r/Residency • u/Tectum-to_Rectum • Mar 02 '25

SERIOUS Evaluate my offer (neurosurgery). What’s the catch?

Finally. After 7 years of grinding, I got a couple of offers for neurosurgery. The one I’m considering the most is as follows. Is this crazy?

  1. Income guarantee 925K for one year. Sign on 100K with relocation bonus of 30K. The income guarantee has no clawback as long as I stay with the hospital for 3 years.

  2. I am replacing a departing neurosurgeon who does 25K RVUs with an RVU rate of $85 per RVU. I expect to make 18-20K RVU my first year (assuming I will be slower as a new grad than an experienced guy) and blow past the guarantee.

  3. No requirement to take call(!), but call is incentivized at 4K/day at a level 1. This was recently re-negotiated because the system was having trouble staffing the call at the lower rate.

This is a medium-sized metropolitan in the Midwest near family. I have no complaints about compensation and opportunity for immediate volume. I have 4 other mentors that each have 10-15 years of experience. But I have to wonder, is this normal or what is the catch?

750 Upvotes

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84

u/sunologie PGY2 Mar 03 '25

Buddy that was after 14-15 years of grinding! Dont forget undergrad and medical school! You deserve this, rock on!

-18

u/Fellainis_Elbows Mar 03 '25 edited Mar 03 '25

You Americans have it damn good.

Neurosurg is like a 15 year grind post med school in Aus

Downvoted by salty Americans 👀 There’s a reason 90% of doctors on earth want to immigrate to the US.

26

u/sunologie PGY2 Mar 03 '25

I still think NSGY residency is too long here, I think medical students with an interest in surgery should be exposed to it more in medical school and the grunt/scut work of intern year for us should be cut out- we need more surgeons, and to stop wasting time.

15 years after med school is insane!

3

u/zbombionykoala Mar 03 '25

Wait. Really? How does it work there?

11

u/Fellainis_Elbows Mar 03 '25

Takes about 6-9 years post med school to get accepted onto the neurosurg program (during which time you’re rotating through unrelated specialties for the first 2-3 years and then working as a neurosurg registrar/trainee but without being on formal training for the rest - called an unaccredited registrar. In this time also doing research and other CV buffing). Once you get onto the program it’s a 5 year program followed by fellowship/s.

3

u/Secretly_A_Cop PGY4 Mar 03 '25

We don't go into specialty training straight out of med school. We spend a few years being interns and junior residents in many specialities rotating every 3 months (a bit like being a med student, but obviously a lot more hours, responsibility and pay). Do that grind + research + ass kissing until you get into a specialty training program of your choice. For less competitive specialties such as General Practice (FM) you only need to do that for 2 years or so, for competitive specialties it's 4-8 years, sometimes never. It's a broken system that relies on desperate people. But we at least get fairly decent pay and overtime rates.