Is becoming a neurosurgeon really as difficult as they say?

<p>NSGYDoc: Thanks for the excellent posts.</p>

<p>NSGYDoc, you are amazing.</p>

<p>But yes, $600,000 a year? Wonderful. How much would someone in Internal Medicine be making after their residency?</p>

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<p>Too general a question. It depends if the resident pursued fellowship training. It depends what area of medicine the physician practiced (outpatient clinic only? academics? hospitalist?). It depends on the location of the physician.</p>

<p>All those factors accounted for, I will acknowledge it’s rare to find someone in pure internal medicine coming close to a neurosurgeon. (The caveat being it’s generally easier to get into IM, easier to survive the IM residency, and will generally enjoy better hours as an IM attending. Yes, exceptions do exist to all the above)</p>

<p>If you just came straight through IM, it’d probably be, what, $150K? Maybe less at an academic center.</p>

<p>ND’s $600K sounds high to me; maybe he’s at a center that’s exceptionally profitable or something. Not that $600K is outlandish for a neurosurgeon; it seems a little high to me but not ridiculousl.</p>

<p>What surprises me is that I had thought that most neurosurgeons take major pay cuts to be in academics; I would have expected him to make much less than half of that, especially as a starting salary.</p>

<p>This is definitely not my field of expertise, but you can color me very surprised.</p>

<p>My fellowship is in an area of neurosurgery that is currently highly sought after. There is a limited supply of people trained in what I do, and the average neurosurgeon isn’t trained to do the types of cases I can do. That is why I can get more from an academic center than a neurosurgeon without that training. I’d say I’m at the upper end of what you can get as a starting salary at an academic center. The low end for someone with my specialized area of training at an academic center would be about $400k</p>

<p>$150k is about right for IM</p>

<p>There we go, he beat me to my answer.</p>

<p>NSGYDoc did you an endovascular fellowship?</p>

<p>IM academic starting is usually about $125K. Are you “pure” academics (tenured route) or nontenured academic affiliated. Being fairly familiar with most tenured positions, I would venture a guess that you are the latter which is really not “academics”??</p>

<p>100 hour work week. Now Neurosurgeon Residents work week is 80 hours/week and will go down to 60 hours/wk probably soon (as for all residencies/fellowships).</p>

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<p>Yes, those are the official rules. I suspect more often than not they are bent in surgical fields, especially neurosurgery. 80 hrs/week is also an average over a month. So there are certainly weeks where you will exceed 80 hrs and then hopefully, weeks where you can fall under so the average comes in at 80. Regardless, residents who routinely state they must “clock out” at 80 hrs are not going to be looked upon favorably in surgery.</p>

<p>I’ve heard rumors of the 60 hrs/week regulations. I find it hard to believe. In an era when more and more people are complaining about escalating student debt, extending residency is not going to be done easily.</p>

<p>Small Child
They are pretty strict. Esp in the surg fields where they know they will be bent. If caught mult times breaking them, they can loose their accreditation and chairman fired by Dean. So the hours are strictly followed in all fields. The faculty can also be fired if they “force” the resident to work more.
It is a new world.</p>

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<p>Lets ask NSGYDoc. Programs certainly can lose their accreditation if caught in violation of the workhour restrictions. And faculty probably don’t “force” their residents to work more than the limit. But these residents in the surgical fields highly motivated and leaving in time for the 80 hr limit often means missing out on OR time. The residents are the ones who often find ways to make their timesheet balance so as not to miss out on operative experience.</p>

<p>Either way, 80 hours is a week is the minimum one should expect to work in residency should you have a serious interest in neurosurgery.</p>

<p>As a Surgical Faculty, I can tell you that we enforce the 80 hour week. Residency programs are doing away with elective research year - or adding year - to make up for missed cases. The residents really have no choice now, if they are caught “bending the rules”, we must put them on time off to balance. It sucks for all but spouses.</p>

<p>The interesting fact is the one study only found that the 80 hour week gave them more time to moonlight.</p>

<p>Didn’t JAMA report that about 5% of all residencies, much less surgical ones, were in compliance with the rules?</p>

<p>Hm. 84% non-compliance according to this link:
[JAMA</a> – Interns’ Compliance With Accreditation Council for Graduate Medical Education Work-Hour Limits, September 6, 2006, Landrigan et al. 296 (9): 1063](<a href=“http://jama.ama-assn.org/cgi/content/full/296/9/1063]JAMA”>http://jama.ama-assn.org/cgi/content/full/296/9/1063)</p>

<p>This was interns-only, however.</p>

<p>Wow. Just everything about neurosurgery deserves a wow. From the length and intensity of the training to the size of the paycheck…wow. Still, my neurosurgeon works so hard and such long hours that I wonder when he has time to spend his money? Last year he took a vacation–>to present at a conference.</p>

<p>You have to really love it, I think, to tolerate that kind of grueling intensity for so long.</p>

<p>The road to being a physician is so tough. My son wants to go into pediatric infectious disease and work internationally. I am proud of him and not because he is going to be a doctor but because he is willing to work to long and so hard without much monetary reward.</p>

<p>Maybe I should tell him to go into neurosurgery…except that I would like to see him again someday.</p>

<p>Jamie,
Most infectious disease docs I know work as many if not more hours than Neurosurgeons (they just are not on call for MVAs)</p>

<p>So how does just a general internal medicine ER doctor compare to this? Is it like night and day, or is simply anything in the medical field going to be grueling?</p>

<p>If you really love being a physician, you’ll like it so much that you could do it for free. And guess what, you’ll probably be the happiest and most successful.</p>

<p>ER docs (are not IM, but specific different residency in emergency med) work 8 to 12 hour shifts and are then off. It is the least “grueling” of all fields as when you are off, you are off. It also has one of the highest malpractice rates as you have to be jack of all trades. Most love it as you see everything.</p>

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<p>Uhh, not in my neck of the woods…</p>

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<p>Many start off thinking that way. By the third year of medical school, even the most idealistic will NOT feel this way.</p>