Neurosurgery is considered one of the most complicated medical and surgical specialties, and it is no wonder that their residency training alone lasts a whopping seven years. Neurosurgeons will split their time between the operating room (OR) and outpatient medical clinic setting. In the OR, neurosurgeons often spend multiple hours performing complex neurosurgery. In the clinic, a neurosurgeon will meet with patients that are about to undergo or have undergone surgery with them.
A neurosurgeon often works very long hours but is well compensated for their time. The medical training path to become a neurosurgeon is very long and challenging, lasting at least 15 years after high school. In this article, we will discuss how to become a neurosurgeon, what neurosurgeons do, how competitive the medical specialty is, the salary and skills required, the difference between a neurologist and a neurosurgeon, and some of the most common surgeries that a neurosurgeon may perform.
Quick Navigation and FAQs
- What is a Neurosurgeon?
What do Neurosurgeons do? - How to become a Neurosurgeon?
- How difficult is it to become a Neurosurgeon?
- How long is Neurosurgery residency?
- How much do Neurosurgeons make?
- Skills needed to become a Neurosurgeon?
- Is becoming a Neurosurgeon worth it?
- Neurologist vs Neurosurgeon?
- Common Neurosurgical procedures
What is a Neurosurgeon?
A neurosurgeon is a medically trained MD (Doctor of Medicine) or DO (Doctor of Osteopathy) physician that has completed a seven-year residency in the field of neurosurgery. A neurosurgeon has completed medical school, residency, and sometimes an additional fellowship prior to practicing medicine. A neurosurgeon performs complex medical health procedures (neurosurgery) on the head, brain, and spinal cord. These neurosurgical medical operations can often last many hours and require intense concentration. Some medical diseases and conditions that neurosurgeons treat may include traumatic injury, central nervous system tumors, cancers, congenital malformations, infections, strokes, or degenerative diseases.
What do Neurosurgeons do?
A neurosurgeon will spend the majority of their time in the medical operating room performing neurosurgery. However, they will also spend a portion of their time rounding on patients in the hospital and seeing outpatients in a clinic setting. For neurosurgery, there are a number of different medical diseases and conditions that affect the brain, skull, vertebrae, spinal cord, peripheral nerves, and blood vessels that a neurosurgeon may operate on. These include:
- Trauma neurosurgery
- Treatment of aneurysms and arteriovenous malformations (AVM)
- Resection of tumors, including cancer
- Peripheral nerve surgery
- Spinal cord neurosurgery
- Insertion of deep brain stimulators
- Herniated discs
- Pinched nerves
- Spinal tumors
Outside of neurosurgery, neurosurgeons spend their time rounding on their medical patients in the hospital. A neurosurgeon is considered a specialist, meaning they only see hospitalized patients when they are consulted, or requested to, by a hospitalist physician. They may also round on patients after they have undergone their neurosurgery to ensure they have a smooth and complication-free medical recovery. There are many reasons why a neurosurgeon may be consulted; some include:
- A car crash victim with head trauma and a cracked skull
- A patient that developed leg weakness and was found to have a pinched spinal cord
- An elderly patient that suffered a fall and now has a brain bleed
- A patient with a headache who was found to have a brain tumor
- A construction worker who herniated a disk when lifting a heavy item
- A patient who was found to have an arteriovenous malformation within their skull
The last location where a neurosurgeon may spend their time is in a medical outpatient clinic setting. Here, a neurosurgeon will visit with healthy outpatients for a variety of reasons. In this medical setting, their duties may include:
- Ordering medical imaging such as a MRI or CT
- Prescribing medications such as pain medication or antibiotics to their patients
- Meeting with a patient for the first time to provide guidance on their next medical steps
- Performing special neurologic medical maneuvers to examine if the brain and cranial nerves are functioning appropriately
- Checking in on patients who are status post neurosurgery to ensure they are healing appropriately
- Ordering and interpreting medical laboratory tests to help guide treatment
- Performing a physical exam on patients
No matter their location, a neurosurgeon performs a variety of medical duties in order to provide excelled medical care for their patients, hospitalized and outpatient.
Neurosurgeon's education - How to become a Neurosurgeon?
There are numerous training requirements to become a neurosurgeon, including undergraduate university, medical school, residency program, and potentially a fellowship program.
- Step 1: Complete prerequisites and apply to medical school. While in university, students should work on their education and complete required prerequisite courses such as chemistry, biology, and physics. During this time, students often also complete research, obtain leadership roles and study for the MCAT (Medical College Admissions Test).
- Step 2: Complete medical school. Medical school is the first big step to become a doctor and lasts four years. During this time, medical students will complete their primary medical education. The first two years of education are spent in the classroom, learning the basics, while the last two years of medical school are spent in the hospital, learning more hands-on training. Additionally, medical students will also study for the STEP or COMLEX examinations. Lastly, medical students will apply for a residency training position during the last year of their medical education training.
- Step 3: Complete residency. Neurosurgery residency is the longest residency of all medical specialties, lasting seven years. During this time, neurosurgeon trainees will receive the medical education they need and learn to perform complex neurosurgical procedures and medical surgeries. All neurosurgeons will need to take neurosurgery board examinations at the end of residency education. This is the last education step required to become a fully-fledged neurosurgeon.
- Step 4: Complete fellowship (optional). After completing residency education, a neurosurgeon can pursue additional medical training in a subspecialty of neurosurgery. This additional training is termed a fellowship. Fellowship education lasts up to two years and may be completed in medical areas such as spinal surgery or critical care medicine.
How hard is it to become a Neurosurgeon?
It is very difficult to become a neurosurgeon. Not only does one have to be accepted into medical school and become a doctor, but matching into neurosurgery residency is also very difficult. Only 74.3% of U.S. medical applicants successfully matched into Neurosurgery in 2020. This is a low percentage of doctors to match compared to an overall match rate of 89.8% across all specialties. Thus it is vital for medical students to receive good grades in medical school, receive good STEP and COMLEX board scores, and complete extracurricular medical activities such as holding leadership roles and conducting medical research.
Neurosurgery Residency - How long is it?
As discussed in the education section, neurosurgery residency lasts seven years. This is by far the longest residency of all medical specialties. The long length is needed to properly provide an education to doctors as the brain and central nervous system are highly complex. Neurosurgery is a complicated type of surgery to perform, and neurosurgeons must be excellent in order to properly complete their neurosurgical procedures.
Neurosurgeon salary - How much do neurosurgical medicine doctors make?
A neurosurgeon may have the highest payout of all medical specialties. This is in part due to their difficult job but also due to their lengthy education requirements. The American Association of Medical Colleges (AAMC) reports salaries of doctors that work in academic settings, often teaching at a large hospital. AAMC reports that Assistant Professors in Neurosurgery make an average of $600,500 yearly, while Associate or Full Professors in Neurosurgery make $752,753 on average yearly.
What skills does it take to do Neurosurgery?
The skills it takes to perform neurosurgery are similar to that of other surgical specialties. First, a neurosurgeon must possess an excellent education and medical knowledge of the anatomy and physiology of the body site on which they are performing their neurosurgical operation. Without this vital education, performing neurosurgery may be next to impossible. Luckily, this education is received during the medical school, residency, and fellowship education process. Other skills that may be necessary to become a neurosurgeon include steady hands during neurosurgical procedures, the ability to quickly adapt when a complication is encountered, an excellent memory to remember all the medical knowledge, and a hard-working attitude to overcome all the hardships during the training and daily practice of neurosurgery.
Is being a Neurosurgeon worth it?
The answer to “is being a neurosurgeon worth it” will vary from individual to individual. However, in general most neurosurgeons enjoy their career and are happy they chose the medical field of neurosurgery. Although becoming a neurosurgeon requires many years of training, most neurosurgeons find it worthwhile and are happy with their professions at then end of their education and training.
Neurologist vs Neurosurgeon - What is the difference?
The most significant difference between a neurologist and a neurosurgeon is that neurologists do not perform surgical procedures, while neurosurgeons do perform surgery. However, there are a number of more nuanced differences between the two medical specialists. The requirements for becoming a neurosurgeon are similar to that of a neurologist; both must attend university, medical school and complete residency. However, neurology residence is much shorter at four years length versus the seven years neurosurgery requires.
Like a neurosurgeon, a neurologist may split their time between the hospital and outpatient clinical settings. While neurologists treat all medical conditions that affect the brain and central nervous system, a neurosurgeon only treats neurologic conditions requiring surgery. Neurologists and neurosurgeons may also treat the same patients. While a neurosurgeon will treat a patient’s medical conditions with surgery, a neurologist may treat patient’s conditions with medication, minor procedures, physical therapy, etc.
What are the most common neurosurgery procedures?
According to AAMC Careers in Medicine, the five most common medical conditions that a neurosurgeon may encounter include:
- Back pain and back neurosurgery
- Brain tumors and brain neurosurgery
- Cervical pain and cervical neurosurgery
- Nervous system trauma
- Nervous system vascular conditions
How to get started in Medicine?
Now that you know much more about Neurosurgery as a medical specialty, you may wonder how to get started in Medicine. It all begins with getting accepted into a medical school like the University of Medicine and Health Sciences (UMHS) and getting your M.D. degree. UMHS is a top-tier Caribbean medical school with a 96% retention rate and a 92% first-time residency attainment rate in 2024. To learn more about UMHS, please check out our Caribbean Medical University overview page. To apply, please start your application here: https://www.umhs-sk.org/apply
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Callie Torres is a Captain in the United States Air Force and a chief resident at Wash U/Barnes Jewish Hospital in St Louis. She is a freelance writer with many published medical articles as well as multiple peer-reviewed medical publications
