Salary lists

[Broke]

Why does neurosurgery never make the highest paying medical specialty lists? What's salary can you expect one year out of residency? What about 10-15 years out of residency? I got loans on loans to pay back.

[Guest]

(02-04-2017, 05:55 PM)Broke Wrote: Why does neurosurgery never make the highest paying medical specialty lists? What's salary can you expect one year out of residency? What about 10-15 years out of residency? I got loans on loans to pay back.

Generally NS is the highest paid. You don't see it on many lists due to the small size of the specialty in comparison to Ortho, Gen Surge, etc. Hence, harder to achieve statistical accuracy or collect data so most studies focus on the larger specialties.

[Guest]

Anyone know of any useful data to share? Its always nice to know there is a light at the end of the tunnel of crippling debt. Anecdotes are nice but lets be honest most of us are number people.

[Guest]

(02-04-2017, 11:42 PM)Guest Wrote: Anyone know of any useful data to share? Its always nice to know there is a light at the end of the tunnel of crippling debt. Anecdotes are nice but lets be honest most of us are number people.

Most NS compensation (salary+bonus) falls between 750K and well over 1M. Variables for the range are, years in practice,  sub-specialty, location, practice type (academic, Private, group, etc.), and very important is the number of hours that you put in.  Per Jackson Coker's Neuro/Spine study showed that , in 2013, Avg. NS was paid about $400 per hour salary+bonus. As demand is increasing and as NS is one of the most profitable specialties for the hospital, today this amount is likely higher than that and may be much higher in 7 years. The study also showed that the hospital on average made $1300 per hour on each NS. Meaning for every dollar that they paid a NS, they took in more than 3 dollars. In 2013, they estimated that average NS made $828K.

[dispo]

I'm interested in your contention that compensation may increase in the coming years. My understanding was always that spine brought in more than crani work, and that spine compensation was either on the way down or was expected to be on the way down in the coming years. Have you heard anything similar or anything that refutes this?

[Guest]

(02-05-2017, 03:18 PM)dispo Wrote: I'm interested in your contention that compensation may increase in the coming years. My understanding was always that spine brought in more than crani work, and that spine compensation was either on the way down or was expected to be on the way down in the coming years. Have you heard anything similar or anything that refutes this?

There is no crystal ball that can predict the exact amounts of compensation in the future. However, if economics of the market (supply & demand) hold, it is inevitable that highly sought after specialties will command more and more compensation. Consider the following factors: 1) A large number of practicing NS are at or past the retirement age. Currently, and for the foreseeable future, there are not enough NS being trained to even come close to fill this gap. 2) Current generation in training put more emphasis on life style and may not maintain the traditional workloads and will also demand higher pay for less desirable geographic areas. This will also drive the need for additional practitioners. 3) The required treatments for the rapidly aging population will drive the need for Crani sky high as we do not have enough in the pipeline to address the upcoming tsunami. 4) US population is increasing and the rate of increase in the training and installation of new surgeons is lagging the population increase. 5) there is a revolution underway in the expansion of knowledge and availability of treatments that fall under NSG. Etc., Etc., Etc. But I could be wrong.

[Guest]

^i agree with that...or at least hope so. I often wonder how Orthopedics will not get saturated with the number of graduates in that field each year. I feel like NS has done a pretty good job with the numbers of keeping the field from being overpopulated. Any thoughts?

[dispo]

Those seem like pretty solid arguments; thanks for the response! Would love to hear if anyone has any counter-arguments to any of these points, or any other thoughts on the matter.

[Guest]

Credit your elders with closing the doors on many with a combo of low number of residency spots and more stringent Step 1 scores. Over the years Step 1 scores in this speciality have risen in an attempt to cut off more students. Each year they seem to artificially raise the average score to make more and more students feel hopeless of getting into the specialty and inflate the ego of the specialty. It creates an artificial aura. In effect it actually worsens the field because you end up having those who have little interest in NSG initially flocking to the field after they get their scores back. NSG recruits not the best possible researchers and clinicians but instead the best test takers. In effect it should be pulling for those with long standing in the field and many publications since starting med school in the field. My prediction is the field will be held back because of this practice. But whatever, can't control the powers that be.

[Guest]

(02-05-2017, 03:18 PM)dispo Wrote: I'm interested in your contention that compensation may increase in the coming years. My understanding was always that spine brought in more than crani work, and that spine compensation was either on the way down or was expected to be on the way down in the coming years. Have you heard anything similar or anything that refutes this?

(02-07-2017, 10:55 PM)Guest Wrote: Credit your elders with closing the doors on many with a combo of low number of residency spots and more stringent Step 1 scores.  Over the years Step 1 scores in this speciality have risen in an attempt to cut off more students.  Each year they seem to artificially raise the average score to make more and more students feel hopeless of getting into the specialty and inflate the ego of the specialty.  It creates an artificial aura.  In effect it actually worsens the field because you end up having those who have little interest in NSG initially flocking to the field after they get their scores back.  NSG recruits not the best possible researchers and clinicians but instead the best test takers.  In effect it should be pulling for those with long standing in the field and many publications since starting med school in the field.  My prediction is the field will be held back because of this practice.  But whatever, can't control the powers that be.

Respectfully, this is an extremely shallow point of view. Number of spots is driven by availability of training sites and funding. Not all hospitals are academic centers and not all academic hospitals have the resources and qualified staff to gain certification to train neurosurgeons. It costs close to 1.5 to 2 million dollars in funding to train a neurosurgeon. This funding comes from the US government and academic institutions. When the congress passed the sequester laws that cut funding for residency training, all specialties suffered setbacks in trying to increase the number of training spots. AANS and other NSG associations have consistently urged the government to provide more funding while warning that there is a severe shortage looming that will impact the public health. 

While we can acknowledge that a few anecdotal examples may exist where someone may have secured a spot without much demonstrated interest in the field,  there are just over 200 spots available each year. Every year there are plenty of candidates who not only possess high board scores and academic achievement, but also have completed research and participated within their home or nearby programs. It will also be unlikely to secure a spot if one does not have strong recommendations from multiple neurosurgeons and to gain that recommendation, one has to have been involved.  

Finally, the future growth of NSG is ensured by extremely smart and dedicated residents who are making amazing contributions to the field.