Pediatric Surgeon

What pediatric surgeons make

Job Bank's pediatric surgeon page pools all surgeons: a median of about $419,000 a year in gross billings, low $144,000, high $767,000. Gross is before overhead. CIHI (Canadian Institute for Health Information) puts the average gross payment for surgical specialists at about $556,000 (2023 to 2024). Nearly every pediatric surgeon in Canada works at a university children's hospital on a salaried or blended plan, so the spread is narrower and overhead is low. Roughly $280,000 to $550,000 net. Varies by province.

During residency

Residents are paid employees. The pediatric years come after a full general surgery residency, so you finish near the top of the resident pay grid, still carrying medical school debt.

Academic pay

Predictable income, protected time for teaching and research, and no office to run. The trade-off is less upside than a busy community surgeon.

What it costs to get there

Undergrad degree (3 to 4 years)

$7,000 to $10,000 a year

Medical school, the MD (doctor of medicine), 3 to 4 years

$15,000 to $28,000 a year

MCAT (medical school admission test), applications, interviews

$2,000 to $5,000

MCCQE (the national medical exam), then two Royal College exams: general surgery and pediatric surgery

$1,500 for the MCCQE, plus several thousand for each Royal College exam

Malpractice fees once practising

Tens of thousands a year, partly reimbursed

Roughly, all in

$79,000 to $175,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is three years of undergraduate study and a three year medical degree at cheaper Canadian schools, plus the MCAT (Medical College Admission Test), the MCCQE (Medical Council of Canada Qualifying Examination) and both Royal College exams, one in general surgery and one in pediatric surgery. The high end is four years of each at the most expensive schools with a longer application run. The seven or more years of residency and fellowship after medical school are paid, so they add fees and time but not tuition. Malpractice cover runs into tens of thousands a year once you are practising, which is a working cost rather than a cost of getting qualified.

Typical debt at the end of medical school is $80,000 to $150,000. Seven years of residency pay slows the bleeding but rarely pays it off.

What comes with the job

• Academic contract

  Protected research and teaching time. Some hospital-employed surgeons join a public pension plan.

• On-call stipends

  Hospitals pay extra for covering nights and weekends.

• Malpractice coverage

  Through the CMPA (Canadian Medical Protective Association). Provinces reimburse part of the fee.

• A full team around you

  Child life specialists, pediatric anesthesiologists and neonatal nurses. Nobody does this alone.

The path

Every doctor's road, a full surgical residency, then a second match into one of the smallest programs in Canada.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. You need a very high average for a science undergrad.

2. 2

   Bachelor's degree

   3 to 4 years

   Any major works. Keep a GPA (grade point average) above 3.8, volunteer, do research. Write the MCAT (medical school admission test).

3. 3

   Medical school, the MD (doctor of medicine)

   3 to 4 years

   Acceptance rates are 5% to 15%. Classes, then clinical rotations. Surgery and pediatrics electives earn the reference letters that decide the match.

4. 4

   General surgery residency

   5 years

   Matched through CaRMS (the residency matching service). Adult surgery: abdomen, breast, trauma, with in-hospital call from year one. Pediatric surgery rotations happen along the way.

5. 5

   Pediatric surgery subspecialty

   2 years

   A second match near the end of general surgery. Newborn surgery for birth defects, childhood cancer surgery, trauma, and the everyday: appendix, hernias, swallowed objects. Pass the Royal College exam to become FRCSC (Fellow of the Royal College of Surgeons of Canada), then register with your provincial College of Physicians and Surgeons.

High school courses that help

• Biology and chemistry

  Required for nearly every pre-med path.

• Calculus and functions

• Physics

  Tested on the MCAT (medical school admission test).

• English

  You will explain surgery to terrified parents and to 6-year-olds, in the same conversation.

Time and money, at a glance

Years after high school

13 to 15

Med school acceptance rate

Roughly 5% to 15%

Pediatric surgery training spots

Tiny. Only a few programs in Canada, and jobs are scarce.

Total tuition

$90,000 to $150,000

Paid while training?

Only from residency on

Heavily regulated

You need a licence from your provincial College of Physicians and Surgeons to practise, and Royal College certification in pediatric surgery to work as one. Children's hospitals will not grant operating privileges without both. The credential is national, so moving provinces is paperwork and fees, but there are only a few children's hospitals to move between.

Ways to shape the practice

• Neonatal surgery

  Operating on babies born days or hours earlier, some weighing under a kilogram.

• Pediatric surgical oncology

  Removing childhood tumours of the kidney, liver and adrenal gland.

• Trauma

  Injured children at the big trauma centres.

• Research

  Rare conditions mean every centre shares data. Academic pediatric surgeons lead the studies.

Nice-to-haves

• Time with kids

  Camps, coaching, hospital volunteering. Being at ease with a scared 4-year-old is a skill.

• Surgery electives and research in med school

  The match is decided by letters from surgeons who watched you work.

• Patience with parents

  You treat the child, but you manage the whole family.

• French

  Opens Quebec, Ottawa and New Brunswick programs and jobs.

Where the jobs are

Pediatric surgeons work at children's hospitals, and Canada has only a small number of them, all in big cities. A new graduate may wait for a job to open or take a position far from home. Some spend a year or two abroad in a fellowship while a Canadian post appears. Plan for that before you commit.

A typical day

7 a.m. rounds in the neonatal intensive care unit and the surgical ward. First case: a hernia repair on a toddler, 45 minutes. Then a newborn whose bowel did not form properly, a delicate 3-hour operation with an anesthesiologist who specializes in babies. Afternoon clinic: kids with lumps, undescended testicles, chest wall shapes, and parents with a lot of questions. On call about one night in four; appendicitis and swallowed batteries do not wait.

The honest trade-offs

Work life

Typical hours

55 to 70 a week, plus call

Remote work

None

Physical demand

High, hours on your feet, often under magnification

Unionized

Residents yes, staff surgeons no

Similar paths

• General SurgeonOperate on the abdomen, breast, skin and trauma cases. About 13 years of training for one of the broadest jobs in medicine.
• PediatricianA doctor for babies, children and teens. Four years of residency after medical school, then a job that never runs short of patients.
• NeurosurgeonOperate on the brain, spine and nerves. The longest surgical training in Canada, one of the highest paid, and one of the smallest job markets.

Kids are not small adults

A newborn's blood volume is about a cup. Drug doses, fluid, anesthesia and even the size of the stitches all change with age and weight. That is the whole reason pediatric surgery is its own specialty.

Some patients are hours old

Babies born with the intestine outside the body, or with a blocked esophagus, go to the operating room within their first day of life. Many are diagnosed on ultrasound before birth, so the surgeon is waiting when the baby arrives.

Button batteries are an emergency

A swallowed coin battery stuck in the esophagus can burn through the wall in a couple of hours. Pediatric surgeons and their emergency colleagues treat it as a race, not a wait-and-see.

Hernias are the bread and butter

Repairing an inguinal hernia, a bulge in the groin, is one of the most common operations in children. A pediatric surgeon may do hundreds in a career, most taking under an hour.