Neurosurgery · Evidence depth: high

Open Cerebrovascular

Moderate-High, prestige driven.

Ownership-sensitivity model

The 10 vectors of a physician career.

Every path is scored 0-100 across 10 critical dimensions using public-data signals, modeled assumptions, and verification prompts. Modeled estimate. Not a salary survey. See methodology.

65/100

Income ceiling

Income ceiling

Constrained by academic models and rapidly shrinking surgical volume.

The reality

Open vascular volume is in structural decline nationwide.

The signal

Endovascular techniques have siphoned off all the 'easy' and moderate aneurysms.

The catch

This is a path chosen for historical prestige, not for maximizing wealth.

The verdict

Absolutely not a wealth-maximizer compared to spine or endo.

35/100

Lifestyle control

Lifestyle control

Dictated by highly complex, high-stakes surgery.

The reality

Emergent aneurysm bleeds will completely disrupt your scheduled week.

The signal

The cases are long, tense, and require intense focus.

The catch

You will be heavily burdened by complex neuro-ICU management.

The verdict

Offers very low control over your time.

Premium analysis

8 more dimensions scored, with the reasoning behind each

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The scores are below. Premium adds what sits behind each one: the claim, the signal supporting it, the limitation that weakens it, and what it should change about your decision.

  • Sleep / call burdenLower is better75/100
  • Ownership / facility upsideHigher is better20/100
  • Geography flexibilityHigher is better30/100
  • Innovation / industry adjacencyHigher is better40/100
  • Training opportunity costLower is better80/100
  • Job-market densityHigher is better25/100
  • Malpractice / litigation pressureLower is better80/100
  • Burnout-mismatch riskLower is better75/100

Scores are modeled from the specialty module's evidence and are estimates, not measurements. Confidence and data depth are labeled inside every premium card.

DoctorCalculator modeled income structure

Hand-authored model

Modeled base range

$605k - $770k

Structurally declining open volume; below endovascular per published ordering.

Production upside

$825k - $1.03M

Scales with volume, payer mix, and efficiency, not guaranteed.

Modeled estimate. Not a salary survey. Hand-authored against a physician-reviewed taxonomy and ingested public data. Income scales with payer mix, ownership, and geography. See methodology.

Want the code-level view behind numbers like these? Open the RVU calculator for this specialty's procedures, CMS times, and locality-adjusted Medicare rates.

AcademicTertiary referral

Best fit

  • The Prestige-Risk Academic. Mission and reputation first. Eyes open about the pay gap.
  • The Acute-Care Identity Seeker. Energized by intensity, emergencies, and high-stakes work.

Poor fit

  • The Metro Wealth-Builder. Big-city life now, serious wealth later. Powered by discipline, not just income.
  • The Lifestyle-First Clinician. A good life on sane hours, and the math actually works.

Premium detail

Common regrets on this path

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2 documented regrets for this path, each with the burnout driver behind it and the question to verify it against a real schedule before you commit. Written from field notes on this specialty, not generic career advice.

This path is described at directional confidence (Evidence depth: high). Detailed evidence cards are added as the module is validated; we will not manufacture precision before then.