To everything there is a season and a time to every purpose: retirement and the neurosurgeon

Neurosurgery has designed a rigid curriculum that must be followed precisely by those who wish to enter the specialty. A similar process at the other end of the practice cycle has never been formalized except for mandatory retirement from certain administrative positions at a particular age. Basic considerations for strategic decision making about voluntary retirement from neurosurgery, especially operative neurosurgery, are investigated. Statistical data from the US Census Bureau and sources in the medical literature were reviewed regarding life expectancy and retirement ages. Age-related differences in verbal and performance intelligence quotients, attention span, verbal memory recall, and visuospatial facility were surveyed. A questionnaire was sent to 29 recently retired academic neurosurgeons about their age and reasons for retirement along with postretirement activities; 22 responses were received. Analysis of the data indicates that surgeons are now retiring at the age of approximately 60 years, whereas life expectancy is approximately 80 years. An individual thus may have 15 to 20 productive years after leaving active neurosurgical practice. Reasons for retirement among the 22 responding neurosurgeons included decreasing personal satisfaction and financial rewards, a desire to pursue other activities, local ground rules mandating age-specific retirement, the general sense that enough is enough, and, overall, a strong desire to stop performing surgery while at the top of one's game. The process of age-related competence assessment of commercial airline pilots is outlined, and a similar process of assessment of practicing surgeons may be warranted, with consideration for mandatory retirement from operative neurosurgery.