Is 42 too Old for Starting Neurosurgery Practice?

[mednsrg]

I apologize in advance for this rather long post. But I need some advice from the wise folks on this forum.

I am a non-traditional student in that I will start medical school at age 30 after working for 5 years in the technology industry. While I realize that interests change as students go through their medical rotations, I am really fascinated with the human brain and Neurosurgery and it actually is the big reason why I am deciding to leave my (well paying) career for medicine.

However, un-wavered by the fact that this will likely not make financial sense due to the lost income over pretty long time period, esp. since I already have a well-paying job that I will be kicking away, my biggest deterrent with this idea is my age. I will be 34 years old when I start my residency and while I am really excited about Neurosurgery -- particularly cerebrovascular and tumor stuffs -- and feel really healthy today with almost infinite energy, I am not sure whether I will be too old for this profession when I actually start practicing. I will be around 42 by the time I am done with my fellowship, and I am not sure how many productive years I can expect for myself thereafter.

Any ideas as to the typical age a Neurosurgeon (even a surgeon for that matter) retires at? Is it due to some sort of physical/mental incapacity that neurosurgeons usually retire? Also, what is the oldest age you have observed among Neurosurgery residents? And how frequent are such encounters?

BTW, a related question, any guesses as to how the field will evolve over the next 20 years? Will it be mostly robotics based such that a neurosurgeon will do operations with fewer physical demands (stamina, dexterity, etc), and hence maybe surgeons will continue operating until much later in their lives than today?

Again, my apologies for this rather long post and I understand these questions are quite subjective, but it will nonetheless be very helpful. Any and all responses are appreciated. It would be particularly useful if some of the practicing (attending) neurosurgeons can share their experiences.

Thanks a lot.

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[xf3rn4nd3sx]

If medicine (possibly neurosurgery) is what you love, then by all means go for it. There is no sense working in a job you do not enjoy. That being said, you should be absolutely sure of your decision because the road is long. For neurosurgery, you're looking at a minimum of 11 years, and while it is easy to say "I'll be 42 when I finish," keep in mind that is a very long period of time for just training. Residency is no walk in the park and can be very difficult if you already have an established family. Secondly, a lot of students think they want to be neurosurgeons, or orthopedic surgeons, cardiologists, etc. but have no idea what life in the field is like. It is unwise to choose a specialty before med school and rotations. Are you interested in other fields in medicine or just neurosurgery??? Neurosurgery is a competitive field and is difficult to match into. If you are unable to match into neurosurgery, would you be happy in another field of medicine? Think very carefully before you make the decision.

That being said, I will answer your question. Statistically, your surgical skills do worsen as you age, but 42 years old is by no means too old to start practicing. A partner I work with is currently 63 and plans to work several more years before retiring. The field is constantly expanding and robotics will likely play a role in future surgeries. I think generally surgeons retire out of desire, not out of necessity.

 

[gonogo]

I don't think 42 is necessarily an old age to be done with training in neurosurgery. Many MD/PhDs who go into neurosurgery don't start residency until they're 30-33.

 

[mednsrg]

Thanks a lot for the info. I really appreciate.

To answer NSURG's question, at this point my interest is mostly Neurosurgery... But neurology also sounds good.

 

[mpp]

Any ideas as to the typical age a Neurosurgeon (even a surgeon for that matter) retires at? Is it due to some sort of physical/mental incapacity that neurosurgeons usually retire? Also, what is the oldest age you have observed among Neurosurgery residents? And how frequent are such encounters?

BTW, a related question, any guesses as to how the field will evolve over the next 20 years? Will it be mostly robotics based such that a neurosurgeon will do operations with fewer physical demands (stamina, dexterity, etc), and hence maybe surgeons will continue operating until much later in their lives than today?

Not sure the typical age that a neurosurgeon retires but I have met plenty in their mid to late 60s and still operating feverishly. It is certainly doable into your 70s if you wish and remain healthy. The good news is, if you play your financial cards right, you could retire in much younger if you wish. I think many retire early because of the vigor required and the frustrations encountered in the ever-changing field of medicine. Many people just slow down; take less call -- do cases that are shorter and are of less complexity and low morbidity. All the new requirements for proper re-imbursement, things like electronic medical records, and even the higher expectations patients have from their encounter with medicine then they did years ago add a lot of frustration to our most elder neurosurgeons that practiced in the "golden era" of medicine.

In terms of age, don't worry about it. I am a soon to be chief resident and in my 40s. We have graduated at least two other residents that were in their 40s. Next week we graduate two more that are in their 40s. It's very doable and very common. All have had their pick of jobs as have I. And in some cases there are advantages of being older; especially if you are financially secure (7 years of resident salary is a bit painful --- but having a nice pool of cash and no debt sure made it a lot easier).

I don't think anyone can predict what will happen over the next 20 years. But certainly we will try to do things less invasively. Robotic techniques in neurosurgery may come but I think are still a long way off. The endoscope has been a great adjunct and there is definitely room to grow there. I think DBS will be a bigger field. Endovascular continues to grow although we are starting to see the appropriate mix of the open/endo in the vascular subspecialty I think. However, none of that matters. The demands of the job will still be there. The acuity level of the patients and the high level of morbidity associated with complications will still exist regardless of how the technology changes.

In terms of technological advancement allowing you to work longer, I don't think it matters.
As fun as neurosurgery is (and even as a hardened resident that's been through hell and back over the last 6 years I still think neurosurgery is the most awesome field of medicine and don't understand why everyone doesn't want to go into it) you will want to retire at some point and enjoy spending all that cash you've hopefully saved up.

 

[Silent Cool]

mpp, thanks for the great, insightful and inspirational post. a voice of reason, as always.

Not sure the typical age that a neurosurgeon retires but I have met plenty in their mid to late 60s and still operating feverishly. It is certainly doable into your 70s if you wish and remain healthy. The good news is, if you play your financial cards right, you could retire in much younger if you wish. I think many retire early because of the vigor required and the frustrations encountered in the ever-changing field of medicine. Many people just slow down; take less call -- do cases that are shorter and are of less complexity and low morbidity. All the new requirements for proper re-imbursement, things like electronic medical records, and even the higher expectations patients have from their encounter with medicine then they did years ago add a lot of frustration to our most elder neurosurgeons that practiced in the "golden era" of medicine.

In terms of age, don't worry about it. I am a soon to be chief resident and in my 40s. We have graduated at least two other residents that were in their 40s. Next week we graduate two more that are in their 40s. It's very doable and very common. All have had their pick of jobs as have I. And in some cases there are advantages of being older; especially if you are financially secure (7 years of resident salary is a bit painful --- but having a nice pool of cash and no debt sure made it a lot easier).

I don't think anyone can predict what will happen over the next 20 years. But certainly we will try to do things less invasively. Robotic techniques in neurosurgery may come but I think are still a long way off. The endoscope has been a great adjunct and there is definitely room to grow there. I think DBS will be a bigger field. Endovascular continues to grow although we are starting to see the appropriate mix of the open/endo in the vascular subspecialty I think. However, none of that matters. The demands of the job will still be there. The acuity level of the patients and the high level of morbidity associated with complications will still exist regardless of how the technology changes.

In terms of technological advancement allowing you to work longer, I don't think it matters.
As fun as neurosurgery is (and even as a hardened resident that's been through hell and back over the last 6 years I still think neurosurgery is the most awesome field of medicine and don't understand why everyone doesn't want to go into it) you will want to retire at some point and enjoy spending all that cash you've hopefully saved up.

 

[DoctorSmoctor12]

mpp, thanks for the great, insightful and inspirational post. a voice of reason, as always.

Just wondering if you decided to go into the field of neurosurgery or not. I really want to know.

 

[bannie22]

Definitely not. I think thats well within range of the average. Just imagine a MD PHD who did a little something before medical school.

 

[crustydriller]

I personally know 2 that finished their residency after 40.

1 was MD/PhD and finished residency around 43 I think. Both are academic attendings now. If you're a good candidate and motivated, it can be done.