CareerExplorer’s step-by-step guide on how to become a neurosurgeon.
Is becoming a neurosurgeon right for me?
The first step to choosing a career is to make sure you are actually willing to commit to pursuing the career. You don’t want to waste your time doing something you don’t want to do. If you’re new here, you should read about:
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High School
All doctors need to understand how the human body works, how chemicals react with it, and how forces act on it. Therefore, students who wish to become physicians are advised to take four years of science in high school, with a focus on biology, chemistry, and physics.
Doctors need to know how to calculate dosages of medicine, read graphs, and understand trends in a patient’s recovery. Strong math skills facilitate these responsibilities. The Bureau of Labor Statistics’ Occupational Outlook Handbook states that pre-med students should complete undergraduate work in math. It follows that high school students who anticipate becoming a neurosurgeon should take as many math classes as possible to prepare for college.
According to the American Medical Women’s Association (AMWA), taking foreign language classes is useful for doctors because many patients do not speak English. By some estimates, one in five people living in the United States do not speak English at home. In addition, knowing Latin can help students understand unfamiliar medical terms that often have Latin roots.
The AMWA also recommends that aspiring surgeons taking as many advanced classes as possible, as a way to determine if they will be able to handle more in-depth biology and chemistry courses in college. Doing well in advanced placement high school science classes may allow students to earn college credit and skip introductory courses in college.
Bachelor’s Degree
While there is not a specific degree required for undergraduate study, aspiring neurosurgeons tend to concentrate their coursework in advanced biological sciences to meet admission requirements for medical school. They must graduate from an accredited Bachelor's degree program with pre-med prerequisite courses, such as microbiology, biochemistry, and human anatomy. Also recommended are classes in English, advanced mathematics, and statistics. Most medical schools require a grade point average of at least 3.5 and may choose only those candidates who rank at the top of their graduating class.
During undergraduate study it is also important for students to gain experience that will set them apart from other medical school applicants and prepare them for their chosen career. This experience may include volunteering at a hospital, performing community service, and research work. Especially valuable are job shadowing programs, which allow students to follow neurosurgeons and other doctors throughout a workday. All of these activities demonstrate work ethic and dedication to the medical field. Whenever possible, these experiences should be documented on letters of recommendation, which can be submitted with medical school applications.
Medical College Admissions Test
During their junior year of undergraduate study, prospective neurosurgeons must sit for the Medical College Admissions Test (MCAT) administered by the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM). Through a set of multiple-choice questions, this standardized exam allows medical schools to evaluate a candidate’s training and skill set. Many schools share their incoming student MCAT score average on their website to inform undergraduates of how well they need to score to compete with other applicants.
To achieve their highest possible MCAT score, students are encouraged to take advantage of assistance available to them. This includes study materials, pre-tests, practice tests, and online and in-person tutoring. These resources are designed to ensure that students attain the best possible score, which will open doors to medical schools.
Medical School & National Licensing
Neurosurgeons obtain either a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree.
Medical school is a very challenging four years of study that is divided into two parts. The first part, comprising the first two years of the schooling, is focused on course and lab work that prepares students intellectually for patient interaction. This training is in the biological and natural sciences, physiology, chemistry, medical ethics, and the art and practice of medicine. Students who wish to become neurosurgeons typically tailor their studies to include advanced classes in medical diagnostics, clinical research, surgical practice, and disease management. To test their grasp of this portion of training, in the second year of medical school students pursuing an MD must take and pass the United States Medical Licensing Examination (USMLE) – Step 1. Those pursuing a DO must take and pass the United States Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) – Level 1. A passing score on the USMLE or COMLEX-USA indicates that students are ready to begin supervised patient visits and gain clinical experience.
The second part of medical school, the second two years, is called Rotations. During this time, students have the opportunity to experience a variety of medical specialties and a variety of medical settings under the supervision of experienced physicians. Rotations further students’ understanding of patient care, situations, scenarios, and the teams that come together to help those that are sick. As they complete rotations, students tend to find out that they gravitate towards certain specialties or environments that fit their particular interests and skill sets. It is important that this time inform their decision of specialty or subspecialty, so that they find complete satisfaction as a physician.
After part two of medical school, students take the United States Medical Licensing Exam –Step 2 or the United States Comprehensive Osteopathic Medical Licensing Examination – Level 2. The objective of these exams is to test whether or not students have developed the clinical knowledge and skills that they will need to transition into unsupervised medical practice.
Internship
After finishing medical school, graduates who wish to pursue a career in neurosurgery are required to spend one year as a hospital intern. Interns do not have the right to practise unsupervised medicine, and must practise within the confines of the training program in which they are enrolled.
Residency
Following completion of an internship, physicians enter a residency program in neurological surgery, which typically lasts between six and seven years. The focus of years one and two is training in neurosurgery, neuropathology, and neuroradiology. In years three and four, some programs offer a choice of laboratory research or experience in a subspecialty of neurosurgery. During the final year or two, primary duties commonly include administrative responsibility for all residents, acting as chief resident in neurosurgery, and assisting in surgeries.
Neurosurgery residencies are assigned through the Electronic Residency Application Service (ERAS), administered by the American Association of Medical Colleges. For details and requirements visit https://students-residents.aamc.org/applying-residency/applying-residencies-eras/.
State Licensing & Continuing Education
All physicians in every state need to be state licensed. To be eligible to sit for a state’s licensing exam, candidates must have completed medical school and a residency program. While licensing rules and regulations vary from one state to another, periodic license renewal and continuing education are common requirements.
The continuing education component can be fulfilled by committing to a fellowship (see Step 9, below) or by attending classes and seminars held by medical schools and professional organizations.
Board Certification (optional)
Board certification is offered by the American Board of Neurological Surgery (ABNS). Though not mandatory, passing the Board’s examination and earning its credential establishes a surgeon’s commitment to excellence in the field and increases credibility and marketability in the medical community. The ABNS publishes its requirements for certification on its website (www.abns.org).
Specialized Training / Fellowship (optional)
A ‘fellow’ is a physician who elects to complete further training or a ‘fellowship’ in a specialty, after or near the end of residency. Neurosurgical subspecialties include pediatric neurosurgery, spinal surgery, and neurovascular surgery.
How to become a Neurosurgeon
The path to becoming a neurosurgeon is rigorous. It starts with enrolling in a pre-medical Bachelor of Science program. With the assistance of a faculty advisor, students construct a curriculum that meets the immediate demands of their major and fulfills their medical school prerequisites. Courses such as anatomy, biochemistry, physics, and math are common. Maintaining the highest possible grade point average while completing undergraduate studies is vital, as it allows students to compete for acceptance to medical school. Many aspiring neurosurgeons volunteer at hospitals and clinics to gain experience and make connections.
It is common for undergraduates to write the Medical College Admissions Test (MCAT) and begin applying to medical schools in their junior year. Test results factor into schools’ selection and admission process; as do pre-med grades, volunteer experience, and demonstrated character.
While completing a four-year doctoral program at an accredited medical or osteopathic college, prospective neurosurgeons should choose electives that are pertinent to neurology or surgery, and whenever possible spend their clinical rotations in neurological or surgical settings.
Following their doctoral studies, newly graduated Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) who wish to practise neurosurgery typically spend a one-year internship in general surgery. They then apply to an accredited residency program in neurological surgery. Once matched, they devote five to seven years learning through hands-on practice, under the supervision and mentorship of experienced neurosurgeons.
After residency and after passing board exams required for licensing, some neurosurgeons complete a fellowship to specialize in a specific area of the field. The neurosurgical subspecialties are:
Functional neurosurgery (surgical management of intractable pain, epilepsy, and movement disorders Neuro-oncology Neurovascular surgery Pediatric neurosurgery Skull base surgery Spinal surgery Traumatology
Due to its complexity and the ongoing advances made in their field, neurosurgeons undergo training and learn throughout their career. This continuing education takes place at annual meetings and conferences; through research; and via study of scientific journals.