If when you get home at night, you wish you were still at work, do neurosurgery

Choosing between these two specialties shouldn't be too difficult if you remember that the only thing they have in common is spine surgery. In neurosurg, spine stuff will be about 75 to 80% of your work during your residency. Also, remember that your average neurosurg procedure will be around 4 hours long.

Neurosurg offers the big risk procedures where the rewards are often fewer and far between than the poor outcomes. If you're interested in NS, then you should really be into the brain at least to the point of accepting that you will be doing a lot of work on it for at least 6 or 7 years. Once you finish, yes, you can do all spine if you want (most do), but you will be doing craniotomies as part of your trauma call.

In ortho, your trauma work will consist of fixing broken legs and arms while during the day you focus on one part of the body if you want. At the end of the day, do you want to be doing brains during your trauma work or fixing bones during your trauma work? Spine is a big part of ortho depending on the institution. Also, if you do ortho spine, the focus is more on deformity correction while neurosurgeons tend to focus on decompression and tumor treatments.

Anyways, best of luck.