Neurosurgery · Evidence depth: high
Open Cerebrovascular
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.
75/100
Sleep / call burden
Sleep / call burden
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Ownership / facility upside
Ownership / facility upside
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Geography flexibility
Geography flexibility
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Innovation / industry adjacency
Innovation / industry adjacency
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Training opportunity cost
Training opportunity cost
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Job-market density
Job-market density
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Malpractice / litigation pressure
Malpractice / litigation pressure
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Burnout-mismatch risk
Burnout-mismatch risk
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Hand-authored modelModeled 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.
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.
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.