General Surgeon

What general surgeons make

The federal wage survey has no line for general surgeons. It files them under Surgeons, All Other, where the 2025 median is $414,010 a year and the bottom tenth sit near $78,000. Treat that middle figure as an estimate: it mixes several surgical specialties and counts only surgeons who are employees, not the ones who own part of a practice. AMN Healthcare (a national physician staffing company) puts average general surgeon pay in 2025 at $420,000 to $480,000.

What you earn while you train

Residents are salaried hospital employees, so it is real money. You are also carrying medical school debt and working the longest hours of your life. The figure moves with the cost of living in the city.

Once you are board certified

Rural hospitals and trauma programs add signing bonuses and loan repayment because they cannot recruit. Surgeons who finish a fellowship in vascular, colorectal or cancer surgery go higher again.

What it costs to get there

Bachelor's degree, public university, in state

Roughly $11,000 a year in tuition and fees

MCAT (Medical College Admission Test) and applications

About $350 for the test, then $1,000 to $3,000 applying to schools

Medical school, public and in state

Roughly $30,000 to $45,000 a year. Private schools cost more

USMLE (United States Medical Licensing Examination) steps

About $675 each for the first two steps, more for the third

Roughly, all in

$168,000 to $340,000

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

The low end is four years at an in state public university, then an in state public medical school at roughly $30,000 a year, plus the MCAT (Medical College Admission Test), applications and the licensing exam steps at about $675 each. The high end is a private medical school and full price tuition all the way through. The five years of surgical residency afterwards are a paid job, so they add nothing here. Most graduates owe well over $150,000 by the end, and the interest on that balance is not included in these numbers.

File the FAFSA (Free Application for Federal Student Aid) every year. Most medical students finish owing well over $150,000 in federal loans. Work for a nonprofit or government hospital afterwards and Public Service Loan Forgiveness can cancel the balance after 10 years of qualifying payments. Your residency years count toward those 10.

Benefits

• Malpractice insurance paid for you

  Employers almost always cover it, and buying it yourself is expensive.

• Public Service Loan Forgiveness

  Nonprofit and government hospitals qualify, and residency counts toward the 10 years of payments.

• Loan repayment for working rural

  Small hospitals and the National Health Service Corps pay cash toward your loans for a few years of service.

• Total job security

  Every hospital with an emergency department needs a general surgeon on call.

The path

The longest common route on this site. Thirteen years after high school before you operate on your own.

1. 1

   High school

   Grades 11 and 12

   Top grades in biology, chemistry, physics and math. Nothing here decides your future, but weak science makes the next step harder.

2. 2

   Bachelor's degree

   4 years

   Any major works as long as you finish the pre-medical science courses and hold a high GPA. Sit the MCAT (Medical College Admission Test) in your third year.

3. 3

   Medical school

   4 years

   Two years of classroom science, then two years of hospital rotations. You graduate as an MD (Doctor of Medicine) or a DO (Doctor of Osteopathic Medicine). Both can become surgeons.

4. 4

   General surgery residency

   5 years

   Matched through the NRMP (National Resident Matching Program). Five years of operating, night call and logged cases.

5. 5

   Board certification

   After residency

   Two exams from the American Board of Surgery: a written qualifying exam, then an oral certifying exam.

High school courses that help

• Biology and chemistry

  Required for nearly every pre-medical program.

• Physics

  Tested on the MCAT (Medical College Admission Test).

• Calculus or statistics

  Most medical schools want at least one math course.

• English and public speaking

  You explain frightening things to families for a living.

Time and money, at a glance

Years after high school

13, or 14 to 15 with a fellowship

Medical school admission

Under half of applicants get in anywhere

Total tuition

$120,000 to $250,000 before living costs

Paid while training?

Yes, from the first day of residency

Licensed by your state, certified by a national board

Every state runs its own medical board and issues its own license, so moving states means a new application. The national exam is the USMLE (United States Medical Licensing Examination), taken in three steps, and osteopathic students may sit the COMLEX (Comprehensive Osteopathic Medical Licensing Examination) instead. Board certification in general surgery is separate and comes from the American Board of Surgery. You get no more than seven academic years after residency ends to finish it.

Two different degrees, the same operating room

An MD (Doctor of Medicine) program and a DO (Doctor of Osteopathic Medicine) program both lead to surgical residencies, and since 2020 they share a single accreditation system. Osteopathic schools also teach hands-on manipulation of muscle and joint. Their graduates do match into surgery, just in smaller numbers, so the path is a little steeper.

Fellowships after residency

One or two more years that narrow what you operate on and usually raise what you are paid.

• Trauma and surgical critical care

  Emergency operating plus intensive care unit work. One to two years.

• Vascular surgery

  Arteries and veins. Two years, and among the better paid.

• Surgical oncology

  Cancer operations. Two years.

• Minimally invasive and bariatric surgery

  Keyhole and weight loss procedures. One year.

• Pediatric surgery

  Two years and one of the hardest fellowships to win.

Nice-to-haves before you apply

• Research and publications

  Surgery programs weigh them heavily when they rank applicants.

• Time inside an operating room

  Shadowing tells you fast whether standing for six hours suits you.

• Stamina and steady hands

  Long cases, no chair, no phone.

• A second language

  Spanish especially. You talk to frightened people all day.

The military will pay the tuition

The armed forces run the Health Professions Scholarship Program, which covers medical school tuition and pays a monthly stipend. In exchange you serve roughly one year for each year of support, usually four. You can still complete a general surgery residency, often in a military hospital. Your pay then follows the Department of Defense basic pay table for your rank and years of service instead of civilian surgeon rates, so you trade future income for a debt-free start.

A typical day

Rounds on your own patients around 6am, first case in the operating room by 7:30. A gallbladder takes under an hour, a bowel resection several. Between cases come clinic visits, consults from the emergency department and conversations with families. On trauma call the day has no shape at all and you may be operating at 3am. Dictation and paperwork fill every gap.

The honest trade-offs

Work life

Typical hours

55 to 70 a week, more during residency

Remote work

None

Physical demand

High, hours on your feet

Unionized

Rarely, though resident unions are growing

Similar paths

• Cardiac SurgeonOperate on hearts. The longest training on this site, and near the top of the pay scale.
• AnesthesiologistYou keep people alive and unaware while someone else operates. Twelve years of training, and among the highest pay in medicine.
• Emergency PhysicianYou take whatever comes through the door, in the order it arrives. Eleven years of training for a job measured in shifts.

The 80-hour week is a cap, not a goal

Residency programs accredited by the ACGME (Accreditation Council for Graduate Medical Education) may not schedule a resident for more than 80 hours a week, averaged over four weeks. The limit grew out of a patient death in a New York hospital in the 1980s, and plenty of surgeons argued against it.

An algorithm decides where you train

The NRMP (National Resident Matching Program) places graduating students into residency using a matching algorithm. The research behind it won the 2012 Nobel Prize in economic sciences. You rank programs, they rank you, the computer settles it.

The certification clock runs out

The American Board of Surgery gives you no more than seven academic years after training ends to pass both certification exams. The clock starts the day residency finishes, and one of the two exams is spoken, not written.

You are tested on cameras as well as scalpels

Before certification the American Board of Surgery expects training in flexible endoscopy, the camera-on-a-tube work used to look inside the gut. Modern general surgery is as much screens and keyhole tools as it is open cutting.