Thoracic Surgeon

What chest surgeons make

There is no separate federal wage line for thoracic surgeons. They sit inside a residual group called Surgeons, All Other, where the bottom tenth are near $78,000 and the published median is $414,010 a year. Treat that middle figure as an estimate for this job rather than a measurement of it. A widely cited 2024 physician pay report from Doximity put average annual pay for thoracic surgery at $720,634, the second highest of any specialty, which is where the top of this range comes from. Government wage surveys count employed doctors only, so surgeons who are partners in their own group are missing from the data entirely.

While you are training

You are paid for every year after medical school, which is the good news. The bad news is that there are seven or eight of those years, on long weeks, while your medical school loans keep growing.

One of the highest paid specialties

Pay tracks operating volume and the kind of cases you take. Complex lung and esophageal cancer work, transplant programs and private group partnership sit at the top. Academic surgeons at university hospitals generally earn less and teach and research instead.

What it costs to get there

Bachelor's degree, in-state public university

Roughly $11,000 to $16,000 a year in tuition and fees

The MCAT (medical school admission test) and applications

Well over $1,000 once you count the test, the application service and interview travel

Medical school

Roughly $30,000 to $45,000 a year in-state public, considerably more at private schools

Licensing examinations

The three steps of the United States Medical Licensing Examination cost several hundred to over a thousand dollars each

Board certification

A written examination and an oral examination after training, each with its own fee

Roughly, all in

$170,000 to $320,000

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

Four years of undergraduate tuition plus four years of medical school, at in-state public rates, with exams and applications on top. The low end assumes in-state public the whole way; the high end is a private medical school. Residency and fellowship are the following seven or more years, and those are paid jobs rather than tuition, which is why they add nothing here. Interest accumulating across that time is not counted either, and it is substantial.

Medical graduates commonly leave with well into six figures of debt. Fill in the FAFSA (Free Application for Federal Student Aid) every year. If you train and then work at a nonprofit hospital, Public Service Loan Forgiveness can wipe out a remaining federal balance after 10 years of qualifying payments, and residency years count toward those payments.

Benefits

• Full benefits from residency onward

  Health insurance, retirement contributions and paid leave start while you are still training.

• Malpractice insurance paid

  Hospitals cover it. In this specialty the premiums are large, so this matters.

• Public Service Loan Forgiveness

  Most residency programs and many hospitals are nonprofit employers, so those years count toward the 10 years of qualifying payments.

• Signing bonuses and loan repayment

  Hospitals outside big cities often offer both to attract chest surgeons, because there are not many.

The path

Fourteen to sixteen years after high school. There is no short version of this one.

1. 1

   Bachelor's degree

   4 years

   Any major, but you must complete the science prerequisites: biology, chemistry, organic chemistry, physics and math.

2. 2

   The MCAT (medical school admission test) and applications

   A year of preparation and applying

   Run by the Association of American Medical Colleges, which also runs the shared application service. About 95,000 people sit the test each year.

3. 3

   Medical school

   4 years

   Two years of science, two years of clinical rotations. You take the first two steps of the United States Medical Licensing Examination along the way.

4. 4

   Surgical training

   6 to 8 years

   Either a general surgery residency followed by a thoracic surgery fellowship, or an integrated thoracic surgery residency entered straight from medical school. Programs are accredited by the Accreditation Council for Graduate Medical Education.

5. 5

   Board certification

   After training

   The American Board of Thoracic Surgery runs a written examination and then an oral examination, held in Dallas, Texas, before it will certify you.

High school courses that help

• Biology

  The foundation of everything that follows. Take the hardest version your school offers.

• Chemistry

  Organic chemistry in college is the course that removes the most people from this path. Start strong.

• Physics

  Pressure, flow and mechanics turn up constantly in chest and heart physiology.

• Math through calculus

  Required by most medical school prerequisite lists.

• Anything that builds steady hands

  Music, model building, sport. Nobody will ask about it, but the dexterity is real.

Time and money, at a glance

Years after high school

14 to 16

Admission

Extremely competitive at every stage, from medical school to the training match

Total tuition

Roughly $160,000 to $300,000, much more at private schools

Paid while training?

Yes, from the first year after medical school, but at a resident's salary

Licensed by a state, certified by a board

Two different things have to happen. Your license to practice medicine comes from a state medical board, and it rests on passing all three steps of the United States Medical Licensing Examination. Board certification in thoracic surgery is separate and voluntary in law, but in practice no hospital will let you operate without it. That comes from the American Board of Thoracic Surgery, an independent nonprofit founded in 1948, and it is not permanent: the board runs continuing certification with either a 10 year cycle or a 5 year milestone examination, so you keep being tested for your whole career.

What the specialty actually covers

• General thoracic

  Lungs, esophagus, airway, chest wall and the space between the lungs. A large share of it is cancer surgery.

• Cardiac

  Heart and great vessels. Many surgeons train in both and the boards cover the whole chest.

• Lung transplant

  A further fellowship on top, done at a small number of centers.

• Minimally invasive and robotic

  Much chest surgery is now done through small incisions with a camera or a robotic system rather than by opening the chest.

Further training that changes your career

• Lung transplantation

  An extra fellowship, and it ties you to a major transplant center for the rest of your working life.

• Esophageal surgery

  A recognized sub-focus with its own complex cancer operations and a small number of high volume surgeons.

• Robotic surgery

  Formal training on a robotic platform. Increasingly expected rather than optional in new hires.

• Research years

  Two years in a laboratory during training is common at academic programs and is close to required for a university job later.

Nice-to-haves

• Genuine physical stamina

  Operations lasting six hours and longer are normal. You stand for all of them.

• The ability to talk about death

  You will tell families that an operation did not work. Nobody is born able to do this well.

• A partner who understands the hours

  Surgeons say this more often than anything else on this list.

• Comfort with being watched

  Everything you do in the operating room is observed, recorded and audited.

Be honest with yourself about the length

This is fourteen to sixteen years from leaving high school, and most of the later ones are spent working 60 to 80 hours a week for a resident's salary while the debt sits there. People leave surgical training in their late twenties and start over. That is not a failure, it is information, and it is far better learned early. Spend time in an operating room before you commit, through shadowing, hospital volunteering or a job as a surgical technologist, and be sure it is the room you want rather than the title.

A typical day

In before six to see the patients you operated on yesterday, most of them in the intensive care unit with chest tubes and monitors. First case starts at seven thirty: perhaps removing a lung lobe for cancer, three or four hours through small incisions with a camera. A break, then a second case. Afternoon is clinic, where you meet the people you will operate on next month and explain honestly what the operation can and cannot do. Evening rounds, notes, and then the phone, because chest injuries and bleeding do not keep office hours.

The honest trade-offs

Work life

Typical hours

60 to 70 a week in practice, more in training

Remote work

None

Physical demand

High: long hours standing, precise hand work

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.
• General SurgeonThirteen years of training to become the person who opens someone up and fixes the problem.
• Vascular SurgeonRepair the arteries and veins that keep people alive. Among the longest training and highest pay in medicine.

The pay figure has to be estimated

The federal wage survey does not publish a separate line for thoracic surgeons. They are folded into Surgeons, All Other, and for years the top of that group was not published at all because the numbers were too high to report. Every figure you see for this job is an estimate built from that group or from private pay surveys.

There is an oral exam, and you travel for it

The American Board of Thoracic Surgery certifies in two parts: a written examination and then an oral examination held in Dallas, Texas, where you are questioned on real cases in front of examiners.

Certification does not end

The board runs continuing certification for the whole of your career, either on a 10 year cycle or through a 5 year milestone examination. Surgeons who stop taking part stop being board certified.

Most chest surgery no longer opens the chest

Much lung surgery is now done through a few small incisions using a camera or a robotic system. Recovery is far faster than the older approach of spreading the ribs, and learning the technique is now part of training rather than an extra.