I would assume that looking for faculty positions as a functional is a bit different because the number of candidates is far less than, say, internal medicine. There's also a big incentive for private practice over academia. Is tenure still outrageously competitive?
OP here - while I am interested in functional, I’d like to reframe my question for all of NSGY: are tenure-track positions easier to come by as a neurosurgeon (compared to IM or a PhD scientist)? At the same time, is it more difficult to secure >50% protected time for research, since clinical time generates more $$ for a hospital/university?
Why do you want tenure? It doesn't carry the same weight as it does in true academia and it doesn't protect your job as a neurosurgeon even if it (somewhat) protects your academic title if achieved. Would you really stay at an institution with tenure if you lost 80% of your salary as a physician? They're separate paychecks basically. Every department has a different cut off but definitely the cut offs are lower than in non-clinical tracts. Get an RO1 or some other major achievement and you probably can get tenure at most neurosurgery programs. I'm sure the cut off is higher at some of the higher end academic programs vs others. Tenure tract doesn't directly have to do with research protected time. I'm tenure tract and did not request protected research days. One of my colleagues is also tenure tract and has two lab days and a basic science lab. My contract has more opportunity for me to do outreach, practice building, teaching, and moonlighting than my colleagues. Depends on what you want and what they will give you. I know a guy who wanted 70% research time and he got it because the hospital system had room for a research but not for another full time neurosurgeon. It really comes down to getting that sort of thing carved out in your initial contract and keeping it there more than getting tenure.
Excellent insight, thanks. Is $400-600k remotely possible for Functional w/ elective spine and ~50% protect time in academia?
Talk with the reps in the room next time you're doing a case. The historically high volume places are UCSF (Starr/Larson), Emory (Gross), Toronto (Lozano & co.), OHSU (Burchiel). There are some other places with decent volume like Stanford (Halpern) and UF (Foote) that are building up steam. Anything over 40/yr is reasonable, and top 10 starts around 70-80/yr (including the private practice guys). Highest I've heard of is Toronto where they claim to do upwards of 140-150/yr. This list is by no means exhaustive.
My sources are reps from all three major companies (Medtronic, Boston, Abbott), as well as reps for robots, BrainLab, etc. at WSSFN/ASSFN.
Pilitsis at Albany at one point was very productive both operatively and academically