samsoccer7,
Neurosurgery is not an easy life. Let's look at academic neurosurgery. Who do you think the resident calls at 2am for an emergency crani? Who will have to staff the OR at 7am, regardless of what you were doing at 3am? Who has to round on patients on the floor or the unit EVERYDAY when they are on service? Yep, the attending, board certified or otherwise. Weekends and holidays, the hospital must be staffed by an attending, period. That means somebody who is already out of residency and "living their life" is tied to that pager and must be ready to come into the hospital if the need arises. Toss in the research requirements of an academic neurosurgeon, and you've got a serious 100 hour week until you retire.
Now let's look at private neurosurgeons. They don't have residents working under them, but they don't have staff call at major academic centers either, so it must be cush, right? You still have patients who need surgery, usually spinal surgery. They'll still line up to see you in clinics and still line up to the OR for their disc or pinched nerve. You'll still have to operate on them first thing in the morning because you'll have other cases backed up well into the afternoon, afterall, that's how you make a living...gotta make money in the OR, so stack them up on the OR schedule. And then, you must see the patients postoperatively. You must see them on post-op days, you must discharge them...etc etc, all the while, you're still stacking up patients in the OR and doing pre-ops or assessments in the clinics. It's just like primary care, except with several hours of OR time a day squeezed into it. With weekends and call, the private neurosurgeon probably push 80 hours a week easily.
I've had the privilege of working with both private and academic neurosurgeons. The hours of the academics are horrible. They show up between 5-6am for some attendings and for the "more relaxed" attendings, 630am was the latest they've ever rounded. Naturally, they leave at night, around 7pm at the absolute earliest I've seen them take off, and usually 8-9pm with 11pm being a late time to leave on a regular basis. A 5am to 11pm day is not a rare event, although it's usually more like 6am to 8pm on a regular basis. This is for the attendings, NOT the residents (The residents must have ALL of the patients seen and notes written by 6am, so you can guess what time they must wake up!). On average, I would say an academic attending will be called to physically staff a case in the OR in the middle of the night, dragged out of bed...about 3 times a week at a medium department that sees about 2000 cases a year. On weekends, my experience with attendings is that they are called in about 1/2 of the time, which means, if you are the attending for the weekend, then you will probably get called to come in at least once either Sat or Sun during the day or night. This does not include the Sat and Sun morning rounds that you will make, because an attending must staff the patients everyday, period.
My experience with privates is that it's pretty much the same, except there's more spine cases, so the patients are less critical, there are no residents, so things are done faster (!), but everything is done by the attending. That means the attending is the intern, resident and attending when caring for his private patients. The private works directly with the nursing staff. Now, keep in mind that private hospitals may see trauma patients and stroke patients too. And those patients will come in at 3am. Of course, private hospitals get a lot less of those patients, so the private docs may have long hours, but their free time is less frequently interupted.
These guys are right. Samsoccer7, while I encourage all medical students to take a look at this great field of neurosurgery, I also think you should think seriously about pursuing another specialty if you do not love neurosurgery enough to make certain sacrifices. As you can tell, I'm deeply passionate about neurosurgery and so are the people I work with. My collegues and I make sacrifices in our lives all the time because we love what we do. We can not have everything we want in life, you need to ask yourself what is the most important thing for you when you are in your 30s, or your 40s. Neurosurgery and family life is not incompatible, but you have to define the extent of familial involvement in your life. There's no way you can be like everybody else if you pursue neurosurgery because not too many people will work the hours you must work. If you have a loving wife, then maybe you can make it work. Will you miss out on your kids? Maybe. Maybe not. The neurosurgeons I worked with see me more than they see their family. They can accept that. The time they share together is quality. That's fine. If you can't accept that, then there are certainly many specialties in medicine that are extremely rewarding, interesting, fun as heck but does not have the same level of time demands as neurosurgery. You chose one of the worst specialties to consider if family life is that important to you. You chose one of the worst specialties if lifestyle is a consideration. The divorce rate among neurosurgeons must be very high, because out here in California, about 50% of the residents and attendings I know are single/divorced. Other poor choices would be vascular surgery, trauma surgery, transplant surgery, thoracic surgery and obstetrics. Too many variables and lots of things happen at night with these specialties. Good choices for a "better" life include optho, ortho, ent, plastics, uro, pediatric surgery and surgical oncology. Many people who will make excellent neurosurgeons, but have desires of a better life end up in ent or ortho because their fields are very similar to neurosurgery in scope of practice and challenges. So similar, in fact, that many cases overlap....acoustic neuromas can be ent or neurosurgery, herniated discs can be either ortho or neurosurg...but the lifestyles are dramatically better in both ent and ortho. Think seriously about the last few sentences I just wrote.
By the way, $800,000 is waaaaay high for a neurosurgeon's salary. Academics in California start with Assistant professor at $160-170K, Associate Prof at $200-250K, Full professor gets $250-300K and the chair of my department (who's nationally recognized, on the board of AANS, CNS, ABNS, Journal of Neurosurgery and Neurosurgery) makes about $400,000. Private neurosurgeons that I've worked with, told me that they clear about $300,000 on average, but that's before their overhead, which includes staff salaries and insurance (His insurance was close to $100,000/yr, and that was in 1999, before things got really bad!!!).
So I hope this answers some of your questions and gets you thinking realistically about your future. If you were my classmate, and came to me with this same question, I'd discourage you from applying to neurosurgery. It sounds like that's the answer you wanted from the start. We lost 2 residents in our program who decided that the lifestyle compromise was too much. One became an anesthesiologist and the other one went into real estate. They took two spots that could have been filled by someone who was more dedicated to neurosurgery and now, the remaining residents have to take up the extra work of two missing residents. If you even have a little bit of doubt, then the best thing is to not pursue neurosurgery. You can be challenged, intellectually and physically in other fields without the time commitment. Try ENT or Ortho. Your USMLE I score is more than enough to get some attention from PDs in those fields. Good luck! And if you have more questions, don't hesitate to ask, that's why this board is here!
This is all from the heart though...
, i'm just one of those guys who likes data. 
