You are using an out of date browser. It may not display this or other websites correctly. You should upgrade or use an alternative browser. Discussion in ' Neurosurgery ' started by samsoccer7 , Sep 27, We are a non-profit academic community founded in Join thousands of fellow college students, health professional students and practicing doctors from across the United States and Canada.

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Learn about SDN's nonprofit mission. Previous Thread Next Thread. What is the lifestyle like of an academic and a private practice neurosurgeon? I know what residency lifestyle is like, but I can't find anything on private practice especially.

I have no idea what to believe and what to expect. Neurosurgery is my love, but if it means missing out on my future family's life, I'm going to do something else. SDN Members don't see this ad. Originally posted by samsoccer7 Neurosurgery is my love, but if it means missing out on my future family's life, I'm going to do something else. GaStu and pencilcase like this. I understand any surgical specialty has a crazy residency. But that wasn't my question no offense. I'm more concerned about AFTER residency.

Chances are you will change your mind along the way. If you feel like family and lifestyle are important then dont even think about neurosurgery. The residency is one of the worst and the lifestyle after residency can be quite bad in most cases. Every neurosurgeon I've ever known was exhausted, bitter and overworked - both private and academic.

The residency is seven long years, and is one of the most inhumane in it's treatment of it's learners. It's really hard to not see your family or friends for seven years, even if you do know that things might be better when you finish. Not many marriages survive, and your children will be raised by someone other than yourself. Well, that's my happy take on the subject.

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 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 And then, you must see the patients postoperatively.

You must see them on post-op days, you must discharge them 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 am for some attendings and for the "more relaxed" attendings, am 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 pm 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 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! 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? The neurosurgeons I worked with see me more than they see their family.

They can accept that. The time they share together is quality. 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. 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 Think seriously about the last few sentences I just wrote.

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.

How Much Money Do Neurosurgeons Earn?

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.

And if you have more questions, don't hesitate to ask, that's why this board is here! Minimalist M , Sep 27, Life AFTER redsidency means you are no longer subjected to some 80 hr work week rule if you are a in a small NS group, you might be working a Hell of a lot more than HiFi , Sep 27, I appreciate your honesty.

I love neuroscience, but at the same time, my parents worked enough when I was growing up, but they were always home by 5: I loved the fact they could come to my soccer or basketball games and not have to worry about anything else.

Obviously they weren't physicians, but still, it made a huge impact on my life. I appreciate your honesty, and even though I think I could make a great NS, I don't want to regret anything later on. What made you choose NS, even with the lifestyle? Can you convince me either way? You did a pretty good job already, but ENT sounds boring, and plastics I'm not sure I could really get at this point, besides doing the 5yr general which must blow so hard and a 2yr plastics fellowship.

What do you think??? Thanks again, your post really makes a difference in my life Did I mention I'm drunk?? This is all from the heart though Minimalist M , Sep 28, GaStu and Gpanda like this. Do these guys have outside money from investments and stuff?

But I really appreciate your input, you're the first person to give me a real glimpse, and I think I'm slowly changing my mind. That being said, will the research I do in NS help me for ENT if that's what I decide to do?

Or should I jump ship I'm working on an NS paper right now and do some ENT stuff? I'm not at Davis I'm further south , but Paul Muizelaar had a Mondial convertible, before his wife took it in his divorce settlement.

Mondials aren't terribly expensive, about the price of a BMW 5 series. I heard he took some of the applicants out in his Maserati Quattroporte for dinner. Very eccentric, to be sure! ENT PDs don't care too much about research. Of course, it won't hurt to have research, but it should be somewhat related to ENT and not all neurosurgery slanted eg.

Avoid brain tumors and spine topics in research, but do consider peripheral neuropathies and things of that nature. Cranial nerve topics like trigeminal neuralgia are great overlapping subjects. If you do a research project that is too related to one field, it may raise eyebrows in another field. Since you've done research in neurosurgery and worked at Northwestern with neurosurgeons?

If you are currently working on a neurosurgery project, that may only reinforce the neurosurgical theme some more. I wouldn't encourage you to "quit" your project, but give it an ent or plastics spin, just to give yourself some options later on. But don't get hung up on research, because ent isn't neurosurgery, research in ent is very low on their list of priorities.

Just get a good sub-internship experience at your desired ENT program and secure some letters. Do it fast, because ENT is an early match too. Be sure to get some face time with the ENTs at your own school. You'll want a letter from the chairman of your ENT department. With ENT, it's all about letters and boards, never research.

Get your Step 2 early ie. That's what you should be concentrating on rather than research. There's spots in ENT and about in neurosurgery, so the numbers are in your favor if you decide to enter that field. Don't let the anonymous postings of a stranger determine your decision on your own future. Spend some time with ent and neurosurgery to make sure that you'll be happy in either field.

Be critical of yourself and figure out what you really want in life. Talk to residents who are in these fields and talk to attendings about their family life and their practice parameters. If you're married, talk to your wife actually, you should probably consult her first! Rounding at 6AM is a rarity in all the programs I've been to, usually closer to 7AM. That means work rounds start at 5: Operations are scheduled to start at 7: NS attendings leave later than other attendings, but by no means is leaving at 7PM considered an early day Most of the time they're just sitting and reading in their office doing nothing important when they're staying in late anyway.

The salary ranges you spoke of seem extremely low, at all the institutions I've been to and got a good feel for the slaries the average income is closer to high 6 figures for all attendings. A full professor making less than K is doing something wrong.

The chief of the department at my institution makes so much that he does not even charge any patients for surgery, he only takes his regular salary home and he is extremely well off.

The private prac NS usually is close to 7 figures as well.

Those in private prac work a lot less than you portray, most of them have PA's or nurse prac's who do the scut work in the hospital. It is not a common event for them to have to go into the hospital at 3AM to do an LP or something.

They have a decent lifestyle. This is the typical hype that surrounds NS and perpetuates the self selectivity of the field. My advice to anyone considering the field is to get a feel for it for themselves.

I wouldnt dare discourage someone from entering the field just after reading a post of theirs on some internet forum. After I spent alot of time in the field, doing research, and rotating at multiple institutions, my observations were that it was much more laid back and promising than what others originally led me to believe.

Basicaly I'm saying that, after reading your post and comparing it with my experiences, I think you make it seem a lot worse than it really is. It is a difficult lifestyle and you have to love what you do, but not to the extent that you wrote of.

Spectre of Ockham and GaStu like this. I think you make it seem a lot worse than it really is. Thanks for all the input. That being said, I know ENT's can do neurotology and some of their surgeries are borderline NS. As for income, I thought minimalist's numbers were, well, minimalistic I figured it'd be upper 6 figs, maybe or g's.

Where would you put ENT, after a neurotology or plastics fellowship? If it's a decent amount, then I think I could be really happy with it. If not, then I might have to learn to like mouths a lot more. I figured it'd be upper 6 figs, maybe or g's. But by not doing NS, aren't I missing out on working with the attending here only 2 attendings, 1 is new, no residency program and thus losing a great rec letter?

That might be a rhetorical question, but I'm just sayin' Is this your day off Minimalist? Lots of quick replies, I like it.

No, I'm in the resident offices and on-call. There's a bit of downtime today. Hopefully it will stay quiet so that I can get some reading done. If you want a neurosurgery rec letter, then yeah, you're going to have a dilemma if you don't rotate with your attending.

But if you're contemplating ENT or another field, then you will be better off exploring that option, just in case it's something that will make you as happy as neurosurgery. You should make an appointment with your residency advisor and see what he recommends regarding exploring ENT vs pursuing neurosurgery and the timing of either plan of attack, remember, both are early matches. Either case, the most important thing for right now is to decide if you're commited to neurosurgery in which case, do the neurosurgery rotation or if you want to pursue another field.

Once you've made that decision ie. If the other specialty is what you want, then you don't have to worry about a neuro letter. If it's not what you want, then you can still take a neurosurgery Sub-I at your home school and one at an away location. But if you're already thinking that neurosurgery isn't the field for you, then you owe it to yourself to explore something else before you invest several years of residency in this field.

The logistics of getting letters and doing sub-Is are small matter when you look at the big picture of whether you will be happy for the rest of your life with the decision you're making right now.

Minimalist sounds like he's speaking from experience. I can definitely vouch for his observations. Mininalist's stated salaries are about right for academics. I never heard of any neurosurgeon making 7 figures!

It does seem like samsoccer is looking for an excuse to not go to neurosurgery. Well you got it buddy. If you don't love it, forget it. It's not worth it. Carbon Klein , Sep 28, Originally posted by samsoccer7 Thanks for all the input.

I love the field, I've said that before, but I have other interests and I really want to be a family man not saying that you don't.

But I need to check all angles, god forbid I realize during residency I'm never gonna have a life afterwards. The input from everyone is awesome and even though you guys haven't changed my mind, you've helped me realize something I think I've been suppressing or repressing in my mind for a while.

I always told myself that, as a neurosurgeon, I will be able to control my practice and work as few hours as I want. It's starting to sound like that's only somewhat true, and that there are WAY too many variables, meaning the hours escalate, and next thing you know, you forgot what your wife and kids look like, and you start calling your residents "hunny" That being said, it seems like my ENT dept at my school might suck, and they've all but told friends of mine who've rotated through there not to go into ENT.

Do you think they're just bored, not respected, or do they really mean "don't go into ENT? Lastly, if I don't get a chance to rotate ENT at my own school, does that screw me over bigtime?

I would then have to do back to back sub-I's july and august next yr, and one would have to be here, and another at my school of choice. Ok, NOW lastly, where can I find info on good ENT residencies?

I'm a midwest guy and would love to go to Chicago or back up to U of Michigan my undergrad. Dude, the fact that you are looking for a reason not to enter neurosurg is reason enuf! You have second thoughts for a reason.

You have been given a lot of advice, which you asked for. Now take that advice and don't look back. Leave neurosurgery for the fanatics like Minimal and me! You'll sleep better at nights, bro. I have to say my mind has been changed.

I'd always had an interest in neurosurgery, but after reading this, I'm extremely doubtful. After all, what good is all that money anyways, if you never have time to enjoy it? I do want to be in a field that I love, but I think the price for me anyways is too high.

While it may be acceptable while I'm still young, I think if I'm working hours in 20 years I'd burn out.

ZanMD , Sep 28, You know, most people do neurosurgery because they enjoy the field. The money is nothing compared to what we could earn with our work ethics in other fields like business. The money is not an issue. If you don't understand what I'm talking about, then you've got your answer, neurosurgery isn't for you, because nothing could scare me away from pursuing my dream of being a neurosurgeon.

Neurosurgeon Salary - How Much Do Neurosurgeons Make?

I probably sound harsh right now, but that's probably what you need to hear. Better now than 8 years from now when you're completely miserable! Since you asked about Michigan As far as neurosurgery residencies go, UMich is probably one of the cushiest if ANY neurosurg residency could be called cushy , as well as one of the best. I'm a general surgery resident there, but had to do a month of Neurosurg as an intern. Yeah, everyone still works like crazy and staff has to come in in the middle of the night for the blown aneurysm or whatever, but there's no pre-rounding, rounds are at 6: The attendings are WONDERFUL.

They're all just bloody brilliant, love to teach even we gut surgeons learned a few things and are some of the best in their field, as well as just plain nice, normal guys with wives and kids, BTW. You couldn't pay me enough to do their job, but compared to the neurosurgeons where I went to med school known as an evil NSurg program , they've got a good thing going on. At least from an outsider's perspective, if one were to decide to go into neurosurg, UMich would definitely be a place to seriously consider.

ENT at Michigan is nothing to sneer at either I almost typed sneeze and then realized the horrible unintentional pun that would make. You really couldn't go wrong here with either specialty, but both are very competitive, top tier programs. LaCirujana , Sep 29, It's nice to hear so many informed replies. I have met a few people who chose ENT as a kind of "back door" to neurosurgery.

But it's worth pointing out that not every ENT program does a ton of acoustics and the like, and the level of involvement that ENTs have in these cases varies by institution. Also, a fellowship is pretty much manditory of you want to do a lot of skull base stuff in practice. You will get lots of exposure to head and neck oncology and facial trauma at most ENT programs, as this is bread and butter for ENT referral centers.

However, most ENTs don't do a lot of head and neck oncology or facial trauma in private practice, because the lifestyle is brutal and the pay is poor. A fellowship in facial plastic surgery is a very appealing option, however this is a competative fellowship in specialty full of people with incredible CVs. If you are considering midwest programs, most would agree that U of Michigan is a stronger program than any of those in the Chigago area. However, you will get very good training at almost all of the or so ENT programs.

And because ENT is so competative, it is a rare applicant that is able to choose where he or she wants to go. DuneHog , Sep 29, BusterDO , Oct 14, BusterDO , Oct 15, I have had a different experience.

I've got a little background, as I was a scrub tech for many years and did a lot of neuro, when I was in PA school I did an elective rotation in a very large academic neurosurgery service and now that I've graduated I work for a private practice neurosurgeon. As far as pay goes, he pays me very, very well and we had a semi-retired neurosurgeon that would occasionaly scrub in surgery and see the new patients a week, all in the mornings.

He was salaried at , a year. Logic would assume that the primary neurosurgeon made a lot more than that. As far as work hours, we are in a smaller city with only 2 neurosurgeons and we take call every other week for a week at a time and get trauma from 's of miles around. We have clinic on Monday and Friday and operate the other three days of the week. We trade weekend rounds. Clinic days usually start at 8 am with rounds in the hospital and clinic starts at 9: We cover two hospitals one is in a sister city 15 miles away and we, about half the time, have to make rounds over there and we usually tag team it so that one of us is not stuck going all the time.

Op days start at 7: Call is, well call. You never really know when its going to be quiet or when you're going to get trauma and consults out the wazoo. On average I would say we work hours a week and we have our occasional 30 and 80 hour weeks. My doc has a wife and three kids and one of the real advantages of him having a PA is getting to spend more time with his family. The other neurosurgeon in town has basically the same set-up.

Just my experience, yours may differ. BTW, I'm not trying to sell you on PA's, but in my experience they do change the equation. Chronic Student , Oct 16, Call for me means that I assist at operation, see consults and yes I evaluate patients in the ER. Typically what happens is that we will get a call from the ED about a patient and my doc will review the images online and talk with the ER doc and decide if the patient requires his immediate attention or if it can wait.

If it requires immediate attention we typically both see the patient and I'll basically scribe while he gets the history and physical. I'll then do the H and P and get the consent ready while he calls the OR and puts in orders. If it is semi-emergent he will typically send me to see the patient in the ER and I will do the H and P and then call him with my findings.

At that point I'll get consent if needed and will write orders and do whatever needs to get done to get the ball rolling. We have never really told the nurses or docs whether to call me or my doc. The other neurosurgeon in town routes all of his calls through his PA except for emergency calls.

As for the calls I get, they tend to be the ones the nurses don't want to disturb the doc for. There are also quite a few calls that require some moderate level of decision making and if I can't answer them or don't feel comfortable I'll call my doc or have them call him.

In emergency situations I will give orders that I feel comfortable with. For instance, my boss has told me that its never wrong to get a CT and I hold him to it. As an example, a few weeks ago I got a call about a patient we were covering for the other neurosurgeon as he was out of town. Guy had an abscess drained days ago and they call me to say that he is bleeding from his wound and that it is copius. I figure that its probably a scalp bleeder, but he didn't hire me not to be cautious, so I also ordered a stat CT and went to the hospital a few minutes later to check on him.

He's already in the CT scanner when I get there and they start the scan and holy crap he has a huge epidural and like 15 mm of midline shift. I called my boss immediately and told him I was going to call the OR to open a room. I guess he trusts me because he said he was on his way and I divert this guy to the ICU which is next to the scanner and have them get IV's, foley and I got phone consent from the wife. This guy starts bradying down and his BP shoots through the roof and he is getting difficult to arouse.

Doc is there in 15 minutes and by the time we get him to the OR he is non-responsive.

Luckily we got to it pretty quickly and he did fine. I did not save the guys life as the same things would have happened with or without me. However, I did get the ball rolling about as quickly as possible and maybe I saved him from permanent neurologic damage. I will also start mannitol, load someone with dilantin or ativan if they are seizing of order BP meds for hypertensive emergencies, etc and then contact my doc.

As far as EMTALA goes, I do see people in the ER. I do not claim to be an expert on those laws but I thought they were entitled to an evaluation.

I did not think that the level of provider was specified. Even if it does the ER doc has evaluated them and I'm the second eval. National Averages shows that at absolute low they make K now there may be a couple exceptions but the average is about K another: DONT WORRY ABOUT ME and worry about yourself o. If you looked, salary. Again, you are posed with the problems i mentioned before. The blogs seem a little more legit, but still, anyone can post a blog and claim whatever they want.

Most likely that data came from some other surveys which broke it down by region. If you notice, some of those numbers were in the K region, i don't know about you, but going from K to high 's is still more than a K drop; if that's not a lot of money to you, call me up in the future and hook me up! The job listing just don't look legit at all. Can you honestly think that a residency trained NS will be looking to that type of website for a job; looked shady to me.

They work a ton of hours, a lot of cool procedures and are compensated. Malpractice is high too. Again, i want to emphasize that if money is the motivation for medicine, you are in for a world of hurt. BusterDO , Oct 17, Oh, yea; clearly in highschool. I'm thinking maybe even middle-school. Last year, just before he decided to do neurosurgery, he was probably set on professional baseball player.

Factors motivating career choice: Saw since "Saw" is what being a neurosurgeon is all about. Easily making over k. Family guy, he's crazy about you. Don't be surprised if you receive some anonymous love notes during recess tomorrow. Sorry to drop in, but I think you guys are underestimating the salaries substantially esp. I'm in cardiology not neurosurgery , and offers first year out of fellowship are around k after malpractice, overhead, etc. The chief neurosurg resident two years ago at my hospital did a spine fellowship and then set up practice in Milwaukee and is pulling in over a million after expenses.

Alot of internists are making around k in good groups. I think you would be hard pressed to find a private neurosurgeon working full-time who is making less than half a mil.

Also, don't believe the salary surveys posted online - they contain crap data. Neurosurgery hours suck in both, but especially private. Sorry to bust your bubble.

BrainDoc22 , Nov 26, Was just popping in here out of curiosity. I'm a pain doc, not a neurosurgeon but have rotated with and worked with my fair share of neurosurgeons.

I have nothing but the most respect for them. But I do believe that is what it takes. If a HEALTHY family and social life is important to you, do not pursue neurosurgery. Ligament , Dec 1, It's great to make all that money. You can buy your wife the nicest gold-laced lingerie JosephFaecesMD , Dec 2, Jackofknives , Dec 3, TweetyPie , Dec 7, Man, I got in on this racquet just at the right time.

Phenomena , Aug 5, Surgeonizer , Aug 9, There are some EXTREMELY MALIGNANT institutions out there where residents and faculty work themselves to death and big surprise they're toxic as hell. I know of several programs in California that have this reputation, including a program that is frequently listed in the top tier of neurosurgery programs nationwide.

Likewise, there are some terrible private practice setups in the community where the attendings are miserable. Even so, there are plenty of great practices in the community where neurosurgeons work a reasonable number of hours and get paid well, leaving ample time to spend with their families.

If you want to have a decent life, there are plenty of options in neurosurgery that will enable you to have a good life. You can focus on spine surgery or do functional. You can join a decent-sized group practice such that the call schedule is reasonable instead of going into a solo practice where you'll be on call You can stay away from level 1 trauma centers where you're gonna be absolutely inundated with head trauma when you're on call.

You can hire a PA to help you with the mountains of paperwork and other b.

Neurosurgeon Salary & - How Much Do Neurosurgeons Make?

Like all things in medicine, neurosurgery is what you make of it. If you want a decent lifestyle, there are avenues in the field that will enable you to have the lifestyle that you desire. It's all about your priorities in life. The truth of the matter is that neurosurgery is an awesome field and neurosurgeons, in general, truly LOVE what they do. There is nothing more exhilarating in medicine than operating on the human brain. I personally don't mind the idea of working a lot as a neurosurgeon because I love the field.

I think many people in neurosurgery would tell you the same thing. Pghboy18 , Aug 12, You must log in or sign up to reply here. Question regarding Academic neurosurgeons Transvaal , Dec 23, , in forum: Surgery and Surgical Subspecialties.

Neurosurgeon lifestyle drpossible , Apr 15, , in forum: Neurosurgeon lifestyle alpha , Oct 21, , in forum: Serous Demilune Oct 21, Kaiser vs Private Practice vs Academic? Share This Page Tweet.

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