Neurosurgery

[0nsp]

I've all of a sudden taking a shining to neurosurg after having completed my first week in it. This is surprising since I have totally hated all previous exposure to surgery. Now before I start diong something drastic, like rearranging my electives, I wanted to get opinions on all aspects of the field.

 

How tough is the residency really ( I hear its the hardest)? Is it possible to have a life (wife and kids)? What are the job prospects? What does it take to get a placement at an acdemic centre? What is the salary? What attributes make a good neurosurgeon? Why WOULDN't neurosurg be a good fit for someone? How hard is it to match CaRMS-wise? For any neurosurgeons or residents who acutally are reading this, what do you like most and least about this career? If you could choose it over again, would you (I have a friend who is doing an ortho trauma fellowship who told me if he could do it over, he would do path). What schools have the best neurosurg programs? How many electives should I have before applying (I have away electives in another specialty that I'm not too keen on rearranging).

 

Any thoughts on any facet of this specialty are greatly appreciated!

[Talon01]

I'd be interested to find out

 

a) if there's any neurosurg residents on this forum

their responses to your questions

[Blake]

Ah, the dreaded double-post.

[Blake]

triple post? even worse.

[Blake]

I've all of a sudden taking a shining to neurosurg after having completed my first week in it. This is surprising since I have totally hated all previous exposure to surgery. Now before I start diong something drastic, like rearranging my electives, I wanted to get opinions on all aspects of the field.

 

How tough is the residency really ( I hear its the hardest)? Is it possible to have a life (wife and kids)? What are the job prospects? What does it take to get a placement at an acdemic centre? What is the salary? What attributes make a good neurosurgeon? Why WOULDN't neurosurg be a good fit for someone? How hard is it to match CaRMS-wise? For any neurosurgeons or residents who acutally are reading this, what do you like most and least about this career? If you could choose it over again, would you (I have a friend who is doing an ortho trauma fellowship who told me if he could do it over, he would do path). What schools have the best neurosurg programs? How many electives should I have before applying (I have away electives in another specialty that I'm not too keen on rearranging).

 

Any thoughts on any facet of this specialty are greatly appreciated!

I'm a first year NS resident, so take my 2 months experience with a grain of salt (actually, make that a truckload of salt).

 

Yes, I believe it's the hardest residency (not only my senior residents keep saying that, but everyone I talk to ends up feeling sorry for me, so there must be some truth to this). I'll be starting on the service in about 5 months or so, so I'll tell you more once I'm knee-deep into it. Why the hardest? Very little residents, a lot of calls, a lot of emergencies with very sick patients, dealing with a lot of mortality/morbidity.

 

Yea, a life is possible, but our definition of life can be different I guess. I know several residents with spouses + kids, and I would be lying if I said I've never seen my seniors have an ''easy day''. Then again, I think my seniors are super(wo)men, but I believe I should be able to reach their level of balance at some point. Probably not during my junior years though, but we'll see.

 

Job prospects aren't the greatest, but there are some good jobs available every year (according to finishing residents). We may have more trainees than ''real'' jobs available, and for some graduates (especially from schools with poor neurosurgical reputation in the small academic world), it's going to be a very uphill battle to get a job in a major urban centre. There's always the USA, but not everyone wants to go there, and depending on the state, it may be very hard for you to be able to work there, although Canadian grads are facing less and less resistance apparently.

 

Don't think about an academic job if you aren't spending close to 8+ years in training (6 years of residency + 1-3 extra research to get a MSc or PhD + 1-3 years of fellowship). Personally, I've aimed for 10 years before I'm out in the real world. Hopefully there will be no major obstacles on the road. *knocks on wood*

 

Ah, the salary question. I'm not sure what the top earners really make in provinces like Ontario and BC, but it's fair to say we're not far behind them. PM me for details, but don't worry, neurosurgeons make more than enough (except in Qc).

 

I can't really tell you what makes a good or bad fit for neurosurgery. Hell, I couldn't even tell you for med school, and I've never been a fan of those pre-made formulas that are supposed to tell you whether or not you're made for this (yes, I'll reluctantly admit I was often outside the criterias for ''good med students'' ). Basically, you love the brain and surgery more than anything else in medicine, and the sacrifice on your personal life seems tolerable as long as you get to practice neurosurgery. While I've met a couple of NS residents who left for various reasons, the vast majority of them actually sticked to this field and made it work, so again it's a bit like med school in the sense that you'll probably be fine, at least in regards to statistics.

 

Matching isn't very hard. Then again, I'm not sure matching is that hard for most canadian grads. Don't be fooled though, just because most of the ''serious'' applicants end up matching in this field doesn't mean it's necessarly easy (we may not be a lot to apply for the spots, but I believe we are, as a whole, a fairly strong pool. About 20% of us this year had a PhD in basic sciences, and the other guys all had something exceptional and remarkable in their applications). Again, I'm not included, haha.

 

Given my whooping 2 months of off-service rotations, I can't tell you exactly what I love and hate about this field (fascinating I know, considering I knew everything I loved and hated about neurosurgery during the interview trail. God I love interviews.). Seriously, you never really know what you're getting yourself into, and residency-matching is a huge leap of faith as far as I'm concerned. Then again, neurosurgery is all about leap of faith.

 

Would I do it again? Well, considering I only applied to this field (like most of the ''serious'' folks I've met during my interviews), I'd have no choice than to say yes. Yes, the young and naive, but I've got that gut-feeling it was the right choice. Well, at least I have a clue about what I'm talking about during academic rounds, and reading actually became interesting. I can't complain, life is good in the grand scheme of things.

 

Some top-training programs in the country : Toronto, Calgary, London (UWO). I won't say which ones I consider the worst, but except 2-3 places in my opinion, the training is pretty much excellent all around the country. You have to choose a place where you feel comfortable, ideally. I sincerely believe I had a decent shot at some of these ''top'' places, but I didn't feel like this would be the best fit for me. I ''settled'' for a less prestigious place, but I'm quite happy ever since I came here. I love my junior co-residents, we hang out often together and we gossip like a bunch of highschool girls, I'm discovering a new city which is pretty exciting, I'm only 1 hour and a half away from my family, I've got a pretty great place to live, and I'm laughing myself to tears everytime we have academic rounds (we have some of the funniest staff on Earth, I'm convinced of it). Definitely glad I matched here (1st choice).

 

By the way, I'd recommend on having at least 2 electives to be somewhat competitive. Only one elective may raise some eyebrows regarding your commitment to this field, and you'll find that most serious applicants have up to 5-6 electives, so 2 is really the minimum I'd aim for. Now it's not all over if you only have 1 elective, but be prepared to answer any concerns regarding your true interest in this field (neurosurgery is a jealous mistress, as they say).

 

 

Hope that was somewhat helpful, and feel free to ask me more questions.

[0nsp]

WOW! Thanks so much for the detailed reply, Blake. I'm surprised you could actually find time to type that much (then again, I'm doing a NS selective and finding time...)

 

I really appreciate your candor. As any senior medical student, CaRMS has me freaked and I really want to know what I'm getting into for the rest of my life. You've mostly confirmed what I've heard from other residents and staff, but the only way to know for myself for sure is to do some more electives.

 

I've also sent a PM. Thanks again.

[Kirsteen]

Hi there,

 

Neurosurgery took a bit of a hit in popularity a few years back when the US decided to close its doors to Canadian-trained neurosurgeons. That is, as of that time, the US decided that their neurosurgery job market was saturated and would not allow Canadian neurosurgeons of any calibre to secure a post there. I know one neurosurgeon who was headed for a stellar career at one of Canada's biggest neurosurgery centres who decided to pack in academic neurosurgery for a job in the US in a private practice before the US job market became off-limits. As one of his former, and disgruntled, colleagues put it, "He had eight-hundred thousand reasons to leave us and take that job".

 

In terms of applying for a neurosurgery residency spot in an academic centre, it helps if you can prove your interests in academic radiology. At UofT, the neurosurgery director is quite heavily invested in research so if you can demonstrate a similar interest then that should bode you well. (As an example, I know one person who successfully matched to UofT neurosurg who had a PhD in a related field from a rather well-known US school.) Also, many surgery residents at UofT (neurosurgery included) seem to opt to complete at least one or two years of research training. If this sound appealing to you then residency at a neurosurgery centre that places a lot of value on academics might be a good fit.

 

Cheers,

Kirsteen

[Satsuma]

Hi there,

 

I think the best way to find out if you like something is to do exactly what you are doing....actually experiencing it first hand.

 

If you love it, you love it...and maybe it is what you should do. I always think that you can`t really help what you like, you just do for whatever reason. So go with your gutt.

 

I seriously considered neurosurg but really didnt like my exposure to it and later found out I really don`t care for surgery in general. If I did like surgery neuro surg would probably be the thing I would do.

 

Blake's post is pretty thorough for pointing out some pros and cons. It is a long haul for sure. And job prospects not all that great...but if after all that hard work you are willing to relocate to find a job then maybe it's not a problem for you.

 

Anyway, I will be applying to something entirely different this year.

 

If I had loved neurosurg I would have sucked it up and spent all those hours in the OR and sleepless nights in the hospital. I just didn`t. But if you do, then probably just go for it! You can always switch out if you really hate it.

 

So there is my not so useful post

Just posting to say....go for it if that is what you want and if you are actually living the whole experience now and you like it, it's probably a good bet you'll like it later on.

 

My most favourite doctor I have met in med school has been a neurosurgeon. He seems to have endless energy and balances alot of responsibilities including family. I will say this though....it wasn`t always the case (the balance) and there are definitely sacrifices that occured. But it is seemingly possible to have balance in the end.

 

As for UWO....you will come out a good surgeon. You will have spent LONG hard hours there and check for current stats but the neurosurg program used to have a very high divorce rate (did my grad school at the epilepsy unit...and that is what I was told). Surg at UWO is known for being rather old school, and well...take all this with a grain of salt, it is just what I have heard.