How to become a neurosurgeon

Aspiring neurosurgeons should focus on taking a challenging and comprehensive course load in high school that prepares them for the rigorous academic requirements of medical school and beyond. Here are some recommended high school courses for students interested in pursuing a career in neurosurgery:

• Biology: A strong foundation in biology is essential for understanding the structure and function of the human body, including the nervous system. Topics such as anatomy, physiology, genetics, and cellular biology are particularly relevant.
• Chemistry: Chemistry provides the fundamental principles underlying biological processes and is a prerequisite for many college-level science courses. Focus on both general chemistry and organic chemistry to develop a strong understanding of chemical concepts.
• Physics: Physics principles are important in understanding how the body interacts with physical forces and energy, particularly in fields such as biomechanics and neuroimaging. Concepts such as mechanics, electricity, and optics are relevant to neurosurgery.
• Mathematics: A solid foundation in mathematics, including algebra, geometry, trigonometry, and calculus, is essential for success in science and medical courses. Mathematics skills are used in various aspects of medical research, data analysis, and problem-solving.
• Anatomy and Physiology: If available, consider taking courses in anatomy and physiology to gain a deeper understanding of the structure and function of the human body. These courses can provide valuable insights into the complexities of the nervous system.
• Advanced Placement (AP) or Honors Courses: Whenever possible, enroll in AP or honors-level courses to challenge yourself academically and demonstrate your ability to handle rigorous coursework. These courses may also earn college credit, reducing the course load in college.
• English and Writing: Strong communication skills are essential for success in medical school and beyond. Take English and writing courses to improve your written and verbal communication skills, critical thinking, and ability to convey complex ideas effectively.
• Extracurricular Activities: Participate in extracurricular activities related to science, medicine, research, or healthcare to gain practical experience and demonstrate your commitment to the field. Volunteer work, internships, shadowing experiences, and involvement in science clubs or competitions can strengthen your college applications and provide valuable insights into the medical profession.

Becoming a neurosurgeon requires a long and challenging educational path. Here are the detailed steps to become a neurosurgeon:

• Undergraduate Education: The first step to becoming a neurosurgeon is to complete a bachelor's degree from an accredited university or college. There is no specific major required for medical school, but most aspiring neurosurgeons choose to study pre-med, biology, or a related field. During your undergraduate studies, you should focus on maintaining a high GPA and taking courses in biology, chemistry, physics, and mathematics.
• Medical School: After completing your undergraduate education, you will need to attend medical school. The application process is highly competitive, and you will need to take the Medical College Admission Test (MCAT) and submit your scores along with your application. Medical school typically lasts four years, during which you will take courses in anatomy, physiology, pharmacology, pathology, and other medical subjects. You will also complete clinical rotations in various medical specialties, including neurology and neurosurgery.
• Residency: After completing medical school, you will need to complete a residency in neurosurgery. Neurosurgery residency programs typically last seven years, during which you will receive extensive training in neurosurgical techniques, patient care, and research. During your residency, you will work closely with experienced neurosurgeons to gain hands-on experience in a variety of surgical procedures.
• Fellowship: After completing your residency, you may choose to pursue a fellowship in a subspecialty of neurosurgery, such as pediatric neurosurgery, spine surgery, or neuro-oncology. Fellowships typically last one to two years and provide additional training in a specific area of neurosurgery.
• Board Certification: After completing your residency and fellowship, you will need to become certified by the American Board of Neurological Surgery (ABNS). To become certified, you will need to pass a written examination and a series of oral examinations that test your knowledge and skills in neurosurgery.
• Licensure: In addition to certification, you will need to obtain a medical license in the state where you plan to practice. Licensure requirements vary by state, but typically include passing a state-specific medical board examination and meeting other requirements, such as completing continuing education courses.
• Professional Development: As a neurosurgeon, it is important to stay up-to-date with the latest advances in the field. This may include attending medical conferences, participating in continuing education courses, and conducting research to contribute to the field of neurosurgery.

Neurosurgeons have the opportunity to pursue fellowship training following the completion of their residency program. Neurosurgical fellowships provide advanced, specialized training in specific subspecialties within neurosurgery, allowing surgeons to further refine their skills and expertise in a particular area of interest. Some common neurosurgical fellowships include:

• Neuro-oncology Fellowship: Focuses on the diagnosis and treatment of brain and spinal cord tumors. Fellows gain experience in surgical techniques, radiation therapy, chemotherapy, and multidisciplinary care for patients with brain and spine tumors.
• Complex Spine Surgery Fellowship: Provides advanced training in the surgical management of complex spinal disorders, including spinal deformities, spinal cord injuries, degenerative spine conditions, and spinal tumors. Fellows learn advanced surgical techniques and patient management strategies for complex spine cases.
• Endovascular Neurosurgery Fellowship: Focuses on the treatment of cerebrovascular diseases using minimally invasive endovascular techniques. Fellows gain expertise in the management of aneurysms, arteriovenous malformations (AVMs), stroke, and other vascular conditions through catheter-based interventions.
• Pediatric Neurosurgery Fellowship: Provides specialized training in the surgical management of neurological disorders in pediatric patients, including congenital anomalies, hydrocephalus, brain and spinal cord tumors, epilepsy, and craniofacial disorders. Fellows gain experience in pediatric-specific surgical techniques and multidisciplinary care for pediatric neurosurgical patients.
• Functional and Stereotactic Neurosurgery Fellowship: Focuses on the surgical treatment of movement disorders, epilepsy, pain, and psychiatric conditions using stereotactic and functional neurosurgical techniques. Fellows gain expertise in deep brain stimulation (DBS), epilepsy surgery, and other neuromodulation procedures.
• Neurotrauma and Critical Care Fellowship: Provides specialized training in the management of traumatic brain and spinal cord injuries, as well as neurocritical care for critically ill neurosurgical patients. Fellows gain experience in trauma surgery, neurointensive care, and the management of complex neurotrauma cases.
• Skull Base Surgery Fellowship: Focuses on the surgical management of complex skull base tumors, including pituitary tumors, acoustic neuromas, meningiomas, and craniopharyngiomas. Fellows gain expertise in skull base approaches, microsurgical techniques, and multidisciplinary care for skull base pathology.

Neurosurgeons can pursue board certification through the American Board of Neurological Surgery (ABNS). Board certification through the ABNS is a rigorous process that requires neurosurgeons to demonstrate their expertise through written and oral examinations, as well as ongoing participation in continuing medical education (CME) activities to maintain certification. Board-certified neurosurgeons are recognized as leaders in the field and are held to high standards of clinical excellence and ethical practice.

The ABNS offers the following board certifications for neurosurgeons:

• Primary Certification in Neurological Surgery: Neurosurgeons who have completed an accredited residency program in neurological surgery are eligible to apply for primary certification through the ABNS. The certification process includes passing written and oral examinations that assess the surgeon's knowledge, clinical judgment, and technical skills in the field of neurosurgery.

Subspecialty Certification
In addition to primary certification, neurosurgeons can pursue subspecialty certification in certain areas of neurosurgery. Subspecialty certification is available in the following areas:

• Neurocritical Care: Focuses on the management of critically ill patients with neurological emergencies, including traumatic brain injury, stroke, and intracranial hemorrhage.
• Pediatric Neurological Surgery: Focuses on the surgical treatment of neurological disorders in pediatric patients, including congenital anomalies, hydrocephalus, and brain tumors.
• Endovascular Surgical Neuroradiology: Focuses on the treatment of cerebrovascular diseases using minimally invasive endovascular techniques, such as coiling and stenting, for aneurysms, AVMs, and stroke.
• Neurological Spine Surgery: Focuses on the surgical treatment of spinal disorders, including degenerative spine conditions, spinal deformities, spinal cord injuries, and spinal tumors.
• Stereotactic and Functional Neurosurgery: Focuses on the surgical treatment of movement disorders, epilepsy, pain, and psychiatric conditions using stereotactic and functional neurosurgical techniques, such as deep brain stimulation (DBS) and epilepsy surgery.

Licensure for neurosurgeons is governed by state medical boards. To practice medicine, including neurosurgery, in any state, neurosurgeons must obtain a medical license from the respective state medical board where they intend to practice. Here is an overview of the licensure process for neurosurgeons:

• Graduation from Medical School: Neurosurgeons must graduate from an accredited medical school and obtain a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
• Completion of Residency Training: After medical school, neurosurgeons must complete a residency program in neurological surgery accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA). Neurosurgery residency typically lasts seven to eight years and provides intensive training in surgical techniques, patient care, and clinical research.
• Passing the United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA): Neurosurgeons must pass the USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) exams, or the COMLEX-USA Level 1, Level 2 Cognitive Evaluation (CE), and Level 2 Performance Evaluation (PE) exams to obtain licensure.
• Obtaining Postgraduate Training: Some states require neurosurgeons to complete additional postgraduate training, such as a fellowship program, before applying for licensure.
• Application for State Licensure: Neurosurgeons must submit an application for licensure to the state medical board where they intend to practice. The application typically includes proof of medical education, completion of residency training, examination scores, and documentation of any postgraduate training.
• Background Check and Verification: State medical boards conduct background checks and verify the credentials of applicants to ensure they meet the requirements for licensure.
• Passing the State Medical Licensing Examination: Some states require neurosurgeons to pass a state-specific medical licensing examination in addition to the USMLE or COMLEX-USA.
• Continuing Medical Education (CME): Neurosurgeons must participate in continuing medical education (CME) activities to maintain their medical license. CME requirements vary by state but typically include a certain number of hours of CME credits every few years.

Once licensed, neurosurgeons are legally authorized to practice medicine within the scope of their training and expertise in the state where they hold licensure. Licensure requirements may vary from state to state, so neurosurgeons should familiarize themselves with the specific requirements of the state where they plan to practice.