Operate on the heart: bypasses, valves, transplants. Six years of residency, very high pay, and one of the tightest job markets in Canadian medicine.
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What you earn and what it costs to get there.
Typical net
$620,000
New or academic
$400,000
Senior, high-volume
$850,000
Net income after overhead. Almost all cardiac surgeons work at hospitals on fee-for-service or blended academic plans. Pay varies by province and billing model. CIHI (Canadian Institute for Health Information) reports average gross payments of about $695,000 for cardiac and thoracic surgery in 2023 to 2024, before overhead, and Job Bank puts the top end for surgeons near $767,000.
$65,000 to $95,000
Salary as a resident, rising each of the 6 years
Residents are paid employees. Quebec pays the least. Expect 70 to 80 hour weeks and overnight call in the cardiac intensive care unit.
About 32 heart centres
Every cardiac surgeon in Canada works at one of them
A job appears when a surgeon retires or a centre grows. Some years only a handful open nationally. New grads often take extra fellowships, work in the US, or wait.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is three undergraduate years at a cheaper province's tuition, a three year medical degree, one sitting of the MCAT (Medical College Admission Test), and the licensing and specialty exams. The high end is four undergraduate years and four medical school years at the most expensive rates, plus several application cycles and interview travel to exam fees. Residency and the extra fellowship years are paid work, not tuition, so they are not counted here. Typical debt at the end of medical school is $80,000 to $150,000, and malpractice fees of tens of thousands a year start only once you are practising.
Typical debt at the end of medical school is $80,000 to $150,000. Add 1 to 2 fellowship years at roughly resident pay.
No employer pension
Most surgeons are self-employed and save through a professional corporation.
Academic salary plans
Nearly all cardiac surgery happens at university hospitals, which often pay a blended salary for research and teaching.
On-call stipends
Extra pay for covering the heart centre overnight.
Malpractice coverage
Through the CMPA (Canadian Medical Protective Association), partly reimbursed by provinces.
The exact path from high school to qualified.
Six years of residency after medical school, entered directly from the match.
High school
Grades 11 and 12
Top marks in biology, chemistry, math and English. A very high average is the entry ticket.
Bachelor's degree
3 to 4 years
Any major, usually life sciences. High GPA, research, volunteering. Write the MCAT (medical school admission test).
Medical school, the MD (doctor of medicine)
3 to 4 years
Acceptance rates are 5 to 15%. Cardiac surgery electives and research in your final year are essential for the match.
Cardiac surgery residency
6 years
Matched through CaRMS (the residency matching service). Paid, supervised. Time in general surgery, cardiology and intensive care before you spend years in the heart operating room.
Royal College exam, licence, fellowship
1 to 2 years
Pass the Royal College of Physicians and Surgeons of Canada exam, register with your provincial College of Physicians and Surgeons. Almost everyone does a 1 to 2 year fellowship.
Biology and chemistry
Required for nearly every pre-med path.
Physics
Blood flow, pressure and pumps. The heart is a plumbing problem.
Calculus and functions
English
You will explain life-or-death choices to families under stress.
You need a licence from your provincial College of Physicians and Surgeons to practise, and specialist certification in cardiac surgery from the Royal College of Physicians and Surgeons of Canada. Hospitals grant operating privileges only with both. Licences transfer between provinces with paperwork and fees.
Things you don't need, but that help.
With so few jobs, most new grads add 1 to 2 fellowship years to stand out.
Heart transplant and mechanical support
Transplants and implanted heart pumps at a few centres.
Aortic surgery
Repairing the biggest artery in the body, often through a catheter.
Minimally invasive valve surgery
Replacing valves through small incisions or a catheter, the fastest growing area.
Congenital (children's) heart surgery
A tiny group of surgeons at children's hospitals.
Published research
Cardiac surgery programs expect it. Many residents do research years.
Electives at several cardiac programs
With 10 to 15 spots nationally, programs match people they know.
Calm under pressure
Bleeding from the heart does not wait for you to think.
Willingness to move
Your first job may be in any province, or the US.
Heart disease is a leading cause of death, but more and more of it is treated by cardiologists with stents and catheters instead of open surgery. That, plus the huge cost of a heart operating room and intensive care team, means centres add surgeons slowly. Expect to compete for every opening and to be flexible about where you live.
Day to day, pros and cons, where you'd work.
6:30 a.m. rounds in the cardiac ICU (intensive care unit). 7:30 first case in the operating room (OR): a triple bypass on a stopped heart, 4 to 5 hours, then often a valve replacement after lunch. Late afternoon is checking on the morning's patients and seeing tomorrow's. On call, a torn aorta or a failing bypass can mean going back in at midnight.
The good
The hard parts
Things people don't tell you.
In 1950, Toronto surgeon Wilfred Bigelow and his team built one of the first pacemakers while researching how to cool the body for heart surgery. His cooling technique made early open-heart operations possible.
For most operations a heart-lung machine takes over pumping and breathing, and the surgeon stops the heart with a cold potassium solution. It restarts when warm blood flows back, usually on its own.
Canada has only about 175 to 200 practising adult cardiac surgeons, spread across about 32 heart centres, according to the specialty's own workforce studies. That is fewer people than a large high school graduating class.
Dr. Pierre Grondin performed Canada's first heart transplant at the Montreal Heart Institute in May 1968, months after the world's first in South Africa.
Last checked September 2026. Pay figures are typical full-time annual amounts in Canadian dollars, based on Government of Canada Job Bank wage data and published salary grids. They vary by province, employer and experience. Tuition is for domestic students.