How does a doctor level up?


I’ve been watching a lot of medical documentaries and they use words like “top neurosurgeon” and “top doctor,” and I always wonder how does a doctor or surgeon achieve that status? Is it anything like the corporate ladder?

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They keep specializing in their field; through education, practice, research work etc. Some get additional qualifications, on top of the specializations they started with; some engage in particular research in their field that yields new knowledge, some work part/full time in academia

There are positions like Head of Neurosurgery Dept., Chief of Surgery, etc. Also, it could be a prestige/status based on skill/outcome, discovery of new techniques, etc. vs. an org chart title… like if you’re the orthopedic surgeon MLB pitchers come to for Tommy John surgery vs. the guy who repairs random people’s knee at some community hospital.

There isn’t really a strict definition of “top neurosurgeon” or anything like that, so it’s mostly marketing. That said here is how being a doctor and “leveling up” works, at least in the USA.

First a person goes to college for four years to get a bachelors degree. Then that person would take a test called the Medical College Admission Test, or MCAT. If they do well and have good grades then they get admitted to medical school.

When a person goes to medical school they spend the first two years in a classroom. After that they spend most of the next two years in clinical settings, usually related to things they may want to go into, for example working with doctors in an ER. Once that person graduates they have a medical degree and are a doctor, though to practice they have to take tests called “boards.”

After a person graduates from medical school they are what is known as an “intern,” usually for one or two years. After internship you become a resident for anywhere from 2 to 8 years based upon your specialty. Then a doctor may pursue specialized training or research known as a “fellowship,” for some years before, hopefully, becoming an attending physician, which are generally the top of the totem pole. They do have people above them like department heads, but it’s generally intern, resident, fellow, attending.

In documentaries, if the journalists behind them are worth their salt, they typically mean, “top neurosurgeon” as in, “this person is recognized in this community as a reliable and trustworthy doctor because their patients have consistently good outcomes.”

But you may see in magazines those silly “Top Doctors” or “Best Doctors” lists. Be aware those are a total scam. The docs on those lists [literally pay to be on them, and they are not required to offer any real proof that they actually produce good patient outcomes](

Anyone may challenge the number 2 doctor in any field for his/her headband in a duel to the death. Only the number two doctor in any field may challenge the number one doctor in that field for their headband in a duel.