Steps to Be a Neurosurgeon

There's a reason people compare tough tasks to brain surgery. Neurosurgeons handle complicated medical procedures in delicate brain and spinal tissue. The specialty is so demanding that training takes 15 years. It's a small universe of professionals who finish the process. The United States has only 3,500 neurosurgeons as of 2013, according to Women in Neurosurgery. Women in the field are even more rare. About 10 percent of neurosurgery residents were women as of 2011, well below the 49 percent share of women medical-school graduates. What's more, only 200 U.S. neurosurgeons were female.

A bachelor’s degree is the first step to neurosurgery. Medical schools don’t typically require a specific undergraduate major, but they do prefer transcripts heavy on science classes. Neurosurgery programs look for candidates with one year each, plus lab work, in chemistry, organic chemistry, biology and physics. They also want students with a background in calculus, statistics or other advanced math. English is important as well, to help doctors develop communications skills. In addition, undergrads should volunteer at local hospitals or clinics because med school admissions committees consider experience and participation in extracurricular activities when reviewing applicants.

Like all doctors, neurosurgeons must complete four years of medical school. They spend the first one to two years mostly in the classroom, studying physiology, anatomy, human disease, pharmacology and medical law and ethics. A few months in, students begin seeing patients in an outpatient clinic, where they learn to examine patients and take medical histories. Intern rotations inside hospitals follow, with students completing work in neurology, psychiatry, radiology, primary care and obstetrics and gynecology. Some neurosurgery programs also recommend that aspiring neurosurgeons finish an internship of up to a year in a surgery department to learn basic clinical skills.

After they wrap up graduate medical education, aspiring neurosurgeons have to complete seven years of residency in a program accredited in neurosurgery through the American Council for Graduate Medical Education. Programs include hands-on study of the cerebrovascular system, the spine and spinal cord, as well as conditions such as trauma and tumors. At least three years of study focus on actual neurosurgical procedures. Programs might also require a year of lab research, and several months of general patient care. Residents meet with faculty every three to four months for evaluation, and to determine whether they can move to the next stage of training. Residents also need to spend at least a year as a senior or chief resident, learning to take primary responsibility for patients.

Neurosurgeons and other doctors need a state license to practice. Requirements vary by state, but typically include both postgraduate residency training and a passing score on a standardized industry test. In California, New York and Florida, for example, U.S.-trained doctors need at least one year of residency. Massachusetts and Michigan require two years of postgraduate training, while Nevada and New Jersey require three years. Also, applicants have to pass either the United States Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination.

Board certification isn’t a requirement for practice, but many employers and patients prefer board-certified doctors, who have gone above and beyond minimum licensure qualifications for training and knowledge. To become board-certified in neurosurgery through the American Board of Neurological Surgery, a candidate must complete her residency and submit a statement from her program director verifying that she is well-prepared to practice independently. Next, she must pass a written exam covering basic sciences, critical care, neurobiology, neuropathology and neurosurgery. She also must submit a list of patients she served and procedures she completed, and pass a three-hour oral exam.

Physicians and surgeons earned a median annual salary of $204,950 in 2016, according to the U.S. Bureau of Labor Statistics. On the low end, physicians and surgeons earned a 25th percentile salary of $131,980, meaning 75 percent earned more than this amount. The 75th percentile salary is $261,170, meaning 25 percent earn more. In 2016, 713,800 people were employed in the U.S. as physicians and surgeons.