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Medical Career Paths Overview

Jul 11, 2025

Overview

This lecture compares medical career paths as a non-surgical doctor (physician) versus a surgeon, focusing on training, compensation, competitiveness, lifestyle, and pros and cons.

Definitions and Career Paths

  • All surgeons are doctors, but not all doctors are surgeons.
  • Physicians earn an MD or DO degree; surgeons are physicians with surgical specialization.
  • Surgical specialties include plastic surgery, neurosurgery, orthopedic surgery, ENT, vascular surgery, and more.
  • Non-surgical specialties include internal medicine, family medicine, pediatrics, psychiatry, dermatology, radiology, and others.

Training & Residency

  • Medical school is 4 years: 2 preclinical (classroom) and 2 clinical (hospital/clinic rotations).
  • After med school, residency is required: 3–7 years depending on specialty.
  • Surgical residencies tend to be longer (minimum 5 years; neurosurgery up to 7 years).
  • Some specialties require fellowships after residency (1–3 years), for further sub-specialization.

Competitiveness & Entry

  • Surgical specialties are more competitive to match into, with four in the top five most competitive.
  • Plastic surgery is especially competitive; dermatology is the most competitive non-surgical field.
  • All five least competitive specialties are non-surgical.

Compensation

  • Surgeons generally earn more than non-surgical physicians.
  • Lowest paid non-surgical: pediatric endocrinology ($218,000); highest non-surgical: radiation oncology ($569,000).
  • Lowest paid surgical: colorectal surgery ($455,000); highest surgical: neurosurgery ($764,000).
  • Top five highest paid medical specialties are all surgical.

Lifestyle and Work-Life Balance

  • Non-surgical doctors have better work-life balance, fewer hours, and are less likely to be on call.
  • Surgical careers require longer, more stressful hours and frequent on-call shifts.
  • Some surgical specialties (plastic surgery, ENT, urology) have better lifestyles than others.
  • Surgical procedures are mentally and physically taxing.

Pros and Cons: Non-Surgical Doctor

  • Pros: Shorter training, less competitive specialties, earlier earnings, better lifestyle.
  • Cons: Lower compensation (generally), work may lack hands-on technical challenges.

Pros and Cons: Surgeon

  • Pros: Higher compensation, technically challenging and hands-on work.
  • Cons: Longer training, later start to high earnings, riskier (higher liability), more demanding lifestyle.

Key Terms & Definitions

  • Physician — A medical doctor with an MD or DO degree.
  • Surgeon — A physician specialized in performing surgical procedures.
  • Residency — Post-medical school training in a medical specialty.
  • Fellowship — Additional sub-specialty training after residency.
  • On-call — Being available to work or respond to emergencies outside normal hours.

Action Items / Next Steps

  • Reflect on personal interests, strengths, and lifestyle goals when choosing a specialty.
  • Review the "So You Want to Be" video series for in-depth specialty insights.
  • Consider the importance of work-life balance versus compensation and training length.