Overview

The path to becoming a neurosurgeon is rigorous. It starts with enrolling in a pre-medical Bachelor of Science program. With the assistance of a faculty advisor, students construct a curriculum that meets the immediate demands of their major and fulfills their medical school prerequisites. Courses such as anatomy, biochemistry, physics, and math are common. Maintaining the highest possible grade point average while completing undergraduate studies is vital, as it allows students to compete for acceptance to medical school. Many aspiring neurosurgeons volunteer at hospitals and clinics to gain experience and make connections.

It is common for undergraduates to write the Medical College Admissions Test (MCAT) and begin applying to medical schools in their junior year. Test results factor into schools’ selection and admission process; as do pre-med grades, volunteer experience, and demonstrated character.

While completing a four-year doctoral program at an accredited medical or osteopathic college, prospective neurosurgeons should choose electives that are pertinent to neurology or surgery, and whenever possible spend their clinical rotations in neurological or surgical settings.

Following their doctoral studies, newly graduated Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) who wish to practise neurosurgery typically spend a one-year internship in general surgery. They then apply to an accredited residency program in neurological surgery. Once matched, they devote five to seven years learning through hands-on practice, under the supervision and mentorship of experienced neurosurgeons.

After residency and after passing board exams required for licensing, some neurosurgeons complete a fellowship to specialize in a specific area of the field. The neurosurgical subspecialties are:

 Functional neurosurgery (surgical management of intractable pain, epilepsy, and movement disorders
 Neuro-oncology
 Neurovascular surgery
 Pediatric neurosurgery
 Skull base surgery
 Spinal surgery
 Traumatology

Due to its complexity and the ongoing advances made in their field, neurosurgeons undergo training and learn throughout their career. This continuing education takes place at annual meetings and conferences; through research; and via study of scientific journals.

How long does it take to become a Neurosurgeon?

The process of becoming a neurosurgeon can last fifteen years or longer:

Pre-med Bachelor’s degree – four years
Medical school – four years
Internship – one year
Residency – six to seven years

Steps to becoming a Neurosurgeon

The decision to become a neurosurgeon is a decision to commit to a lengthy and rigorous educational track, multiple levels of examinations and licensing, a demanding internship, an arduous residency, and career-long learning and dedication.

1 High School

All doctors need to understand how the human body works, how chemicals react with it, and how forces act on it. Therefore, students who wish to become physicians are advised to take four years of science in high school, with a focus on biology, chemistry, and physics.

Doctors need to know how to calculate dosages of medicine, read graphs, and understand trends in a patient’s recovery. Strong math skills facilitate these responsibilities. The Bureau of Labor Statistics’ Occupational Outlook Handbook states that pre-med students should complete undergraduate work in math. It follows that high school students who anticipate becoming a neurosurgeon should take as many math classes as possible to prepare for college.

According to the American Medical Women’s Association (AMWA), taking foreign language classes is useful for doctors because many patients do not speak English. By some estimates, one in five people living in the United States do not speak English at home. In addition, knowing Latin can help students understand unfamiliar medical terms that often have Latin roots.

The AMWA also recommends that aspiring surgeons taking as many advanced classes as possible, as a way to determine if they will be able to handle more in-depth biology and chemistry courses in college. Doing well in advanced placement high school science classes may allow students to earn college credit and skip introductory courses in college.

2 Bachelor’s Degree

While there is not a specific degree required for undergraduate study, aspiring neurosurgeons tend to concentrate their coursework in advanced biological sciences to meet admission requirements for medical school. They must graduate from an accredited Bachelor's degree program with pre-med prerequisite courses, such as microbiology, biochemistry, and human anatomy. Also recommended are classes in English, advanced mathematics, and statistics. Most medical schools require a grade point average of at least 3.5 and may choose only those candidates who rank at the top of their graduating class.

During undergraduate study it is also important for students to gain experience that will set them apart from other medical school applicants and prepare them for their chosen career. This experience may include volunteering at a hospital, performing community service, and research work. Especially valuable are job shadowing programs, which allow students to follow neurosurgeons and other doctors throughout a workday. All of these activities demonstrate work ethic and dedication to the medical field. Whenever possible, these experiences should be documented on letters of recommendation, which can be submitted with medical school applications.

3 Medical College Admissions Test

During their junior year of undergraduate study, prospective neurosurgeons must sit for the Medical College Admissions Test (MCAT) administered by the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM). Through a set of multiple-choice questions, this standardized exam allows medical schools to evaluate a candidate’s training and skill set. Many schools share their incoming student MCAT score average on their website to inform undergraduates of how well they need to score to compete with other applicants.

To achieve their highest possible MCAT score, students are encouraged to take advantage of assistance available to them. This includes study materials, pre-tests, practice tests, and online and in-person tutoring. These resources are designed to ensure that students attain the best possible score, which will open doors to medical schools.

4 Medical School & National Licensing

Neurosurgeons obtain either a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree.

Medical school is a very challenging four years of study that is divided into two parts. The first part, comprising the first two years of the schooling, is focused on course and lab work that prepares students intellectually for patient interaction. This training is in the biological and natural sciences, physiology, chemistry, medical ethics, and the art and practice of medicine. Students who wish to become neurosurgeons typically tailor their studies to include advanced classes in medical diagnostics, clinical research, surgical practice, and disease management. To test their grasp of this portion of training, in the second year of medical school students pursuing an MD must take and pass the United States Medical Licensing Examination (USMLE) – Step 1. Those pursuing a DO must take and pass the United States Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) – Level 1. A passing score on the USMLE or COMLEX-USA indicates that students are ready to begin supervised patient visits and gain clinical experience.

The second part of medical school, the second two years, is called Rotations. During this time, students have the opportunity to experience a variety of medical specialties and a variety of medical settings under the supervision of experienced physicians. Rotations further students’ understanding of patient care, situations, scenarios, and the teams that come together to help those that are sick. As they complete rotations, students tend to find out that they gravitate towards certain specialties or environments that fit their particular interests and skill sets. It is important that this time inform their decision of specialty or subspecialty, so that they find complete satisfaction as a physician.

After part two of medical school, students take the United States Medical Licensing Exam –Step 2 or the United States Comprehensive Osteopathic Medical Licensing Examination – Level 2. The objective of these exams is to test whether or not students have developed the clinical knowledge and skills that they will need to transition into unsupervised medical practice.

5 Internship

After finishing medical school, graduates who wish to pursue a career in neurosurgery are required to spend one year as a hospital intern. Interns do not have the right to practise unsupervised medicine, and must practise within the confines of the training program in which they are enrolled.

6 Residency

Following completion of an internship, physicians enter a residency program in neurological surgery, which typically lasts between six and seven years. The focus of years one and two is training in neurosurgery, neuropathology, and neuroradiology. In years three and four, some programs offer a choice of laboratory research or experience in a subspecialty of neurosurgery. During the final year or two, primary duties commonly include administrative responsibility for all residents, acting as chief resident in neurosurgery, and assisting in surgeries.

Neurosurgery residencies are assigned through the Electronic Residency Application Service (ERAS), administered by the American Association of Medical Colleges. For details and requirements visit https://students-residents.aamc.org/applying-residency/applying-residencies-eras/.

7 State Licensing & Continuing Education

All physicians in every state need to be state licensed. To be eligible to sit for a state’s licensing exam, candidates must have completed medical school and a residency program. While licensing rules and regulations vary from one state to another, periodic license renewal and continuing education are common requirements.

The continuing education component can be fulfilled by committing to a fellowship (see Step 9, below) or by attending classes and seminars held by medical schools and professional organizations.

8 Board Certification (optional)

Board certification is offered by the American Board of Neurological Surgery (ABNS). Though not mandatory, passing the Board’s examination and earning its credential establishes a surgeon’s commitment to excellence in the field and increases credibility and marketability in the medical community. The ABNS publishes its requirements for certification on its website (www.abns.org).

9 Specialized Training / Fellowship (optional)

A ‘fellow’ is a physician who elects to complete further training or a ‘fellowship’ in a specialty, after or near the end of residency. Neurosurgical subspecialties include pediatric neurosurgery, spinal surgery, and neurovascular surgery.

Should I become a Neurosurgeon?

A neurosurgeon’s medical diagnostic and surgical skills are, naturally, at the core of his or her work. However, in addition to being qualified to diagnose conditions and perform difficult procedures, the most successful brain surgeons understand these truths about their profession:

Neurosurgery is more art than science.
Because the stakes are higher in neurosurgery than in some other fields, there is less likely to be a clinical trial establishing superiority of some treatments over others. This means that the practice of neurosurgery involves more educated guesswork than expected, which can lead to variability in practice. Every surgeon ends up doing what they think is best for the patient, but there isn’t always one ‘right answer.’

If you’re working with brain trauma, be prepared to handle life-or-death decisions every day.
‘Are they going to live? Are they going to really live? Will they be able to speak and interact and function the way they could before? Will they drive? Will they work?’ These are the questions asked by the families of patients, as they live the most harrowing experience of their lives. For neurosurgeons, this is just the daily routine. Nearly every patient is a high-stakes case, which makes this work incredibly important, but also nerve-wracking.

Delivering bad news never gets earlier.
In a microsecond, things can change for the worse. Telling people that their loved one won’t be the same or won’t make it is very difficult and draining. The positive outcomes, however, outweigh the negative ones, but about ten to one.

When someone else’s brain is in your hands, you have to take exceptionally good care of yourself.
Not being vigilant about your own health could affect your patient’s health. As simple as these things are, going to bed early the night before surgery, eating a hearty breakfast, and drinking plenty of water can definitely contribute to successful surgical outcomes.

A scientific study can be interpreted to say anything you want it to say.
For example, the media recently quoted a published study which concluded that thirty percent of men who played contact sports would develop a form of dementia in adulthood. Reports did not say that subjects in the study were asymptomatic, meaning it was not clear that they had dementia at all. Neurosurgeons must carefully read data from other people’s research and draw their own conclusions to inform their practice.

Often, you’ll have to make a choice between being a surgeon and doing research.
It is becoming less common for hospitals to allow their neurosurgeons to conduct research, since it is more economical for a hospital to have them operating on a full-time basis.

Try different things before you commit to a specialty.
It is very common for neurosurgeons to choose a subspecialty during residency. When doing so, be certain to consider all aspects of potential specialties. For instance, the emotional impact of a potential negative outcome with a child patient may be enough for some neurosurgeons to avoid specializing in pediatric neurosurgery.

Surgery is all about teamwork.
People tend to think of operating rooms as very austere, isolated places; but you are always working and communicating with a team, and everyone plays an important role. This typically includes neurosurgery residents, a scrub nurse, and an anesthesiologist. If one person makes a mistake, another person needs to catch it. Something as trivial as failing to check a preoperative laboratory value can have fatal consequences. The stronger your team, the easier it is to avoid that situation.

Each day at work feels like solving a complicated, beautiful puzzle.
The work of neurosurgery is extremely challenging and those who do it experience a high level of job satisfaction. The experience of seeing enormous gratitude in people’s eyes when you tell them that an operation went well is not something that can be replicated in a typical nine-to-five job.

If you are motivated by the information presented above, consider, as well, the soft skills and qualities that operating on the most vulnerable organ in the body requires:

Critical thinking
Neurosurgery has only been practised since the early 1900s, making it one of the newest surgeries in modern medicine. As the discipline evolves, brain surgeons have to make time-sensitive decisions on a case-by-case basis. Especially in unconventional cases, they rely on their problem-solving skills to figure out new ways to diagnose and treat neurological diseases.

Motor skills
Neurosurgeons work with the body’s nerves and spinal column; one wrong move could cause paralysis or permanent brain damage. They rely on acute hand-eye coordination and a steady hand. They work with advanced instruments and must be able to work in small spaces using technical maneuvers.

Physical & mental stamina
The U.S. has less than four thousand neurosurgeons; so, they are overworked. Physical stamina and mental focus are essential for these doctors, who often perform lengthy surgeries, some lasting more than twelve hours. Hours are also irregular; for example, a surgeon may have to wake up in the middle of the night to perform an emergency surgery.

Technology savvy
Neurosurgery is one of the most technologically involved surgical specialties. New discoveries are made every year, and many of them incorporate new operating room technologies and high-tech surgical tools, such as medical drills and robotic arms.

Advanced reading comprehension
Interpreting graphs and charts are a major part of neuroscience. Doctors order brain scans to find evidence of tissue scarring, clots, and tumors. They must accurately interpret X-rays and images to diagnose neural conditions and determine treatment options.

To work in neurosurgery requires a genuine love of humanity, combined with the capacity to drill a hole in someone’s head without fear of hurting them. The task can be life altering. It is both profoundly technical and profoundly human.

What are Neurosurgeons like?

Investigative

The capacity of neurosurgeons to manage high pressure and stress cannot be over-emphasized. They are typically individuals who welcome intense intellectual challenge and take great satisfaction and intrinsic rewards from performing advanced and life-saving surgeries.

Neurosurgeons by Strongest Interest Archetype

Based on sample of 43 Sokanu users

Are Neurosurgeons happy?

No specific statistics exist that speak to how happy most neurosurgeons are. A very high happiness quotient in the field would not be surprising, in view of the vital work that these surgeons do and the personal reward they reap from it. On the other hand, the demands of the job – from the career’s lengthy and competitive educational track to the demands it places on time and energy – could support a low measurement on the happiness scale.

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