path to neurosurgery

surag · May 15, 2007

I'm heading into medical school soon and I just finished a year of post-undergraduate work, doing research at the NIH

I was wondering how many neurosurgical residents took time off from undergraduate before entering medical school? I ask mainly because of all the time involved and whether taking that time off, whether its 1,2,3 years or more before entering medical school made you think twice before going into neurosurgery.

i had to take time of because of grades, was that an issue with anyone as well.
37mcat

surag · May 16, 2007

anyone?

Noeljan · May 16, 2007

surag said:
anyone?

Hey I also want to go into NS and I took 2 years to finish my MS, so I am right there with you

It would be nice to hear from some NS's that have done such things. I think I may try and get on a NS project/lab early on.

greymew · May 16, 2007

I took some time off between college and medical school. I was a scrub tech in that time, so that was good experience for both rotations and neurosurgry specifically. It helped me more than I thought it would on the neurosurgery services and interviewing.

I think your NIH thing is great. There's a neurosurgery resident 2 years ahead of me who did something similar. So it will not hurt you from my experience. Let me know if you have other questions.

-Jason

Noeljan · May 16, 2007

greymew said:
I took some time off between college and medical school. I was a scrub tech in that time, so that was good experience for both rotations and neurosurgry specifically. It helped me more than I thought it would on the neurosurgery services and interviewing.

I think your NIH thing is great. There's a neurosurgery resident 2 years ahead of me who did something similar. So it will not hurt you from my experience. Let me know if you have other questions.

-Jason

Hi Jason
thanks for answering our questions

I have many questions for NS's, sorry if some seem silly. But, is it really as impossible as the rumors (the lifestyle of a NS)? Obviously I expect it to be very difficult, but can I count out wanting a child or two (I am female). I want to get as much feedback on this as possible. I had an eye appt recently, and the Dr (who was very very nice) was talking to me about med school (since I will be starting this August) and what I want to do. He told me that NS residencies don't want to take you if you have a family (or are less likely) and that I should say I don't want one. What is your take on that?

Also, many people say not to worry about grades in medical school, or don't be soo anxious to pick a specialty. However, I also hear people complain about what they didn't focus on their first few years in med school (like they should have in fact focused more on grades from the start and research, etc). Do you think it is wrong to be focused on something from the start?

Lastly, how will non NS publications help out when it comes to residency (I am talking about DNA replication work, so basic science)?

One more thing, I am pretty intimidated to try and talk to NS's in person and ask them such questions, or advice. Do you think it bothers them to have someone wanting advice??

thanks a lot

greymew · May 16, 2007

Hi Noeljan,

Everything I'm going to tell you is from my experience and in my opinion...

About kids and family... after residency you basically make your own hours, so it shouldn't be a problem. When it comes to applying and interviewing, sometimes there is some bias against people getting pregnant. So just don't address it - it's illegal for them to ask you about that. Still, they might, then it's up to you. Personally, I'd tell them what they want to hear, then do what you want when you're in the program.

Grades in medical school... mine were not super (some a little above average and some a little below) and I got a position. However, I had to get to know everyone and work my butt off on (neurosurgery) rotations. I'm talking first one there and last to leave, plus every weekend. Bottom line... to even get an interview you have to have great academics or have rotated there (and did a great job).

Focusing on a specialty... I did. But I was 100% for neurosurgery. I attended the national conferences and stuff every year. That really helped with networking. On the other hand, lots of people changed their minds over and over. So go with what works for you, there's really no right answer for this one.

Publications... anything helps, but they don't matter too much either way. I would suggest writing a paper for a resident or attending in the program you want. That's what I did. I'm not into research, so it was like selling my soul for a year, but it worked out. And about type of publication, neurosurgery > neuroscience > other science > fashion magazines

.

Intimidation... I know. You feel like who are you to speak with so-and-so. Some people will blow you off, but screw them. The ones worth getting to know will treat you well. It can't hurt to approach someone, go to their clinic, call, etc. My best advice though is to talk with residents (like this). They have the best and most current information. The attendings are often too far removed from what it was like to be a student trying to get a residency spot.

Anyway, I hope this helps. Please email with additional questions. If yo have a lot, I'll give my my number and we can talk it out.

Later,
-Jason

[email protected]

surag · May 17, 2007

DUDE this is awesome. You're doing a great service by posting information, as long as its honest and based truly from your experiences...which I wholly believe

I dont see myself doing anything in medicine but neurosurgery!

So you can see why this is so important for me to discuss now...so here are a few more questions.

Alright, you say after residency its basically I do what I want?
Lets say I want a 9-5 job or w/e number of hours is considered average or 'easy on you' or 'not too stressful' and say work 4-5 days a week. How much salary can I expect starting off?

Can I start off as a neurosurgeon after residency? Do i do an internship or something like that, post doc or something, i cant think of the word. Also do i need board certification, or can i get good salary and get board cert. while I'm making good money?

Also, how about lawsuits? Is it a big deal, I mean do most NS get sued, do the settle mostly, how bad does it reflect, costwise how does it affect.

Do i have to pay for malpractice out of my pocket? In which cases do i have to do so, how much does it affect me?

I am now 23 and heading into medical school, year after most students enter med school(or is it most, perhaps I'm part of the majority?) anyway, is it worth the sacrifice in say this one year, or another year b4 i go into medical school? IT seems like I'll be nearly 35 before I even make a decent salary with decent hours.

Honestly, if you're a girl and you're really determined to be a NS thats pretty amazing, especially if u want kids, congrats.

I know I'm asking now, but as I already said, I don't think i'd enjoy any career but neurosurgery in medicine, not neurology, not cardiovascular surgery not anything else, so finding out now is very important for me.

BTW, how 'brilliant' are NS? I mean, i've done really well in my MCATs, 37 but terrible GPA, 3.11....thats y worked for one year doing research. I got a whole basket of C's and one D+. Most professors prior to my senior year(when i got my act together) would say I'm unfocused, immature, and lazy....I think i've certainly improved since then, but I'm hoping my late blooming maturity won't hinder my chances for success as a surgeon

I'm really interested in the 5 year programs...to make up for lost time.

-Goose- · May 17, 2007

surag said:
I'm really interested in the 5 year programs...to make up for lost time.

First, you're going to have a tough time finding 5 year programs... They are pretty much all moving towards a 7 year format (including internship). I say this b/c my home program is currently a 6 year program that will be switching in the very near future...

Secondly, 23 is not 'old' to be starting medical school. Sure, alot of kids went straight into school, but plenty took AT LEAST a year off. Enjoy the road, don't look at it as something to be endured.

Jackofknives · May 17, 2007

Exactly, dont rush it, the road to NS is a maraton not a race, its very important that you enjoy your journey to becoming NS otherwise its not well worth it.

Noeljan · May 17, 2007

greymew said:
Hi Noeljan,

Everything I'm going to tell you is from my experience and in my opinion...

About kids and family... after residency you basically make your own hours, so it shouldn't be a problem. When it comes to applying and interviewing, sometimes there is some bias against people getting pregnant. So just don't address it - it's illegal for them to ask you about that. Still, they might, then it's up to you. Personally, I'd tell them what they want to hear, then do what you want when you're in the program.

Grades in medical school... mine were not super (some a little above average and some a little below) and I got a position. However, I had to get to know everyone and work my butt off on (neurosurgery) rotations. I'm talking first one there and last to leave, plus every weekend. Bottom line... to even get an interview you have to have great academics or have rotated there (and did a great job).

Focusing on a specialty... I did. But I was 100% for neurosurgery. I attended the national conferences and stuff every year. That really helped with networking. On the other hand, lots of people changed their minds over and over. So go with what works for you, there's really no right answer for this one.

Publications... anything helps, but they don't matter too much either way. I would suggest writing a paper for a resident or attending in the program you want. That's what I did. I'm not into research, so it was like selling my soul for a year, but it worked out. And about type of publication, neurosurgery > neuroscience > other science > fashion magazines .

Intimidation... I know. You feel like who are you to speak with so-and-so. Some people will blow you off, but screw them. The ones worth getting to know will treat you well. It can't hurt to approach someone, go to their clinic, call, etc. My best advice though is to talk with residents (like this). They have the best and most current information. The attendings are often too far removed from what it was like to be a student trying to get a residency spot.

Anyway, I hope this helps. Please email with additional questions. If yo have a lot, I'll give my my number and we can talk it out.

Later,
-Jason

[email protected]

Thank you sooo much for taking the time to answer questions. I really appreciate it. I will let you know if I have more questions (which I'm sure I will

greymew · May 17, 2007

surag said:
DUDE this is awesome. You're doing a great service by posting information, as long as its honest and based truly from your experiences...which I wholly believe

I dont see myself doing anything in medicine but neurosurgery!

So you can see why this is so important for me to discuss now...so here are a few more questions.

Alright, you say after residency its basically I do what I want?
Lets say I want a 9-5 job or w/e number of hours is considered average or 'easy on you' or 'not too stressful' and say work 4-5 days a week. How much salary can I expect starting off?

Can I start off as a neurosurgeon after residency? Do i do an internship or something like that, post doc or something, i cant think of the word. Also do i need board certification, or can i get good salary and get board cert. while I'm making good money?

Also, how about lawsuits? Is it a big deal, I mean do most NS get sued, do the settle mostly, how bad does it reflect, costwise how does it affect.

Do i have to pay for malpractice out of my pocket? In which cases do i have to do so, how much does it affect me?

I am now 23 and heading into medical school, year after most students enter med school(or is it most, perhaps I'm part of the majority?) anyway, is it worth the sacrifice in say this one year, or another year b4 i go into medical school? IT seems like I'll be nearly 35 before I even make a decent salary with decent hours.

Honestly, if you're a girl and you're really determined to be a NS thats pretty amazing, especially if u want kids, congrats.

I know I'm asking now, but as I already said, I don't think i'd enjoy any career but neurosurgery in medicine, not neurology, not cardiovascular surgery not anything else, so finding out now is very important for me.

BTW, how 'brilliant' are NS? I mean, i've done really well in my MCATs, 37 but terrible GPA, 3.11....thats y worked for one year doing research. I got a whole basket of C's and one D+. Most professors prior to my senior year(when i got my act together) would say I'm unfocused, immature, and lazy....I think i've certainly improved since then, but I'm hoping my late blooming maturity won't hinder my chances for success as a surgeon

I'm really interested in the 5 year programs...to make up for lost time.

Hi surag,

Salary... I know we talked about the money privately, but for the others here, the attendings I've worked with make between $500K/year (starting out) to $2 million / year or more. It all depends on how motivated and efficient you are. More surgery = more money. So you can work 9-5, 3-4 days a week, but you'll be on the low end of the spectrum.

After residency... you will be qualified to practice as a general neurosurgeon. There are fellowships (I think that's the word you were searching for), which is sub-specialty training, in endovascular, complex spine, neuro-oncology, functional/stereotactic surgery, and pediatrics available. They are an extra 1-2 years. Internship is your first year of residency. Programs are 6-8 years long depending on the amout of research. The longer programs may also include Ph.D degrees. Board certification is important becasue not being certified may limit what hospitals allow you to work (privliges). Being board certified is also necessary for some professional organizations. And it covers you somewhat in lawsuits.

Lawsuits... they happen. It's an ugly side of the job that people just deal with. Neurosurgeons pay a lot in malpractice insurance (I've seen from $75K/year to $200K/year). It's a big deal in the sense that it wastes time (earning potential), energy, and stress. Many cases do settle, but it still may negatively affect how much you pay in malpractice. The insurance companies have their own motivations with lawsuits (pay as little as possible), so they do not care how it may affect your reputation, etc.

Like others said, 23 is not too old at all. There were people older than 40 in my class starting out. I was 25 myself. I will be done with residency when I'm 35. That gives me plenty of time. Plus, you can't just worry about the money. It's too long of a road for that to be your primary motivation.

How brilliant are neurosurgeons... ask the average one and they'd say pretty darn brilliant. But the truth is they are no smarter than anyone else. They're jsut especially focused. Grades in college and MCAT scores don't mean crap in the real world. They're just a means to get into medical school. So do what you have to do, then don't worry about them. It's the same with medical school grades, class ranks, and board scores... they're just a means to get into residency. After that they're meaningless. Really it's all about the kind of person you are and how well you can do your job to help the patients. That's it. The rest is just a means to an end.

Wow, sorry this got so long. Hope it helps though. I've been posting more because I see all these questions being asked without many answers. Feel free to email at any time and good luck.

-Jason

[email protected]

surag · May 17, 2007

I know i asked u a bunch of questions again, and I'm glad and want to thank you for your time!

Also, the longer it is the more awesome it is because there is so little information out there so don't apologize!

Thanks again.

I've just been on the down lately cuz my poor grades made me rethink if I'm truly ready to be a good doctor, but the way I see it, i think im smart and certainly dedicated to anything I'm interested in. I think i recently asked you how the path to neurosurgery is during residency as well as the negative sides of it. thanks for all the help man. ill ask u more questions as they come along.

naegleria brain · May 19, 2007

surag,

jason gave you a nice, somewhat happy overview of neurosurgery. i'm going to give you another viewpoint, don't take offsense to it, but in my opinion, jason's taking away the negative stresses and pressures and doing a little sugarcoating so as to motivate you. i'm not going to do that because everyone gets a bit cynical and de-motivated when you start jumping through the hoops.

one other thing, while jason is an actual resident, i'm only a med student working on getting in. i spend plenty of time with the residents and attendings here watching operations, research, etc. so this is a view from an outsider looking in.

1. time off between undergrad and grad. makes no difference, don't worry about it. they don't care about your undergrad application, they want to know what you did in medical school. med school and undergrad are two different worlds, the second you step here the undergrad world shrivels away and no one really cares except for reminicing at a bar.

2. kids and family. yes it's illegal for them to discriminate and ask about that, but they do. youre not in a position to tell them its wrong when they have the power, so, i agree with jason, tell them what they want to hear. it is difficult to keep a family in residency, and damn near impossible to have a kid (i've seen residents do 36 hr shifts; there is no way that's possible or healthy for a 7-month pregnant mother). forget family while in residency, and don't even tell them that youre thinking about one, it will reflect negatively. they want you to be focused on one thing while youre with them, and thats neurosurgery. that being said, many residents are married; but IMO, hold off on the kids till afte residency.

3. the important grades are your clinical years - years 3+4. these evals show how you work with other people. theyll be stuck with you for 7 years, so they better like you. really do well on these. years 1+2 is summarized in the step 1. so do well on step 1 and you won't have to worry too much about years 1+2 grades.

4. all research is good. but neurosurgical research allows you contact with neurosurgeons who can help you out in the future. this is a small field, use every connection you can.

5. neurosurgeons can be douchebags. but there are always a couple who are very friendly. ask the residents about which attending you should talk to. hell, talk to the residents too, they might have some projects theyd be happy to let you on boards. the point is, there's always someone to help, just find him and you can go from there.

6. 9-5 M-F as a neurosurgeon...if this is what you want in life, this is NOT the field for you, immediately forget it. look, dermatologists have the nicest lifestyles of any medical profession, and even THEY work 42 hours a week (which is a tiny bit more than 9-5, M-F). operations take long, you'll be operating for 4+ hrs on ONE case. in academics, don't even think about cush hours, and even PP theyd much rather hire people who want to work hard (everyone in this field is a workhorse, its not hard to find them). if you want 9-5 for the rest of your life, youre not going to fare well in a 120-hr residency (the 80hr limit is a myth in MANY neurosurgical residencies), and you certainly won't find an academic position, and even a private practice may be difficult. you can control hours, but not this low, that's a severe rarity, and don't expect to be one.

7. you can start out of residency with no fellowship if youve been trained well. some programs do not teach residents well enough, and they go for a 1yr fellowship to gain expertise. academic positions (esp peds, some vascular) require a fellowship to get a post. most pp don't require one.

8. board eligible and board-certified; academics they want you to be certified, pp eligible or certified. most residencies will push you to get your certification your final year, so dont think about it now.

9. malpractice. some of the guys i've worked with spend over 220k on malpractice. in pp, youre damn right it comes out of your own pocket. but even with that neurosurgeons bring home over 250k. this is the worst field for malpractice. you will get sued...a lot. its not a question of if or when, its a question of how much. and it gets annoying, but its something you learn to work with.

10. no 5-yr programs. neurosurgical training starts PGY2 (post grad year 2). your first year is a surgical internship. so when they say 5 year programs, they mean neurosurgery is 5 year, your internship is 1 yr, making it six. by the time you get here, all will be 7 years total. most already are 7 total, a few are 6, and they are rapidly switching to 7. basically, expect 7 years after medical school, not including a fellowship.

11. yes neurosurgeons are brilliant. but theyre known for their hard work. everyone i know is an absolute workhorse, rounding by 430-5am, in the or by 8, operating all day, clinic, research, etc. 4th year when you subintern with them, expect to put in over 120 hrs a week in the hospital. brilliant lazy people dont go into neurosurgery, its the intelligent ones with an incredible capacity for work that do.

hope that helped

danielmd06 · May 19, 2007

naegleria brain said:
2. kids and family. yes it's illegal for them to discriminate and ask about that, but they do. youre not in a position to tell them its wrong when they have the power, so, i agree with jason, tell them what they want to hear.

One small amendment to the above articulate post...

If you happen to be married when you are applying for residency...you can simply state that you and your wife have no plans to have children at that particular time. That brings the question to a polite and respectable close.

Pardon my candor, but if you are looking for a 9-5 job M-F, then you need to seriously reconsider why you are interested in Neurosurgery as a career.

Noeljan · May 19, 2007

danielmd06 said:
One small amendment to the above articulate post...

If you happen to be married when you are applying for residency...you can simply state that you and your wife have no plans to have children at that particular time. That brings the question to a polite and respectable close.

Pardon my candor, but if you are looking for a 9-5 job M-F, then you need to seriously reconsider why you are interested in Neurosurgery as a career.

Quick question...what if you have a child by then (like going into residency?)

surag · May 20, 2007

danielmd06 said:
One small amendment to the above articulate post...

If you happen to be married when you are applying for residency...you can simply state that you and your wife have no plans to have children at that particular time. That brings the question to a polite and respectable close.

Pardon my candor, but if you are looking for a 9-5 job M-F, then you need to seriously reconsider why you are interested in Neurosurgery as a career.

dude i super appreciate your candor.

For me, money is important but more imprtantly I want that life where I can spend enjoying it, time wise with a girlfriend, wife, family, myself, whomever.

I dont want my life revolving around work. But I also want to do a job that i would enjoy and surgery is definately that field. Can you tell me if could at least have a good lifestyle after residency? Or is it all seriously hardwork for a very long time?

And those guys who pay 220 in malpractice...is that the average for high paying salaried NS? or just the high end cost in areas like pennsylvania?

danielmd06 · May 20, 2007

Noeljan said:
Quick question...what if you have a child by then (like going into residency?)

I checked your previous posts and profile and note that you are beginning medical school. Congratulations! But let us put things in some semblance of order...

Neurosurgery is competitive. To be able to consider it as a residency option you need to have a competitive USMLE Step I score. Work hard these first two years of medical school to get as good of a generalized background as you can and be as prepared as you can for that test.

Neurosurgical research is something you could delve into right now that could help, but I strongly believe it should take a back seat to your grades in the first two years and the USMLE.

Now. With regards to BOTH garnering a residency position and the specific question you raised...

I think the best advice of all would be to express your interest to the Neurosurgical faculty at your medical school and ask for their thoughts on these matters. I personally don't think it would be wise to have a child prior to starting a Neurosurgical residency. The time constraints would be overwhelming. There is much demand on your time and life from this career path...and I honestly think you need to seriously research exactly what a Neurosurgery residency entails if you are female and are currently interested in starting a family. I am not trying to dissuade you, but I am trying to carefully express to you that there may be much more to this residency than you think. Good luck and enjoy your summer!

danielmd06 · May 20, 2007

surag said:
I dont want my life revolving around work. But I also want to do a job that i would enjoy and surgery is definately that field. Can you tell me if could at least have a good lifestyle after residency? Or is it all seriously hardwork for a very long time?

I am a PGY-1 about to start a Neurology residency who strongly considered Neurosurgery as a third and fourth year medical student. As such, I can give you my own findings on private practice Neurosurgery...but I want to be clear about who and what I am in the process of doing so. I would not presume to have extensive firsthand knowledge of every aspect of what you are asking about.

Neurosurgery is a full-time obligation. As a residency, it assumes the position of greatest significance in one's life for six years - longer if a fellowship is involved. My hours per week as a third year medical student involved q2 call and an average of 120 hours per week for two weeks. My experience with Neurosurgery as a fourth year medical student involved an average of 120 hours per week for one month (q2-q3 call), and 100 hours per week for a second month (q2-q4 call). This was accurately reflective of a PGY-2 and PGY-3 Neurosurgical resident's schedule at my home medical center.

I did not go to church. I did not see my brother, my mother, my friends, or have time for any of my hobbies. I only saw my then-girlfriend (now wife!) when she brought me a supper that she had cooked for me to the hospital while I was on call. I did not eat lunch or breakfast...but always managed to get a good dinner at home or at work. When I wasn't at the hospital, I was asleep.

I loved the subject of Neurosurgery. I read dozens of articles, read for cases, read about its history, and read about anatomy...and never got tired of it. But I realized that to become a Neurosurgeon was unavoidably going to change me into something I didn't personally want to be. That I would lose pieces of myself that were irreplaceable in the process.

The private practice world of Neurosurgery offers better hours than 120/week, but the averages that I personally found were always in excess of 55/week. It obviously will depend on the size of the group you are working with. The larger the group...the more ways your call schedule will get split up. It is possible that you could find what you seek (a work week that equals 40 hours or less), but that is beyond the scope of what I saw or heard about.

There are many "lifestyle-oriented" specialties in medicine, and many of them incorporate procedural skills that might interest you. Have you read much about Emergency Medicine?

In closing I would like to reiterate that I have the utmost respect for Neurosurgeons, and just because I didn't feel the residency was a good fit for myself doesn't mean that you guys (and others!) wouldn't love it or be fantastic at it.

Best wishes on your hunt!

Noeljan · May 20, 2007

danielmd06 said:
I checked your previous posts and profile and note that you are beginning medical school. Congratulations! But let us put things in some semblance of order...

Neurosurgery is competitive. To be able to consider it as a residency option you need to have a competitive USMLE Step I score. Work hard these first two years of medical school to get as good of a generalized background as you can and be as prepared as you can for that test.

Neurosurgical research is something you could delve into right now that could help, but I strongly believe it should take a back seat to your grades in the first two years and the USMLE.

Now. With regards to BOTH garnering a residency position and the specific question you raised...

I think the best advice of all would be to express your interest to the Neurosurgical faculty at your medical school and ask for their thoughts on these matters. I personally don't think it would be wise to have a child prior to starting a Neurosurgical residency. The time constraints would be overwhelming. There is much demand on your time and life from this career path...and I honestly think you need to seriously research exactly what a Neurosurgery residency entails if you are female and are currently interested in starting a family. I am not trying to dissuade you, but I am trying to carefully express to you that there may be much more to this residency than you think. Good luck and enjoy your summer!

Thanks
I am actually going to meet with a NS this summer, and hopefully ask him some of these questions.

danielmd06 · May 21, 2007

Noeljan said:
Thanks

Not a problem in the least. Good luck to you!

naegleria brain · May 21, 2007

surag - neurosurgery has been quoted to have >80% divorce rate. academic neurosurgeons are very busy. residency is extremely busy, and that's a minimum 7 year commitment. do not put all your eggs on working less than 60hrs a week, because then you're expecting to be a low-minority of neurosurgeons.

taking neurosurgery isn't a light commitment, until you become a neurosurgeon, neurosurgery is your entire life, moreso than sleeping.

the 220k malpractice is in pennsylvania, where its especially bad. neurosurgeons will pay the most malpractice pretty much anywhere tho; people say obgyns have it bad, not as bad as us. but that's offset by a higher salary, so the concern isn't as much the malpractice itself, but the meeting with lawyers, going to court, etc.

if you feel you still want to do this, start getting in contact with your neurosurgical department, and theyll help you out. if youre not sure, explore other career options. i think you might like orthopedic surgery, or plastics. both are very hands on, procedure oriented, and certainly more controllable than neurosurgery. it may not have the same gravitas and excitement, but certainly fills in the rest of your lifestyle expectations, which in the long run you may come to appreciate more

surag · May 21, 2007

Its so nearly hard for me to do another area of medicine. Even without starting medical school, I've been enamored by the brain for a very long time. My major is Neuroscience! I've been devouring information the brain for a long time and the fact that its such a mystery is a big draw for me. At the same time I love hands on work and surgery seems to be the way for me

BTW, what do neurologists do? Specifically, I mean when you say diagnose what does that mean? What would you do in a typical month or so?

Thus, as a neurophile, I dont see myself doing orthopedics and especially not plastics(I have a moral stance against it and while I could do re constructive surgery they pay is a lot less)

Thanks for the heads up for how difficult it is.

BTW, how is your family life? Do you ever have regrets you dont spend enough time with family?

-Goose- · May 21, 2007

naegleria brain · May 23, 2007

i'm young and unmarried. i'm also a guy. i don't plan on getting married till after residency - i hope to find a girlfriend, etc. in the relatively light research year. its not at all my priority though, and if it doesnt happen, i'm personally okay with it. so in that sense, i can't comment on not spending time with family.

i can't really tell you what neurologists do either; i dont spend much time with them. neurosurgeons joke all the time about how useless they are, but remember before a guy sees a neurosurgeon, he usually sees a neurologist first. i know of a couple neurologists who read EEGs and map the brain, and pretty much direct the neurosurgeon where to cut in the OR when taking out lobes in epilepsy surgery.

look into interventional neuroradiology. that is very procedure oriented, and also involves the brain. there are paths through radiology, and also, i believe, through neurology, in case you find a pediatrics fellowship more interesting than an interventional one.

neurosurgery is VERY anatomical, that molecular neuroscience stuff you did doesnt mean a whole lot, except, of course, in basic science research. if you like biochemical abnormalities and such, better go for neurology; and get a phd too so you can research the stuff that interests you. of course, there are a lot of neurosurgeons with phds who also do basic science research, but that's a whole other topic.

if you like the anatomy of the head a lot, look at ENT too. I personally am very interested in craniofacial-fellowship ENT surgeons, they often work with neurosurgeons in accessing skull-base tumors in removal. plusses include more lifestyle friendly and excellent salary as well. also very competitive.

my advice - take weekend call. you have time to decide, spend one weekend on call wtih a neurosurgeon, interventional neuroradiologist, neurologist, ENT, etc. its the only way you'll know what you like and don't like.

ilovehedgehogs · May 23, 2007

surag said:
Its so nearly hard for me to do another area of medicine. Even without starting medical school, I've been enamored by the brain for a very long time. My major is Neuroscience! I've been devouring information the brain for a long time and the fact that its such a mystery is a big draw for me. At the same time I love hands on work and surgery seems to be the way for me

BTW, what do neurologists do? Specifically, I mean when you say diagnose what does that mean? What would you do in a typical month or so?

Thus, as a neurophile, I dont see myself doing orthopedics and especially not plastics(I have a moral stance against it and while I could do re constructive surgery they pay is a lot less)

Thanks for the heads up for how difficult it is.

My problem with neurology, which I realized after doing clinical research in a pediatric neurology department, is that your mode of intervention is pharmaceutical. In neurology, there is a lot of adjusting and tapering of medications, especially in pediatric epilepsy cases. The field tends to be pretty cerebral and "thinking" oriented, and it is often a criticism that there is a lack of actual "doing." Neurologists tend to spend inordinate amounts of time thinking about what to do, and a good neurologist is one who enjoys this and finds it exciting. I came to the realization that I need something much more fast paced and something that involves working with the hands-being physically involved in the intervention, but still neuro related, thus my interest in neurosurgery.

So I think you just have to be honest with yourself about your own personality and what you want out of a career. And as Naegleria said, you should take call with members of both the neurology and NS fields. You will see the difference in pace, personalities, and the types of cases dealt with by each.

Noeljan · May 26, 2007

Hey guys
just wanted to update, I met with a neurosurgeon on friday. We talked for an hour and a half, and he was soooo nice and helpful. He gave me a lot of good advice and ideas about what you need to do to get into NS. I think it's a good idea to do this if you are considering it. He also said he thinks it is a good thing that I am so focused early on. About the women in NS thing, he said it's dependent on the program. He said there are definately more liberal/female friendly ones, and more old boy ones. He gave me a lot of hope.
thanks again for the advice guys

naegleria brain · May 27, 2007

great to see your still in it! however, you should remember that getting in isn't easy. the ones that are family-filled tend to be easier, nicer, and thus MORE SOUGHT AFTER, making them generally very competitive!

off the top of my head, Johns Hopkins and Mayo are rumored to be kinder, but extremely competitive. and its very rare (and a bit arrogant) to say you'll get in there for sure.

if you really are serious, i recommend this summer when you get free time, or whenever, look into programs and figure out which ones are kinder and which ones you might want to try to steer clear from. this lets you set your sights, know exactly where you want to sub-I at, and, if close enough, even get involved with research there so youre a familiar face.

also be prepared that if you really want to do this, you may have to end up ranking more "malignant" programs and chance being stuck there for seven years. its not a good idea to assume you'll get into a kind program for sure. research this early, and know what your med school plan will be. people will say its too early, but the truth is, it never is!

if you visit nsmatch.com, there are two links, one redirecting you to uncleharvey, and one linking you to nsmatch, the old version. the old version has tons of very...crude...discussions about programs. be careful, some are just rumors and wrong info, but you can see recurring themes as to which programs tend to push their residents to the edge whereas which ones tend to allow their residents to tend to their families now and then. if nothing else, it's a fun read. armed with this, you can ask members of your own dept about which programs they know of might be a good match for you. between the two, you should be able to get a good list of prospective targets, and figure out where you want to rotate at 4th year to increase your chances of matching there

good luck

doc-oc! · Sep 7, 2015

greymew said:
Hi surag,

Salary... I know we talked about the money privately, but for the others here, the attendings I've worked with make between $500K/year (starting out) to $2 million / year or more. It all depends on how motivated and efficient you are. More surgery = more money. So you can work 9-5, 3-4 days a week, but you'll be on the low end of the spectrum.

[email protected]

What distinguishes the surgeons making 500k/year vs 2 million/year?

Winged Scapula · Sep 7, 2015

doc-oc! said:
What distinguishes the surgeons making 500k/year vs 2 million/year?

Closing as this has been cross posted multiple times.

path to neurosurgery

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