Vascular Surgeon

What vascular surgeons make

Job Bank's vascular 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). Vascular surgeons work mostly in hospital, so overhead is lower than a clinic-based doctor, and long operations and heavy call push billings up. Net is roughly $300,000 to $700,000. Varies by province.

During residency

Residents are paid employees. Expect 60 to 80 hour weeks, in-hospital call from year one, and medical school debt still on the books.

Gross versus net

Overhead for a hospital-based surgeon is roughly 15% to 25%: a small office, a secretary, malpractice fees and licence costs.

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) plus the Royal College vascular surgery exam

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

Malpractice fees once practising

Tens of thousands a year, partly reimbursed

Roughly, all in

$74,000 to $165,000

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 the Royal College vascular surgery exam. 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 the five or more years of training 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 sits outside the cost of qualifying.

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

What comes with the job

• No employer pension

  Most vascular surgeons are self-employed and save through a professional corporation.

• On-call stipends

  Hospitals pay extra for covering nights and weekends, and vascular call is among the heaviest.

• Malpractice coverage

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

• Academic salary option

  University hospitals often pay a fixed amount instead of per-case billing. Lower pay, more research and teaching.

The path

Every doctor's road, then one of the newest direct-entry surgical residencies 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. Vascular electives and reference letters decide the match.

4. 4

   Vascular surgery residency

   5 years, or 5 plus 2

   Direct entry from medical school through CaRMS (the residency matching service). The older route still exists too: 5 years of general surgery, then a 2-year vascular fellowship. Open operations, wire-and-stent repairs through the groin, ultrasound and imaging.

5. 5

   Royal College exam and licence

   End of residency

   Pass the Royal College exam to become FRCSC (Fellow of the Royal College of Surgeons of Canada). Register with your provincial College of Physicians and Surgeons. Some add a fellowship in complex aortic work.

High school courses that help

• Biology and chemistry

  Required for nearly every pre-med path.

• Physics

  Blood flow is fluid dynamics. Tested on the MCAT (medical school admission test) too.

• Calculus and functions

• English

  You will write, present and explain for the rest of your career.

Time and money, at a glance

Years after high school

11 to 15

Med school acceptance rate

Roughly 5% to 15%

Vascular residency spots

Very small. Only a handful of positions across Canada each year.

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 vascular surgery to work as one. Hospitals will not grant operating privileges without both. The credential is national, so moving provinces is paperwork and fees.

Skills that shape the practice

• Endovascular repair

  Fixing aneurysms and blockages from inside the vessel with wires, balloons and stents, guided by X-ray. Now most of the workload.

• Complex aortic surgery

  Big open operations on the body's main artery. Fewer surgeons do them every year.

• Limb salvage

  Bypasses and wound care to keep diabetic patients from losing a foot or a leg.

• Vein clinic work

  Varicose veins, often private-pay. Lighter hours, regular schedule.

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. Vascular call is relentless.

• Fine hand skills

  Sewing vessels a few millimetres wide, sometimes under magnification.

• French

  Opens Quebec, Ottawa and New Brunswick programs and jobs.

Call is the job

A ruptured aneurysm, a leg with no pulse, a stab wound to a major artery: these cannot wait for morning. Vascular surgeons at big hospitals take call one night in three or four for their whole career, and a call night can mean a 4-hour operation starting at midnight. Ask yourself early whether that is a life you want.

A typical day

7 a.m. rounds. First case: an aneurysm repair through two small groin punctures, watching the stent open on the X-ray screen. Then a leg bypass, several hours of stitching an artery a few millimetres wide. On clinic days, 20 patients with leg pain when they walk, foot wounds that will not heal, or a narrowed neck artery that could cause a stroke. On call, you might open a ruptured aneurysm at midnight with the patient's life measured in minutes.

The honest trade-offs

Work life

Typical hours

55 to 70 a week, plus heavy call

Remote work

None

Physical demand

High, hours standing, often in a lead apron

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.
• CardiologistThe heart doctor. Six years of residency after medical school, among the longest paths in medicine, and among the best paid.

A burst aneurysm is a race

An aortic aneurysm is a bulge in the body's main artery. When it bursts, most people do not survive, and the ones who do are the ones who reach a vascular surgeon fast. Screening catches many before they burst.

Many repairs need no big cut

A generation ago, fixing an aneurysm meant opening the abdomen. Now many are repaired through small punctures in the groin, threading a stent up the artery while watching on X-ray. Patients can go home in a day or two.

Diabetes keeps vascular surgeons busy

High blood sugar damages small arteries, especially in the feet. Vascular surgeons are the ones fighting to keep those feet on. Preventing an amputation is a routine week's work.

Stitches thinner than a hair

The sutures used to sew small arteries are finer than a human hair, and surgeons often work under magnifying loupes. A leak the size of a pinhole matters.