6:00, your alarm goes off. You get up, shower, wash your face and eat breakfast before brushing your teeth and running out the door of your penthouse apartment. Taking the elevator down to the garage you go through your schedule, consultations and surgery today. Walking through the parking lot muttering through the procedure you will be performing today, you arrive at your jaguar and unlock the door before speeding off to the hospital. Once you arrive at the hospital, you start with consultations. After three hours you head to the locker room and change into your scrubs. You head to the sinks to wash your hands for 3 minutes, making sure to wash every finger and two inches above the elbows before entering the surgery room, where you get dressed by the nurse, surgical gown, cap and two layers of surgical gloves and you're ready. One brain with 14 tumors, time for the show to start, three deep breaths and you begin… 10 hours later and you're washing your hands heading out to your jaguar to head home where you pass out from another day as a neurosurgeon.

Neurosurgery, the most clamorous and famous speciality in the world. Only the smartest and hardest working a cableple of achieving such a career making it a  status symbol and a stable in hollywood. Whether it be Gifted Hands or Dr. Strange, neurosurgery is a shining star in Hollywood movies and never ceases to draw in audiences. Despite the prevalence of neurosurgery and neurosurgeons in movies and tv, there are only 330 practicing neurosurgeons in Canada and fewer than 3700 practicing in the US. To put this into perspective the current population of Canada is over 41 million and the US has a population over 345 million. If you are a woman you are even more of a rarity as less than 10% of neurosurgeons are female, so if you have ovaries and can do brain surgery you are truly one of a kind.  It is clear that being a neurosurgeon and becoming one is a lot harder than we realize so let's break it down. 

To begin, every neurosurgeon must go through dreadful and deceptively long high school. Academically speaking high school grades are not the end all be all. Although flawless high 90’s look great on paper, they are not at all required for high school,  low to mid 80’s is plenty. This leads me to my next point, if you want to be a neurosurgeon, there is no need to go to a big fancy school. Not only is medical school extremely expensive, so why waste money on an extremely fancy school for your undergraduate degree. All in all high school is more about finding what you like, developing good studying habits and skills and of course having fun and finding your passions. Finding your passions is extremely important, if you want to become a neurosurgeon you have to find the things that make your life fun and enjoyable or else you won't make it through the more than 12 years of post secondary education. 

After high school the next step to becoming a neurosurgeon is your undergraduate degree. There are a couple of important things to consider and pay attention to when you begin university. Firstly, you do not need to study science. I know it sounds counter intuitive, and studying science is an option. But to get into medical school you actually need specific credits, as long as you get them you can apply to medical school. This means that your opportunities are numerous. This allows you to explore your other interests and further enriches your experience at school and could help you find your potential specialty. 

Medical School! The next step in becoming a neurosurgeon. Medical school is notoriously difficult and is another four years of hard work. But, it is a huge step in the direction of becoming a doctor. In addition you will not be alone in your struggles of getting enough sleep and fighting your caffeine addiction. All this to say medical school is challenging but not impossible, there will always be a test or an assignment but thinking of it as an opportunity that few get might be a way to encourage yourself. More on the actual process of medical school the four years are divided into two. The first two years are in class work, your standard class work, lectures, tests and exams. The last two years of medical schools are clinical placements in different types of specialities,  general medicine, cardiology, orthopedics and every other specialty. This is your chance to figure out what specialty you want to apply to for your residency. After you complete medical school you must take the licensing exam in order to receive your M.D. The exam is difficult, no surprise, it covers everything you learned in medical school. Diagnostic scenarios, medical procedures and complex biological processes the exam covers it all. You will need to begin your preparation during medical school and keep careful track of the subjects you covered in order to ensure that you are fully prepared for the exam. Once you pass the exam you are officially a doctor, and the last and final step in your journey awaits. 

The final step on your journey to becoming a doctor of any kind, neurosurgeon or other is your residency. Residencies can be difficult to get into as you have to match with one. Unfortunately neurosurgery is the second most competitive residency, so you will need to make your skills and accomplishments shine in your application. Once you get accepted into your residence you will be working in a hospital, you are now officially a doctor, however you are not an independently practicing doctor. Neurosurgery unfortunately has the longest residency of any specialty, with a long 6-7 year residency. The average annual salary of a doctor in residency is 65,000 annually. However if you break down hour by hour the 65,000 annually becomes $8 an hour. Safe to say that no matter what specialty you go into residency is long and hard. To top it off you will most definitely will be poor thanks to the hundreds of thousands dollars of student debt and your below minimum wage salary. You will be working alongside other neurosurgeons assisting them in surgery. Residency doctors spent a lot of their time simply observing the surgeons, and doing meaningless tasks as well as taking the hard late night shifts. I know it seems discouraging all these years of work for little pay. This is one of the times where the passions and hobbies you find in university and high school come in super handy. If you keep your motivation up and make it to the end, which I know you can, there is one final step that is optional, fellowship. 

Neurosurgery is a specialty with many sub specialties and a fellowship is how you further deepen your knowledge in order to do these specialities. There are many subspecialties within neurosurgery… 

 

Neurovascular surgery is a subspeciality of neurosurgery that deals with aneurysms, hemorrhagic strokes and bypassing blockages in the brain. In other words, it's a highly technical speciality. The outcomes of these kinds of surgery is not always sunshine and rainbows, and the hours and call schedule can be hell. Simply put, this speciality is not for the faint of heart. Make sure your soul is in it or you’ll fall flat on your face from exhaustion. 

Functional and stereotactic surgery is not bad as far as specialties go, it deals with the neural pathways of the brain, the electrical circuiting in your brain. The majority of these doctors have Ph. D’s and or a computer science background.

Spinal surgery falls more into the orthopedics. The orthopedic surgeries are a little less detail oriented, a lot of hacking and sawing away at bones. The ailments these kinds of doctors deal with are a lot more closely connected to locomotion however you still get all the fun of dealing with finicky nerves.   

Pediatric neurosurgery, is as the name says quite the speciality. Performing brain surgery on children is not for the faint of heart. Not only is it very stressful but kids needing brain surgery is not a lovely situation, happy endings are not a guarantee. Yet the specialty can be incredibly rewarding if it is for you. 

Peripheral nerve surgery is a very unique subspecialty, for one you can approach from multiple angles as it is not exclusive to neurosurgery. Plastic surgery and orthopedics both have subspecialties that cover peripheral nerves. You get it operated all over the body and peripheral nerves are found everywhere. 

Surgical neuro-oncology, is a subspeciality dealing with brain tumors and cancer. It is not a happy specialty, but that’s medicine for you. This specialty is filled with research opportunities as treatment methods for brain tumors are varied; you will most likely be spending half your time in a lab.

Trauma neurosurgeons focus on patients with traumatic neurological injuries. Think immediate life saving surgeries, and after trauma care. Trauma neurosurgeons not only work as trauma surgeons but also work in the after care for patients recovering from traumatic brain injuries.

Out of these many specialties you are guaranteed to find something you like, or you could stay general and forgo the fellowship. Know on to the fun part once you complete all of that education and secure your first job as a practicing neurosurgeon you can make anywhere from 300,000 to 700,000 dollars a year. Your exact salary depends on where you work, what your subspecialty is and your experience (how many years you have been practicing). Depending on your speciality you will be handling all kinds of brain surgeries and doing in person consultations. You can even research if you're more the anti-social type and would rather be working behind the scenes. One thing is for sure neurosurgery is a difficult specialty, yet rewarding and deserving of all the attention it gets.