Neurosurgery

Profile
Updated
December 2019

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Table of Contents Slide
 General Information 3-6
 Total number & number/100,000 population by province, 2019 7
 Number/100,000 population, 1995-2019 8
 Number by gender & year, 1995-2019 9
 Percentage by gender & age, 2019 10
 Number by gender & age, 2019 11
 Percentage by main work setting, 2014 12
 Percentage by practice organization, 2014 13
 Hours worked per week (excluding on-call), 2014 14
 On-call duty hours per month, 2014 15
 Percentage by remuneration method 16
 Professional & work-life balance satisfaction, 2013 17
 Number of retirees during the three year period of 2016-2018 18
 Links to additional resources 19

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General information
Neurosurgery focuses on the central, peripheral and autonomic nervous systems. Practitioners diagnose
problems through physical examination with the aid of such tools as MRI, CT scans and laboratory tests
and frequently provide surgical treatment. Neurosurgery includes management of diseases of the skull,
the brain, the pituitary and the spinal cord. Management of head and spinal injuries is a major challenge.
As many head injuries and acute intracranial emergencies occur in off-hours, this is not a specialty for
those who value lifestyle. It is, however, a very challenging and rewarding career.
Neurosurgery as a discipline arose as a result of an increasing need for special expertise in the surgical
and non-surgical treatment of various diseases affecting the nervous system and supporting structures.
Therefore, it involves the ability to diagnose, and the technical expertise for the effective surgical
treatment of congenital and acquired abnormalities. It also requires expertise in trauma and diseases
affecting the nervous system that can be potentially prevented, alleviated or cured.

Source: Pathway evaluation program 3

General information
This specialty requires the physician to be well-grounded in the principles of both neurosurgery and
surgery in general. Thus, the fully-trained resident must demonstrate proficiency and expertise in the:
 care of neurosurgical emergencies;
 principles of pre- and post-operative general surgical care;
 treatment of deep vein thrombosis;
 management of fluid and electrolyte disturbances;
 treatment of sepsis, the use of antibiotic therapy and an understanding of the implications of antibiotic
prophylaxis;
 understanding of vascular shock and its treatment;
 an understanding of the diagnostic importance of disordered blood gas analyses and their treatment ;
 acute, subacute and chronic management of parenteral nutritional support.

Source: Pathway evaluation program 4

General information
A neurosurgical resident must have knowledge, clinical ability and surgical skill as these apply to surgical
diseases of the nervous system. They must have familiarity with, and knowledge of, the related
disciplines of basic neuroscience, neurology, neuropathology, neuroimaging and neuropsychology.
Neurosurgical residents must also demonstrate a detailed knowledge of the normal structure and
function of the nervous system and of the pathological processes that unbalance it. They must develop
learning strategies to enhance their knowledge and expertise so as to maintain excellent and current
standards of care. Interprofessional skills are imperative as they must become effective neurosurgical
consultants with respect to patient care, education of colleagues and the provision of medical legal
opinions. Finally, and most importantly, the neurosurgical resident is expected to demonstrate
unequivocal high moral and ethical behaviour.

Source: Pathway evaluation program 5

General information
Upon completion of medical school, it takes an additional six years of Royal College-approved training to
become certified in neurosurgery. This period must include:
 2 years of core training in surgery and 3 years of Royal College-approved resident training in
neurosurgery. Up to six months of this period may be spent in pediatric neurosurgery;
 1 year of training that must include 3 months of residency in neurology, 3 months of residency in
neuropathology, and 3 months of residency in neuroimaging.
For further details on training requirements please go to:
Royal College of Physicians and Surgeons of Canada
Canadian Neurological Sciences Federation

Source: Pathway evaluation program 6

Total number & number/100,000 population by province, 2019
Province/Territory Physicians Phys/100k pop'n

Newfoundland/Labrador 3 0.6
Prince Edward Island 0 0.0
Nova Scotia 11 1.1
New Brunswick 10 1.3
Quebec 80 0.9
Ontario 120 0.8
Manitoba 14 1.0
Saskatchewan 14 1.2
Alberta 42 1.0
British Columbia 45 0.9
Territories 0 0.0
CANADA 339 0.9

Source: 2019 CMA Masterfile 7

Number/100,000 population, 1995 to 2019
0.95

0.90

0.85

0.80

0.75

0.70

0.65

0.60
1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019

Source: 1995-2019 CMA Masterfiles 8

Number by gender & year, 1995 to 2019
400

350

300

250

200

150

100

50

0
1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019

Total Males Females

Source: 1995-2019 CMA Masterfiles 9

Percentage by gender & age, 2019

Gender Age Group

11% 4%
15%

28%

22%

89% 31%
Male Female 65+ 55 - 64 45 - 54 35 - 44 < 35
Excludes those where gender or age is unknown.
Source: 2019 CMA Masterfile 10
Number by gender & age, 2019

65+ 46

55-64 7 62

45-54 10 89

35-44 13 77

<35 2 12

Female Male

Excludes those where gender or age is unknown.

Source: 2019 CMA Masterfile 11
Percentage by main work setting, 2014*

Academic Health Sciences Centre 57%

Private Office/Clinic 16%

Non-AHSC Teaching Hospital 9%

Community Hospital 6%

Free-standing Lab/Diag Clinic 5%

Other 3%

Nursing home/ long term care

3%
facility/ seniors’ residence

*Most recent available data for this specialty

Source: 2014 National Physician Survey. CFPC, CMA, Royal College 12
Percentage by practice organization, 2014*
0%
17%

3%
Solo Practice
3%
Group Practice

Interprofessional Practice

Hospital-based Practice

NR

77%

*Most recent available data for this specialty

Source: 2014 National Physician Survey. CFPC, CMA, Royal College 13
Hours worked per week (excluding on-call), 2014*
Activity Hours worked per week
Direct patient care without teaching component 15.7
Direct patient care with teaching component 13.4
Teaching without patient care 3.8
Indirect patient care 5.5
Health facility committees 1.2
Administration 2.6
Research 4.8
Managing practice 1.8
Continued professional development 2.3
Other 0.4
TOTAL HOURS PER WEEK 51.5

*Most recent available data for this specialty

Source: 2014 National Physician Survey. CFPC, CMA, Royal College 14
On-call duty hours per month, 2014*
2%
11%

28%

Up to 120 hrs/month
More than 120, up to 180 hrs/month
23% More than 180, up to 240 hrs/month
More than 240 hrs/month
No response

36%

Time spent on call in direct patient care = 56 hrs./month

*Most recent available data for this specialty
Source: 2014 National Physician Survey. CFPC, CMA, Royal College 15
Percentage by remuneration method
Primary payment method1 in 2013**
7%

23%
40% Average gross payment per physician for
Neurosurgery in 2017/18 (those earning at
least $60,000) = $570,4952

19%
12%
*Other includes capitation, sessional, contract and other methods
90% + fee-for-service 90% + salary
**Most recent available data for this specialty
90% + other* Blended
1 National Physician Survey, 2013, CFPC, CMA, Royal College
NR 2 National Physician Database, 2017/18, CIHI
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Professional & work-life balance satisfaction, 2013*

Balance of
personal &
8% 34% 16% 42%
professional
commitments

Current
7% 18% 13% 63%
professional life

NR Dissatisfied or very dissatisfied Neutral Satisfied or very satisfied

*Most recent available data for this specialty

Source: 2013 National Physician Survey. CFPC, CMA, Royal College 17
Number of retirees during the three year period of 2016-2018
Male Female
11
10

34 and Under 35-44 45-54 55-64 65 and over Total

Age Group

Source: CMA Masterfile – year over year comparisons

Note: “Retired” is based on giving up licence and therefore excludes those who have retired from clinical practice but
are still licensed; those younger than 45 may include physicians who have temporarily given up their licence but
return to practice at a later date. 18
Links to additional resources
 Association of Faculties of Medicine of Canada

 Canadian Institute for Health Information

 Canadian Medical Association’s Physician Data Centre

 Canadian Post-MD Education Registry (CAPER)

 College of Family Physicians of Canada

 National Physician Survey (2004-2014)

 Royal College of Physicians and Surgeons of Canada

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