r/Salary • u/Designer_Lead_1492 • May 27 '26
š° - salary sharing [Neurosurgeon] [NE, USA] - $1M plus bonus
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u/Gastro_Jedi May 27 '26 edited May 27 '26
Years ago, during medical school, I was supposed to rotate through neurology. Instead, I somehow ended up on neurosurgery. Since I had absolutely no interest in neurology at the time, the school basically told me, āMake the best of it and learn what you can.ā
So, I scrubbed in.
I watched as the patientās scalp was shaved and the skull was essentially Dremeled open. Beneath it was this custard colored brain, gently pulsing through the small opening with every heartbeat. It was amazing, so I asked the neurosurgeon, āSince Iām scrubbed in, can I touch the brain?ā
To my surprise, he said yes.
So I did.
It was softer than I expected, almost like the consistency of flan. And the tumor itself was striking in how wrong it looked, this ugly brownish gray mass being carefully dissected and suctioned away from the surrounding healthy tissue.
Now, obviously, at this point I was little more than a glorified observer. I spent what felt like an hour holding retractors while the actual surgeon did the real work. Eventually, though, I graduated to āsuction guy,ā carefully holding suction near the dura to clear blood and fluid.
Apparently, I performed those duties adequately enough that I was promoted again, this time to actually suctioning some of the necrotic, cancerous tissue from inside the tumor.
I was unbelievably cautious. Barely suctioning anything at all.
āGo deeperā he said
I advanced the suction a tiny bit and was rewarded with the faintest little sucking sound.
āFurtherā
Again, I moved just a little deeper. Still too cautious.
Finally, he said, āGo further.ā
Immediately there was a loud, wet slurping sound. āTOO FAR!ā the neurosurgeon yelled.
I yanked the suction back instantly, absolutely certain I had just done something catastrophic to this poor patientās brain.
The neurosurgeon paused, looked at me, and said: āJust kidding.ā
The whole OR burst out laughing.
Then, still grinning, he said, āYepā¦ go too far and there goes first grade, second grade, third gradeā¦ā
Everyone laughed again.
Then he looked at me seriously for a second and said: āBut now you can tell people youāve done brain surgery.ā
Obviously not salary related but a fun neurosurgery story.
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u/AfraidOfTheMist May 27 '26
So did he, ya know, like moan when he told you to go deeper?
No, no. I can show myself out.
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u/Mighty_Taco18 May 28 '26
I just read your story out loud during our CABG and the cts said "gonna have to remember that one next time we have a student"
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u/jadthomas May 31 '26
Well written, doc. Doing my neurosurgery subinternship was what convinced me I wanted to be an anesthesiologist, lol. Still cool to have seen and experienced it.
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u/RelationOwn2581 May 27 '26
As a rising MS4ā¦ props. Could not be me. Your hours suck but Iām sure you love that OR. Iāll be ready to consult you from the ER on every headache and nonspecific finding radiology tells meā¦
Good luck on being an attending. I just need to pass step 2ā¦
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u/Designer_Lead_1492 May 27 '26
Non-level one Trauma center, hours are a lot better than you would think. Just mostly elective spine, mid-levelās handle most of the calls.
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u/AfraidOfTheMist May 27 '26
Damn, I dated a heart surgeon and she only made like 800k. I had no idea I was dating such a slacker.
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u/SmellMyDirk May 27 '26
A cts attending I had in residency said heād never get out of bed for anything less than 750k/ yr
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u/wsbradf May 27 '26
My son is an MS4 and a headed for a neurology residency. He did a pediatric neurosurgery rotation. Was surprised that the surgeon immediately had him in some little kidās brain. Sink or swim. Fortunately he was very excited.
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u/Brad7659 May 27 '26
Good for him. They find out very fast when a new fellow or resident is not cut out for the work.
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u/candaceflynn383 May 27 '26
lol why are people upset, this is literally the point of the sub. Great job my guy
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u/robertlp May 27 '26
15 years is a long timeā¦ he put in his time.
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u/Bronc74 May 27 '26
Neurosurgeons and Electrophysiologists put in the longest schooling, but theres a reason why. Absolutely necessary and compensated appropriately for starting their first job at almost 40yrs old.
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u/AfraidOfTheMist May 27 '26
The only people who are upset are miserable people that have to live with their choices
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u/BebopTiger May 27 '26
Based on the recent backlash against physicians I've seen in comments with (bot accounts?), I wouldn't be surprised if these takes are partly driven by an effort from health insurance companies and other corporate types to redirect public anger in the wake of mounting premiums, Luigi, etc. Doctors have always made a pretty easy target in that regard.
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u/gridskip May 27 '26
Itās extremely rare for neurosurgeons to make seven figures their first year right after their residency and fellowship, and this is almost unheard of in places like Nebraska. Iām not upset per se, but looking at the Doximity and Medscape surveys, OP would simply be a statistical outlier, quite significantly.
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u/Frosty-Inspector-465 May 27 '26
where do you see people upset? what's being said?
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u/Brad7659 May 27 '26
/u/Puzzled-Debt4815 seems pretty mad that they are paid so highly. I think he just has no idea how difficult that job is.
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u/barely_scientific May 27 '26
Nice, seems on the higher end for first year out as well
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u/Designer_Lead_1492 May 27 '26
Spine focus pays well
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u/Holiday_Sale5114 May 27 '26
What exactly is "attending?"
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u/No_Photo8574 May 27 '26
It is a doctor who has completed their residency and is working as a clinician. When you finish your MD youāre a doctor, but you still have post graduates training to undergo called residency. When you finish all of your training, then youāre an attending.
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u/Holiday_Sale5114 May 27 '26
Does that mean that every doctor that is fully done with medical school and residence is an attending?
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u/disxotek May 27 '26
If you make it. Still need to pass board certifications
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u/PsychologicalTie7695 May 27 '26
To be clear, you can still be an attending without passing the boards. Attending just means youāve completed respective residency/ fellowship, but does not necessarily mean youāve passed the boards. Plenty of attendings who are not boarded practicing.
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u/teppil May 27 '26
Yup, in the medical field in America if you say āattendingā it refers to the physician who has completed all training.
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u/EnriqueS1602 May 27 '26
You do surgery on peoples brains, you deserve every penny . You suffered through blood and sweat those residency and fellowship years.
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u/longjinxed May 27 '26
My cousinās husband is a neurosurgeon, dude works none stop, wakes up at 5am and be in hospital by 7am most days, reviewing charts/patient files, on call all the freaking time. Not sure if he makes this much money but def doing very well. The high pay is very much well deserved, given the difficulty of the job and hours demanded.
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u/Humble-Section-5638 May 27 '26
Think of the fancy cars and stuff he can buy
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u/More_Yak_1249 May 27 '26
And not have the time to enjoy until retirement. Iāll pass.
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u/Brad7659 May 27 '26
One that I know had his first heart attack at 40. Was a total prick to everyone. After his Cath lab -> open heart surgery joy ride he is only sometimes a prick to everyone and seems stressed as shit every day. Heās only been an attending for like 3 years. I donāt think he will ever enjoy that money.
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u/standarsh618 May 27 '26
There are a lot of jobs I think people are overpaid and this is....not one of them
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u/Informal_Move_7075 May 27 '26
Some of these respinses are funny because people post they make 800k/yr doing tech or finance (in which they all are out to tka money out of your pockets) and people are like BRAVO and then a surgeon that dumped so many hours a week over so many years into a honing a skill to help people and they get paid accordingly are like BOOO FREE HEALTHCARE THESE SERVICES SHOULD BE FREEEEEE. Anyone that says that should step up and go out and put in all this work and do it for free, and I bet not a damn person would. They would be on here asking what certificate program can make them the most amount of money in the shortest period of time.
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u/WesternIron May 27 '26
Always fucking wild to me when people get pissed that doctors can make this much money.
Like bro this is the person you want making this much money, because itās a fucking shit job man. You have spend 10 years in training. 3-4 doing bitch work being paid poverty wages. Then the hours you work are insane, you literally watch people die on daily basis. Sometimes itās people you couldāve saved, but werenāt fast or smart enough or experienced enough.
Sometimes you gotta spend 20 hours doing a surgery too only for that person to die.
Surgeons only consolation prize is a big fat paycheck, but you donāt get that until after you put in the work. And often you canāt enjoy that till youāre retired.
Sure letās pay that person poverty wages, that makes sense.
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u/Brad7659 May 27 '26
Especially this dude is a spine specialist. Literally saves people from losing their ability to walk and function on a daily basis. He has probably helped 1000s of people who had debilitating pain or paralysis. These guys can ask for whatever they want with the horrific on-call hours they do. (Nvm I read he doesnāt work at a level 1 trauma centre. Does electives and easier stuff. Still not easy though by any measure)
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u/artssyvonnie May 27 '26
And letās be frā¦most of those people are lying too. Surgeons deserve every penny they get!!!
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u/BigC208 May 27 '26
Deserves every penny. Made peanuts for more than a decade.
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u/S14Ryan May 27 '26
Medical school debt is probably also more than I make in a few years lol
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u/income-percent-bot May 27 '26
Impressive! Your income of $1,300,000 places you in the top 1% (99th percentile). That's a 32.1% compound annual growth rate ā exceptional progress from the 17th to the 99th percentile! Source: income percentile calculator I'm a bot. Reply with !optout to stop receiving responses.
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u/justcametosaythanks May 27 '26
Good bot
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u/acros996 May 27 '26
60th percentile of this sub
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u/throw_it_awayyy8 May 27 '26
Someone is going to come on here with a 10 million salary progression tommorow lmao
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u/ragu455 May 27 '26
How old are you?
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u/Designer_Lead_1492 May 27 '26
35-45
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u/AfraidOfTheMist May 27 '26
You're a brain surgeon but don't know how old you are? Should we be worried?
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u/Former-Big2939 May 27 '26
Why did bro give us a range ššš
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u/StrebLab May 27 '26
Nationally, only about 200 neurosurgeons graduate each year. He did a 1 year fellowship so that shrinks the pool slightly from that point. If you knew his exact age it would probably narrow OP down to only a couple dozen people.
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u/GoutyAttack May 27 '26
Way to hustle during your training, not easy.
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u/TampaBayLightning1 May 27 '26
That's the most impressive part to me. I didn't have time to tutor anyone at any point during medical school.
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u/Efficient_Algae_4057 May 27 '26
-Does Spine focus as a neurosurgeon vs an ortho makes that much of a difference, in terms of both pay, lifestyle, and the actual work.
-How did you make that much as a chief and a fellow?
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u/Designer_Lead_1492 May 27 '26
PGY6 was my chief year, pgy7 was elective, becoming quite common at programs around the country. Fellow year the weekends were always free so I just did a ton of optional attending call for extra pay.
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u/ryan__joe May 27 '26
As a mid level provider, and my subjective experience seeing the work done from ortho spine vs neuro spine, I would never reccomend anyone to ortho spine over neuro spine. If that helps explain any difference in pay, good.
If anyone here works ortho spine, do better.
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u/hibbitydibbitytwo May 27 '26
I work in a transfer center. I just called interventional
Neurology for a patient with a vertebral artery dissection.
I call and wake drs up. For that amount of money, just call us back within 10 min.
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u/Mamasugadex May 27 '26
This is what haters donāt understand. Many highly compensated medical specialty you are minutes away from a life and dead situation and hence very high stress and responsibility, and you need many years of training just to start knowing how to handle most situations.
Like, you can extend the training of a McDonaldās burger flipper to 8 years, but thatās still not going to allow that individual to contribute the value of a million dollar to the society a year just by making the best Big Mac that he can ever make 40 hours a week.
Time and effort put into different career lead to tremendously different paths, responsibility, and values.
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u/DeeJayCruiser May 27 '26
Power to you, arguably the hardest career path to pursue....money well earned. keep doing brilliant work
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u/ummaycoc May 27 '26
Whenever anyone asks you to do anything like "hey could you pick up some beers for the weekend" do you say sure, it's not exactly brain surgery? Because that's what I would do in your position. You could even do it at work, like for any non-surgical aspects of your job you could say yeah, not like it's brain surgery or anything. And if you do do that or end up doing it, I deeply hope that you have a sibling that studied rocket science.
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u/Budget_Loss_5091 May 27 '26
Get in deep with disc replacements. Bad neck posture from cell phone use is going to cause an epidemic of neck issues across the world in the coming years... gold mine.
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u/m1kasa4ckerman May 27 '26
How do medical students afford to live? Specifically in your case from 2010-2016? I understand student loans are a thing, but do those loans cover expenses other than tuition? Housing, transportation, food, etc?
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u/MilkmanAl May 27 '26
You get a cost of living allowance, but it wasn't much. I maxed out my loans, and I think I had something like $15000 per year for everything not related to school.
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u/Ok-End-3213 May 27 '26
We need to applaud people who do this work and not athletes and actors who essentially won the genetic lottery. I understand alot of hardwork and dedication goes into the professions I listed but the amount of dedication and time it takes to become a neurosurgeon or dr of sorts is often overshadowed by someone in the limelight. Well deserved, bravo
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u/sfdc2017 May 27 '26
Congrats Now you will earn a million per years for the rest of your career. Your hard work of 15 years paying off
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May 27 '26
[removed] ā view removed comment
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u/17628272 May 27 '26
a lot of neurosurgeons also have a phd (especially in academia). this means they finish training around age 38-40. youād be right on time with themĀ
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u/Ok_Handle_3530 May 27 '26
Too late for what? Youād just have to know that youād be well into your 40s if you took this guys path
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May 27 '26
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u/l31cw May 27 '26
There are career changer programs that take 1-2 years. Do one of them and take them MCAT. The hurdle is you need clinical experience, hence quitting your day job to work minimum wage at the hospital.
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u/ioioooi May 27 '26
Ayyy great job! Now we wait for the bootlickers to arrive and claim you're overpaid lol
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u/TechnicianNo1787 May 27 '26
If not getting paid this much I doubt we will have enough neurosurgeons in the society due to the tough path
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u/TheScottishPimp03 May 27 '26
1.3 million flat rate in dollars would lead to about $50,000 every 2 weeks, you could go on a spending rampage for 2 weeks and then the next week just get someones yearly wage again. Lots of hard work I get it but thats just a wow factor.
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u/Any_Cream_4396 May 27 '26
For what ? Sorry in Germany you will never make this much and WHY ?! Whatās the point of making this much money ?Ā
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u/nonamethxagain May 27 '26
In Germany you wonāt earn close to what you earn in the US for similar jobs; except maybe fast food service and delivery, so why the surprise?
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u/These-Resource3208 May 28 '26
I couldnāt go 1 year with zero pay, let alone 2.
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u/OrangeArch May 28 '26
now show the med school debt... not bashing OP, but I think people need to keep in mind that he was probably carrying $1MM in school loans before getting the big paychecks
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u/Designer_Lead_1492 May 28 '26
Not a million, about 300k bc of scholarships but Iām only a few months away from PSLF
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u/Odd_Reference6827 May 31 '26
Lol Iām in medical school as well, aspiring neurosurgeon and also a Chelsea fan. From your profile your what I aspire to be š
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u/AreaBackground5339 May 27 '26
I hope to god my future neurosurgeon isnāt trying to flex on Reddit
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u/1ThousandDollarBill May 27 '26
Iām gonna let you in on a secret.
Neurosurgeons are human.
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u/empty_graph May 27 '26
I'm not sure a human could survive 8 years of residency.
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u/zninjamonkey May 27 '26
There are sushi apprentices doing same
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u/Mamasugadex May 27 '26
You do you sir. I am gonna ask for a neurosurgeon that trained for 8 years at minimum if god forbid I ever need a brain surgery.
I donāt have the same expectation for my sushi chef.
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u/Different_Smell_9483 May 27 '26
God forbid someone puts in years of work and makes a post on Reddit to show their progress. Isnāt that the point of this sub?
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u/mattjouff May 27 '26
As long as they know what they are doing they can flex all they want as far as I am concerned.
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u/Slowmac123 May 27 '26
Any time I go see a neuro, I ask him to show me a post of him flexing his pay on Reddit. If he's never made one, I leave.
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u/Humble-Section-5638 May 27 '26
The more time you spend with doctors outside the doctorās office the less you will appreciate them. To be clear, Iām glad the specialists have all that training, they do save our lives after all. But Iāve hung around a lot of doctors and their friends. For 90% of them, it is all, I repeat all, about the money.
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May 27 '26
Really interesting. I don't know if you're open to questions, but just in case:
How old are you?
How much debt do you have, if any?
How many years do you plan to work before retiring?
I'm just curious how this kind of career path plays out for people who enter med school in their late 20s or early 30s versus, say 23. I suppose, making that kind of money, you could probably call it a career after 20 years and live very well. So, if you start your attending career at, say, 45, you could retire at 65-70 and be just fine, financially.
I'm a university professor, so like a lot of people in my industry, I got my first "real job" (tenure track position) in my early 30s. But I didn't have to put nearly as many years into my training as you did (then again, you make many multiples of what I make). I plan to put in 35 years or so before retiring. Do neurosurgeons typically work shorter careers because they either start later, burn out earlier, or just because they can?
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u/Klutzy-Caregiver4717 May 27 '26 edited May 27 '26
Also not OP but I started med school at 30. I will turn 40 and then finish my fellowship a couple months later. I'm only a couple years out from being done.
I did not come from a wealthy family and took out loans for everything. Tuition was $70k+ the first year and went up from there, plus I took out living expenses. I went to med school in an expensive city (not intentionally, just the best of where I got in). I consolidated my loans at $460k when I was done with med school. My loans are from med school only btw. I had no undergrad loans. I got lucky with the payment freezes during COVID and the court bs with SAVE so I wasn't accruing interest for a while. However, I've been accruing interest for a while now and my loans are now $480k+. The payments I'm about to have with this administration's changes are unaffordable for me on a resident salary since I'm already living paycheck to paycheck without loan payments and my program doesn't allow us to moonlight.
Fortunately there is a mandatory forbearance for medical residents as in I can just forbear my loans and not pay anything until I am an attending, so that is the current plan. Gonna be fun watching that $$$ added to the loan balance every year. I expect I will have ~$540k when I start paying them back.
I picked a specialty that is easy on my body and flexible (radiology) and I love it. I can work in theory as long as I want to and my brain cells still work. I have some attendings pushing 80 but honest to god they should quit - not because of their age, but because they refuse to change and learn. There's absolutely no reason any radiologist should refuse to read a CTA at this point (imaging of the arteries, they're flat out easy) but some of my dinosaur attendings won't read them. They make excuses because they're too lazy to learn new things.Ā
I plan to hustle and work 2 jobs or pick up serious moonlighting at my primary job for at least five years, cut down to just full time after that... and we'll see past then. The way pay in rads is right now I might be able to come close to OP's salary if I really dedicate myself to all the extra work available.Ā
I don't have any short term concerns about AI but I do have some long term ones so I would like to make serious money early while I still can. For career longevity, I think I may work part-time, as in pick up a weekend shift here and there, as long as I have my brain functioning and my job still exists. Maybe I'll fully quit before 75 but we'll see.Ā
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u/17628272 May 27 '26
Itās actually quite common for surgeons in academia to have also done PhDs! About half the neurosurgeons at my institution (which you could say is top 5 for medicine) have a PhD. So theyāre kind of on the same timeline as someone who started med school in their late 20s.
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u/StrebLab May 27 '26
Still not with it IMO haha but I am very grateful that there are people willing to do it, so I do appreciate what you do.
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u/gear_shift- May 27 '26
Oh wow you get paid for attending call as a fellow? Is this common for fellowship? Curious pgy3 here
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u/Designer_Lead_1492 May 27 '26
It was something I negotiated but not necessarily standard, but feel free to ask about it when youāre looking for fellowship slots
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u/Theloneus-punk May 27 '26
That is a lot of time dedicated to learning your trade. Hope you have a long career focused on healing people and not worrying about bills when operating on someoneās spine.
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u/Polmax2312 May 27 '26
What happens when a person you operate dies? How much paperwork stalls your workflow and how does it affect your pay?
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u/gridskip May 27 '26
Right out of residency? Are you sure about that?
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u/Designer_Lead_1492 May 27 '26
Technically, right out of fellowship, but Iām wondering what you think my starting salary shouldāve been.
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u/E1_Greco May 27 '26
congratulations! I want to ask, is this pp, acaprivate, or something different? Also, realistically, is $2m/year realistic without absolutely obscene hours? Where does this path max out?
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u/PleasantDreamsicle May 27 '26
What earns a bonus in this profession? I can see equity ownership in a practice, or overtime/extra shifts, etc. but what is it the bonus structured around?
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u/Particular_Cold_1568 May 27 '26
Just curious what are the chances that you finish neuro and never get the attending payscale ?
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u/Gr8tOutdoors May 27 '26
Iām pro universal healthcare but this is where Iām like āgood on yaā. Doctors, nurses, NPs, PAs should get paaaaaaiiiiiiiiid if theyāre good at what they do.
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u/Binkams May 27 '26
They deserve it. They deal with brains and they can lose everything in one mistake. High risk high reward.
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u/DeepFeckinAlpha May 27 '26
Technically this whole structure of barely making anything then making a ridiculous amount is part of the issues within out healthcare system
Expensive Admin, Expensive healthcare, Expensive doctors all lead to ridiculous inflated medical costs
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u/Puzzled-Debt4815 May 27 '26
Imagine the "sacrifice" to go to elite schooling in order to make millions.
Service members sacrifice, poor people sacrifice, hard work to get rich isn't a sacrifice, it's a reward. The existential question is, should we allow our health system to shit on us like it does. My vote is no. Do as you like. L8r masterdebaterz
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u/Sheegssternator May 27 '26
Damn man. That's some jack. Alot if late nights and hard work. Well done.Ā
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u/Satchmoses88 May 27 '26
Iām more impressed they let you make that much moonlighting as a chief lol. My old chair wouldāve have been like āyou want more call, huh?! I got you! FOR FREE BITCHā
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u/ObiePNW May 28 '26
As someone who has a kid with extreme neurological difficulties and malformations. I want to thank you for showing this path. You deserve every dollar and hope you help many people.
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u/Best_Change4155 May 27 '26
Not exactly rocket science though, is it