Scholar, specializes in skull base surgery, a highly complex field focused on treating tumours located at the base of the skull. She is also one of only 40 female neurosurgeons currently practicing in Canada.

Born and raised in London, England, Dr. Alli completed her medical degree at Imperial College London. She began her neurosurgical training in the UK before relocating to Toronto to pursue a PhD at the University of Toronto. In 2018, she transitioned into U of T’s neurosurgery residency program and later completed a fellowship in skull base surgery at the world-renowned Cleveland Clinic.

We recently spoke with Dr. Alli about her new role at St. Michael’s, her vision for the future, and the lessons she’s carried with her from training across four continents.

Q: What inspired you to begin your career at St. Michael’s?

During my residency, I had the opportunity to rotate through several hospitals across Toronto. St. Michael’s always stood out to me.

There’s something truly special about the culture here. Everyone, from physicians to nurses to allied health professionals, is deeply focused on providing the best possible care for patients. That kind of team-based, patient-first approach really resonated with me.

Now that I’m here full time, I feel like I’m exactly where I’m meant to be. I’m excited to contribute to making this already exceptional hospital even better.

Q: What are your goals for the future at St. Michael’s?

One of my top priorities is to help establish a centre of excellence in skull base neurosurgery at St. Michael’s Hospital. This would include adopting more minimally invasive approaches to treating tumours and abnormalities at the base of the skull. My goal is to really solidify St. Michael’s reputation as a leader in managing the most complex brain tumours.

Achieving this requires a highly collaborative, multidisciplinary approach. It means bringing together specialists from across surgical disciplines so each step of a procedure is performed by the expert best suited to it, ultimately leading to better outcomes for patients.

We already have incredible expertise at St. Michael’s, and I hope to build on that by helping us remain at the forefront of innovation, technology, and patient care.

Q: What part of your training best prepared you for this vision?

I’ve been fortunate to train in several countries—England, South Africa, the U.S., and Canada—and each experience has shaped my approach to neurosurgery. Being exposed to different healthcare systems and surgical philosophies helped me build a broad, adaptable skill set.

Now, I’m excited to integrate the best of what I’ve learned here at St. Michael’s alongside a world-class team. Our commitment to innovation is strong, but we can’t become complacent. It’s essential to keep pushing ourselves because that’s what our patients deserve.

I’ve also had incredible mentors who believed in me, challenged me, and reminded me that great surgery isn’t just about technical skill, it’s also about mindset, compassion, and continuous growth.

Q: Can you tell us about your current research?

I’m in the process of launching a basic science research lab focused on two key areas.

Firstly, we’re exploring why certain cancers metastasize to the brain while others don’t—and whether we can predict which ones will.

Secondly, we’re studying rarer skull base tumours that can behave very differently from patient to patient. Some remain stable for years; others grow aggressively. We aim to better understand their biology so we can classify them more accurately and improve treatment options.

Q: What drew you to neurosurgery?

I was always fascinated by neuroanatomy. It felt intuitive and elegant to me. Pair that with my problem-solving personality and love of hands-on work, and neurosurgery just made sense.

During my final year of medical school, I trained in South Africa and was exposed to a wide range of neurosurgical conditions. I absolutely fell in love with the field. I also knew I wanted to focus on the most delicate and complex aspects of brain surgery, so it was a natural inclination to skull base surgery.

Now that I’m entering this next chapter and launching my career as a neurosurgeon, I know I made the right choice. It’s deeply fulfilling work, and I truly love what I do.

Q: As one of the few female neurosurgeons in Canada, have you faced any barriers along the way?

One of the biggest challenges has been a lack of mentorship. Research shows that people often mentor those who resemble themselves, so as a woman of colour in a male-dominated field, it was sometimes difficult to find support.

There were also moments when my skills were questioned simply because of my gender. But I’ve always chosen to tune out the negativity and stay focused on the work.

For me, surgical excellence is non-negotiable. I push myself to keep improving and to be the best surgeon I can be. Equally important is how I care for my patients: taking time to explain things clearly, answering questions, and making sure they feel seen and supported. That’s the standard I hold myself to, and it’s what helps me sleep well at night.

Q: Finally, what do you enjoy doing outside of work?

I love spending time with my partner and our two children, especially when it involves being out in nature or eating great food! I also love to travel and connect with people from all over the world and learn about different cultures. We’re very fortunate to live in Toronto, where all these things are on offer.