Thoracic Surgeon

What thoracic surgeons make

Job Bank's thoracic 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). Most thoracic surgeons work at teaching hospitals, often on a blended or salaried plan, so the spread is narrower than in community surgery. Net is roughly $300,000 to $600,000. Varies by province.

During residency

Residents are paid employees. The thoracic years come after a full general surgery residency, so by the end you are a senior resident on the top of the pay grid, still carrying medical school debt.

Gross versus net

Hospital-based, so overhead is low, roughly 15% to 25%. Academic contracts trade some income for protected research and teaching time.

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 thoracic 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

$74,000 to $169,000

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

The low end is a three year undergraduate degree at a cheaper university, a three year medical school at the lowest domestic tuition, and the exam fees: the MCAT (medical school admission test), the MCCQE (the national medical exam), and two Royal College certification exams. The high end is a four year degree, a four year medical school at 28,000 a year, and the same exams at their upper fees. Residency is paid work, so those years add no tuition, but most finish medical school owing 80,000 to 150,000. Malpractice coverage costs tens of thousands a year once you practise and is partly reimbursed, so it is a working cost rather than a cost of qualifying.

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

What comes with the job

• Academic salary option

  Nearly all thoracic jobs are at university hospitals. Many pay a fixed amount instead of per-case billing.

• 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.

• No employer pension

  Unless you are a hospital employee, you save through a professional corporation.

The path

Every doctor's road, a full surgical residency, then a second match into a tiny subspecialty.

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 electives earn the reference letters that decide the match.

4. 4

   General surgery residency

   5 years

   Matched through CaRMS (the residency matching service). Abdomen, breast, trauma, and in-hospital call from year one. Cardiac surgery is the other door into thoracic.

5. 5

   Thoracic surgery subspecialty

   2 to 3 years

   A second match near the end of general surgery. Lung cancer resections, esophagus surgery, keyhole and robotic chest surgery, airway work, chest trauma. 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). Breathing is pressure and volume.

• English

  You will deliver cancer diagnoses and explain big operations for a living.

Time and money, at a glance

Years after high school

13 to 16

Med school acceptance rate

Roughly 5% to 15%

Thoracic training spots

Very small. Only a few programs in Canada.

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 thoracic surgery to work as one. Hospitals will not grant operating privileges without both. The credential is national, so moving provinces is paperwork and fees. Jobs, though, exist only at a few dozen hospitals.

Ways to shape the practice

• Minimally invasive lung surgery

  Removing part of a lung through small ports with a camera, or with a robot. Now the standard at big centres.

• Esophageal surgery

  Cancer and severe swallowing disorders. Long, technically hard operations.

• Lung transplant

  Only a few centres in Canada do it. Extra fellowship training and a lot of nights.

• Research and trials

  Screening programs and new surgical approaches. Academic thoracic surgeons lead them.

Nice-to-haves

• Surgery electives and research in med school

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

• Stamina

  Sports, shift work, anything that proves you can function tired.

• Fine hand skills

  Instruments, sewing, drawing. Sewing an esophagus back together is delicate.

• French

  Opens Quebec, Ottawa and New Brunswick programs and jobs.

Hospital-based, not office-based

Thoracic surgeons rarely run a private clinic. You work where the operating rooms, intensive care and cancer centre are: a teaching hospital in a big city. That means academic colleagues, residents to teach, and research expectations, but also that your job options are a short list of cities.

A typical day

7 a.m. rounds on the thoracic ward and the intensive care unit. First case: a lung cancer removed through three small ports with a camera, about 2 hours. Second: a lung biopsy. On a big day, an esophagus cancer operation that runs 6 hours or more. Clinic another day: 20 to 30 patients with nodules on a scan, cancer results, swallowing problems, or a chest wall deformity. On call about one night in four; chest trauma and blocked airways come in at any hour.

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

Unionized

Residents yes, staff surgeons no

Similar paths

• Cardiac SurgeonOperate on the heart: bypasses, valves, transplants. Six years of residency, very high pay, and one of the tightest job markets in Canadian medicine.
• General SurgeonOperate on the abdomen, breast, skin and trauma cases. About 13 years of training for one of the broadest jobs in medicine.
• OncologistThe cancer doctor. Long training, mostly salaried jobs in cancer centres, and patients who will remember you for the rest of their lives.

Lung cancer kills more Canadians than any other cancer

The Canadian Cancer Society expects about 32,900 new lung cancer cases and 19,300 deaths in Canada in 2026, roughly 22% of all cancer deaths. Surgery is the best chance of cure when it is found early, which is why screening programs matter to thoracic surgeons.

The first lung transplant that worked was done in Toronto

In 1983 a team at Toronto General Hospital performed the first lung transplant where the patient lived for years afterward. Canada has been a leader in lung transplant ever since.

You can live with one lung

Removing an entire lung, called a pneumonectomy, is a real operation for some cancers. The remaining lung takes over, and many patients return to normal daily life.

Most lung operations are now keyhole

VATS (video-assisted thoracoscopic surgery) uses a camera and a few small cuts between the ribs instead of a large incision. Less pain, shorter hospital stays, and patients home in a few days.