Neurological surgery, or neurosurgery, is a demanding but rewarding career. After 14 years or more of postsecondary education and clinical work, you can be fully qualified to practice neurosurgery. With the ability of operating on the brain comes the responsibility of being precise because one move can either permanently destroy the quality of life for the patient or save the patient from paralysis.
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One of the early contributors to neurosurgery was Sir William MacEwen (1848-1924), a native of Scotland, who advanced the surgical field and neurological mapping of the brain as to what part of the brain controls what bodily function. He performed the first successful intracranial surgery by determining the correct site of a meningioma on a teenage girl without the use of body-imaging devices in 1879. Another great contributor to the field was Harvey Cushing (1869-1939), an American who studied medicine and was recruited as professor of surgery at the Harvard Medical School and surgeon-in-chief at the new Peter Bent Brigham Hospital in Boston. He was responsible for developing the methodology that reduced the high mortality rate of brain surgeries to 10 per cent and incorporated X-rays to image the head.
After completing four years of college, prepare for another four years of medical school. Studying medicine is a competitive field and even if you apply to state universities instead of a prestigious school such as Harvard Medical, only a small percentage of qualified applicants will be accepted. To maximise chances of acceptance, stay on top of your studies and maintain high test scores. After medical school comes residency. Neurosurgery, at seven years of residency, is the longest program, and due to the limited positions, only two to three residents are accepted per year at some schools, it's very difficult to be selected. Some applicants may have to wait a year or two before being accepted to their school of choice. After completing residency, options of completing a fellowship for an additional year or two are available. This offers specialisation in a specific field such as paediatric neurosurgery, spinal surgery, neuro-oncology (brain cancer), or functional neurosurgery.
Neurosurgeons are responsible for the care of the nervous system, which includes the brain and any associated structures including the spine, nerves (including peripheral nerves), or blood supply to the brain and vertebral column. This broad range means neurosurgeons should understand not only brain functions but also the cardiovascular system and the complete human anatomy. Typical disorders a neurosurgeon attends to are head or brain injuries, brain tumours, aneurysms, herniated discs and spinal deformities.
There are a few career paths with neurosurgery. You can be an academic neurosurgeon or a private-practice neurosurgeon. The academic neurosurgeon will be paid under a school medical program where he or she will be required to teach and perhaps do research. Neurosurgeons are also hired at hospitals and paid by salary. Private-practice neurosurgeons are those who run their own business and handle all aspects of the clinic or hires someone to do so. All neurosurgeons maintain schedules of 60 to 80 hours per week minimum where the surgeries can be long and complicated. Neurosurgeons must stay healthy to endure long hours. Many say working hours run from 6 a.m. to 7 p.m. on average, which leaves little time for family, social life or other activities.
Starting out as a neurosurgeon resident, salaries range from £26,000 to £32,500 per year. Until being hired as a full-time neurosurgeon, expect the salary to stay at this range. The average salary of employed neurosurgeons according to the 2008 AMGA Medical Group Compensation and Financial Survey is £377,650. The more years of experience you have, the more pay in salary and bonuses you will receive. Private-practice neurosurgeons can earn up to a seven-figure salary. Working in cities with high living costs will also generate more income than working in small cities.
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