Whether you work in rural BC or a busy Ontario hospital, surgeons are some of the most in-demand professionals in Canada – and general surgeons are especially needed. The field of surgery as a whole is becoming increasingly specialized and the definition of what is a general surgeon is changing; disciplines that used to be part of general surgery (like obstetrics, otolaryngology, and urology) are no longer being practiced by most generalists, but although some of these more specialized subdisciplines have reported difficulty finding work in recent years, general surgeons have been consistently in demand. With an average gross salary of $466,000, general surgeon salary is among the highest in Canada.
So how much does a general surgeon make? General surgeon salary in Canada is dependant on a few variables:
1. The Kinds of Procedures you Bill
No matter where you work, under the fee for services model – which almost 75% of surgeons use, – you will be billing the government for each procedure you perform. Since each of these services – and each patient – will have different levels of complexity and time based on the circumstances, a lot of the variability in what you earn will come from the work that you do. This can even be impacted by where in the country you work; general surgeons in more rural or northern centres are likely to see a wider range of surgical procedures, such as gynecological, orthopedic, or ENT surgeries, while those in city centres or academic health sciences centres might be limited to one subspecialty.
Billing lengthier surgeries, consultations with patients (which require a referral) or seeing a more specialized patient group (like seniors, morbidly obese patients, or those with critical illnesses) could increase your earnings overall. So could working in a busy centre where you spend plenty of time on-call or come into the hospital for emergencies, which would allow you to take advantage of billing incentives like special visit premiums or trauma premiums.
Surgical procedures especially can have significant differences in billing rates depending on the complexity of what is being done. The removal of a tumour that is less than five centimetres will earn you much less than one that is twice the size. In many cases you’ll have little control over these kinds of payment differences – you will likely see the patient regardless of the size of the tumour – but as you progress in your career or near retirement, you might find yourself being called on for larger or more complicated procedures, which would give you the option to earn more. Assisting in surgeries, being the trauma team leader, or being the second surgeon on a team are also roles that have differences in pay and could change over the course of your career.
2. The Hours you Work
Although 25% of general surgeons in Canada report earning a blended income of both salary and fee for services billings, the vast majority of surgeons earn through the fee for services model alone. This can have consequences on how much you will earn. General surgeons report spending about 23% of their income on overhead costs – which are typically fixed – but the amount you bring in over and above this will depend on your hours. While surgery may have a reputation as a specialty with long hours and a poor work-life balance, many surgical residents report being happy with the flexibility of a general surgeon’s lifestyle and 76% of them report being satisfied with their professional life as a whole. Many roles will give you the option to work longer or shorter hours if you want more balance or a higher income.
Hours for general surgeons in Canada are relatively consistent at an average of 56.5 hours per week, one of the highest among all specialties, but this could vary considerably depending on the job – 93% of general surgeons have some on-call time during the month, and your age, community size, and stage of your career could all impact whether you have a longer or shorter workweek and your salary as a whole. Rural doctors report working longer hours with more responsibility, which could result in you earning more, but doctors in academic medicine or busy city centres could be involved in more specialized procedures or have other pursuits, such as research, that take up more of their time and impact their billing potential.
3. Your Location
Although the amounts you can bill for each procedure will be relatively similar across Canada, the place where you practice does make an impact on how much you’ll earn. According to the Royal College of Surgeons, general surgery is one of the most heterogeneous of all specializations, and your workday could change a lot depending on where you work and who you are working on – to the extent that some consideration has been made by the body about adding additional proficiencies to surgical training for doctors who work in certain areas. General surgeons in rural settings, for example, are eight times more likely to perform a cesarean section than doctors in city centres, where obstetrics specialists would be able to fill the role.
Differences across provinces exist as well – surgical specialists overall (including subspecialties like ophthalmology or cardiovascular surgery) earn a gross average of $489,000 in Ontario, whereas the same population in BC earn $487,000 – but these earnings are more consistent across the country than many other medical specialties. Although surgeons in Ontario do bill for slightly more, general surgeon salary in Ontario is more likely to be impacted by how much you work, the types of patients you see, your clinical setting and your community’s size and composition than any incentives or billing differences from working in the province itself.
4. Your Patient Community
Whether you’re in a busy city, an academic centre, or a rural hospital, it’s the type of patients you see that will give you the biggest differences in income. Billing incentives exist for patients who are over 75, who have specialized conditions (such as morbid obesity), or who come into the emergency department with trauma. Taking a role in an academic centre where you assist in more complicated procedures will look a lot different – both in terms of your workday and in billing – than a surgery position in a rural community.
As you progress in your career, you might find yourself taking on new surgical interests or working with different types of patients, which can impact how much you will earn. In addition to your duties in the operating room, you might also choose to take on different roles in your clinical practice – like department chair or chief of staff, which could potentially involve using your management skills or teaching other surgeons. This could earn you more in terms of salary or other incentives on top of your fee for service earnings.
Overall, the salary for general surgeons in Canada is steady and high; slight differences occur based on the province where you work, but overall, general surgeons are some of the most consistent earners in medical practice. This consistency – and the demand for general surgeons in virtually all medical practice settings – will allow you to shape your career around work that fulfills and motivates you. And with general surgery offering a plethora of practice options for both new and established doctors, there’s never been a better time to be a surgeon.