Busy CT Surg fellow here. Have any questions? Ask away!

[Buzz Me]

Is there a light at the end of the tunnel hours/workload wise, or do most attendings continue to push 80 hrs/wk once residency/fellowship is over? I realize that this is probably highly variable, but some surgical specialties (nsurg) seem to be more known for extreme hours even after training is finished.

Read my previous posts - most attendings work far less than 80 hours a week (more like 50-60), sometimes a little more if there are takebacks or emergency cases at night/on the weekends, sometimes less if they're not on call that week.

Also realize fellows don't work only 80 hours a week.

What do you think of Emergency Medicine? Do you honestly believe ER docs are inferior compared to surgeons?

Winged Scapula answered this question well. We don't "compare" one field to another, and certainly not in the way that pre-meds want to (e.g. "which specialty is the best?", or "how would you rank the different specialties?"). EM and CT Surg are two completely different fields with different training, environments, approachs to medicine and philosophies.

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[Buzz Me]

1] You know, I've always wanted to do surgery, in particular CT/transplant. Because of my life situation, I've had to delay med school... I've already wasted three years of my life, although I'm highly qualified. I want to have a family, and have been thinking IM might be something better for that... I come from humble beginnings (unfortunately, I'm still in my beginnings); money shouldn't play a role in choosing a specialty, but the older I get, the harder it seems that surgery is a possibility (other than gen). Do you have any words of advice? (Apart from the do what you love, because the older I get, the more sacrifices I have to make)

2] Any procedure that you hate? Feel like a drag?

3] Any specialties come close to CT?

4] Can you comment on your experiences with a transplant (heart and/or lung)? What you liked, what you didn't, that feeling when the lifeless organ flushes pink...

(1) Where are you in your training? As you go through your rotations just keep an open mind and see what you like. It's often difficult for me to explain my decision making because I love CT Surg so much. I enjoyed IM/Cardiology OK (in med school, though the endless rounds just about killed me) and I did fine in Gen Surg residency but knew I didn't like anything as much as CT Surg. For me, doing what I love was worth putting up with miserable hours, malignant attendings, bad lifestyle, and the like.

(2) TAVR, or transcatheter aortic valve replacements, are just brutally painful because we just stand around watching Cardiology do the case. All we do is open the groin, expose the vessels, stand for a while wearing lead while getting irradiated, then fix the femoral artery and close up the groin when they're done. [Then we take care of the patient post-op, deal with their heart block, etc., but that's a rant for another time.]

(3) Nope. How could they? What other field operates on the heart and lungs?!

(4) Technically, the cases are cool. Putting a patient on bypass, taking out their heart/lungs, putting in new ones, doing the anastomoses and then coming off bypass...what else could compare to that?! Certainly not the liver, kidney, pancreas, etc. (all of which I've helped do in residency). But going on late-night procurements, dealing with these patients post-op (social and medical nightmares), dealing with the inevitable rejection...that can be very painful.

Sorry if this has already been answered, but when you say you work 100 hours a week does this include break times, time to do paperwork, or time to eat ? Or is it just pure work for 100 hours?

Depends. Some days, you'll have 30-60 minutes downtime here and there - before/between/after cases, etc. Other days you're running around nonstop from 5 am until 10 pm with barely enough time to sit or use the bathroom. Or you can be in the OR all day, or at the bedside in the ICU taking care of sick-as-hell patients.

 

[iforget2]

Thanks for the response! 2nd question, though. As a surgeon, if you hypothetically injured your finger playing a sport and the injury caused you to not be able to perform at your best, what would happen? Would you just kind of "sit out"?

 

[Buzz Me]

Thanks for the response! 2nd question, though. As a surgeon, if you hypothetically injured your finger playing a sport and the injury caused you to not be able to perform at your best, what would happen? Would you just kind of "sit out"?

We all worry about injuries. For the most part, people are lucky - my cofellows (and coresidents back when I was in residency) still lifted weights, played ball, went rockclimbing, etc. - and didn't get hurt. One resident broke his arm playing sports and was in a sling for a few weeks and he just transferred to a more clinic/outpatient-based schedule while he healed. It's a big deal, though, and certainly not as simple to deal with as if you were on a less procedure-based field, such as Medicine or Psych.

You'll find that in surgical programs, which tend to be smaller than the other fields, it's not always so easy to just pull a resident and have everyone else cover his/her work.

 

[Buzz Me]

Nurses.... SHAKE MY HEAD

Careful with that!

 

[GandalfTheWhite]

How old were you when you started medical school and how old will you be by the time you are an attending physician?

 

[badasshairday]

Do you see CT-surgeons entering the endovascular arena, a la vascular surgery?

 

[Untraditional]

Jonah Odim, any thoughts as a soon-to-be attending?

 

[Winged Scapula]

Do you see CT-surgeons entering the endovascular arena, a la vascular surgery?

I believe he already mentioned TAVR and Evalve but yes this is been going on for quite some time.

 

[nimbooda]

Have you run across anyone in your Gen Surg or CT Fellowship that was a non-traditional student? I'm 31 and starting medical school this fall and therefore will be 35 when I graduate. Since committing to a medical career later in life, I've been fascinated with surgery, particularly CT. My research mentor and a vast majority of my shadowing experience has been with the Chariman of CT surgery and I love everything about the cases, physiology, and scope of CT.

That said, lifestyle and length of training issues might be legit concerns for me.

1) A 6-year integrated program would put me at 41 years old. Is saving a couple years at that age worth gunning for one of these out of the gate?

2) I'll probably get married during year 2 of medical school. Would an "older" married guy like me have the energy to survive residency?

3) How long do CT surgeons typically operate? Into their mid-60's or 70's?

I know I have a lot of time to explore all areas of medicine in school, but CT is my biggest interest right now and it couldn't hurt to know these things when I start! Thank you.

 

[Buzz Me]

How old were you when you started medical school and how old will you be by the time you are an attending physician?

26 and 37.

Do you see CT-surgeons entering the endovascular arena, a la vascular surgery?

Gradually. This is more for TEVARs (especially with the hybrid debranching cases) and transcatheter valves (which can also be transapical, which Vascular obviously can't do).

Have you run across anyone in your Gen Surg or CT Fellowship that was a non-traditional student? I'm 31 and starting medical school this fall and therefore will be 35 when I graduate. Since committing to a medical career later in life, I've been fascinated with surgery, particularly CT. My research mentor and a vast majority of my shadowing experience has been with the Chariman of CT surgery and I love everything about the cases, physiology, and scope of CT.

That said, lifestyle and length of training issues might be legit concerns for me.

1) A 6-year integrated program would put me at 41 years old. Is saving a couple years at that age worth gunning for one of these out of the gate?

2) I'll probably get married during year 2 of medical school. Would an "older" married guy like me have the energy to survive residency?

3) How long do CT surgeons typically operate? Into their mid-60's or 70's?

I know I have a lot of time to explore all areas of medicine in school, but CT is my biggest interest right now and it couldn't hurt to know these things when I start! Thank you.

You do realize, at 31, you're only 5 years older than the average starting M1, right? So you're at no disadvantage there.

There are lots of people who didn't go "straight through" - either they did research before med school, or during residency, or a PhD somewhere along the way. There are those who didn't fly through college in 4 years. Those who had previous jobs - business, engineering, finance, just to name a few people that I personally know - before committing to medicine.

Sad to say, the fear about being a "nontraditional applicant" is only a pressing concern among the pre-meds. Once you're in med school and beyond, no one cares.

Most CT surgeons - especially in cardiac - tend to operate into their late 60s/early 70s. It's amazing.

 

[GandalfTheWhite]

thanks.

How much were you paid as a resident? and as a fellow?

Im interested in CT Surg but I have a little brother to take care of so the length it takes to become one of concern.

 

[Buzz Me]

thanks.

How much were you paid as a resident? and as a fellow?

Im interested in CT Surg but I have a little brother to take care of so the length it takes to become one of concern.

Depends on which program you go to, and where's it's located in the country. Nowadays residents in Gen Surg make around $40-60k, and fellows around $70-90k.

 

[GandalfTheWhite]

Depends on which program you go to, and where's it's located in the country. Nowadays residents in Gen Surg make around $40-60k, and fellows around $70-90k.

if its on the upper end (60k ->90k) then its doable for me.
Unfortunately I think Texas is on the lower end of that income level spectrum

 

[dynx]

(3) Interventional cardiologists are starting to get into the Medtronic CoreValve (still in trials) and Edwards Sapien transfemoral/transapical aortic valve stents. But these hybrid cases still need a cardiac surgeon in the room (you're not just "backing them up").

Just to clarify how this is working out as I've seen it at 3 different institutions.
CT surgery is getting the most from these perc valves for very simple reasons:

1. they HAVE to be turned down by surgery first for a standard valve replacment. that means:
a. lots of referals for perc valves that dont meet criteria that you then get to operate on
b. CT surgery input and ownership of a patient rather than cards just pulling the old cath lab move without you ever seeing them like they do with a "lot" of patients getting stents that should be getting CABG.

2. CT surg deals with the complications, that means CT surg runs the valve deployment. I have a hard time imagining its to different at other institutions unless you have an old guy CT surgeon not interested in the new-fangled catheter things. We, as a profession, need to keep the old dudes out of the room and stick together so the guy who "plays nice" with the perc valves doesnt get a referral advantage over the guy that stands up and takes control.
A CT surgeon is not giving up control when he's in the room and he has to deal with a bad outcome in the OR with a high risk patient.
What i've seen cards do is float the pacer in and run the pigtail cath, and thats perfectly fine with me.

3. Cards isn't going to do a trans apical. If anyone has seen them do so at their institution please let me know.

 

[dynx]

(2) TAVR, or transcatheter aortic valve replacements, are just brutally painful because we just stand around watching Cardiology do the case. All we do is open the groin, expose the vessels, stand for a while wearing lead while getting irradiated, then fix the femoral artery and close up the groin when they're done. [Then we take care of the patient post-op, deal with their heart block, etc., but that's a rant for another time.]

I just vomited a little in my mouth. Will we never learn? Let me guess...the dude at the end of his career is the CT surgery attending in these cases?

 

[Buzz Me]

I just vomited a little in my mouth. Will we never learn? Let me guess...the dude at the end of his career is the CT surgery attending in these cases?

Strangely enough, no, it's a middle-aged guy. We do the groin cutdowns for the transfemorals...and obviously either the mini-thoracotomy or mini-sternotomy w/ ascending aortic exposure for the transapicals.

 

[Dan Plainview]

Here's one from a PGY-1:

What is life like for the private practice guys? How many cases a day? Do they often have first assistants/PA's for vein harvest or sternotomy closure? Can you do just cardiac or do you do some thoracic/esophagus to pay the bills?

Also, for fellowship matching purposes, how many interviews is a good number?

Thanks!

 

[Cardiothoracic]

Thank you for starting this thread Buzz Me. I find it very informative. It helped clear up quite a bit of confusion for me. I'll take the opportunity and ask a couple of questions of my own.

1. I'm always hearing that CT surgery isn't very flexible. To what extent is this true? Would I be able to work 10-14 hour days with weekends off, or every other weekend off (no on-call)?

2. If somehow you weren't able to go into CT surgery, what other specialty would you choose?

 

[Buzz Me]

Here's one from a PGY-1:

What is life like for the private practice guys? How many cases a day? Do they often have first assistants/PA's for vein harvest or sternotomy closure? Can you do just cardiac or do you do some thoracic/esophagus to pay the bills?

Also, for fellowship matching purposes, how many interviews is a good number?

Thanks!

From what I've seen here, they do 1-2 cases each operating day, and do 1-2 days of clinic a week. All have midlevels (PAs/NPs) help first assist...which means open the chest (to varying degrees), harvest vein (often endoscopically), and later help close. Some midlevels (or First Assists) actually take down mammaries as well.

Private practice guys tend to do a little of both...though usually they favor one field over the other. The guys doing Ivor Lewis esophagectomies aren't doing a whole lot of CABGs.

For interviews...depends on where in the country you want to go. It's not a competitive field as a whole (always more spots than applicants), but many programs aren't that desirable. So the competitive programs are much more heavily sought after. From the interview trail, it seemed most competitive applicants interviewed at 8-12 spots.

 

[Buzz Me]

Thank you for starting this thread Buzz Me. I find it very informative. It helped clear up quite a bit of confusion for me. I'll take the opportunity and ask a couple of questions of my own.

1. I'm always hearing that CT surgery isn't very flexible. To what extent is this true? Would I be able to work 10-14 hour days with weekends off, or every other weekend off (no on-call)?

2. If somehow you weren't able to go into CT surgery, what other specialty would you choose?

(1) It's certainly possible to work 12-hour days even on your busy operative days - see my earlier posts. Your weekend call duties depend on whether you're in private practice or academics, and how many people share the call duties with you. The most junior guys obviously also take more call.

(2) There's nothing else in medicine I love as much as CT Surg. Many other fields seem tolerable, but only just barely. I don't have the personality where I can look at x-rays and CT scans all day, or deal with the strange environment of the ER, or round all day in the ICU, or only deal with kids, etc. Outside of medicine, I guess I'd be a teacher (professor?).

 

[jwhitebc22]

I think I have read the vast majority of the information available on the different I6 program's website, blogs, etc.... With that said, I do not have a lot of very specific questions other than I would love to hear your thoughts on CT surgery, CT fellowship, and I6 VS. 5+2.

The only specific question I have is, how are the fellowship opportunities after the I6 VS. the 5+2? If one wants to do congenital CT, is either route preferred by the various fellowship programs?
Thanks a lot for doing this.

"A year or so ago I ran across an article that mentioned an alternate route to CT surgery being: 5 year vascular integrated + 2 year CT fellowship. Here recently I searched for that pathway track, but I am coming up empty. Does such an option an exist? Is this a path that any take if it does exist? Is it feasible, frowned upon, etc...? Or am I mixing this up? I ask because I have read people talk about how it might be an advantage for a CT surgeon to have some wire skills in the future. With job market fluctuations, new procedures, PP patient base, etc... I don't think it is a bad idea for me to research the various options, especially as I am not in the position of having to choose my exact path at this exact moment. This question applies to not only Buzz Me but anyone who has the answer."

http://www.sts.org/sites/default/files/documents/pdf/BecomeACTsurgeon.pdf

Here is the article I was referring to earlier in the thread. Took my a while to find the original source. Second page, fourth paragraph discusses the vascular plus CT route very briefly. Even after reading this a second time, I have yet to hear of anyone going this route. I know Columbia has a route to interventional cards after CT training, or something very similar. Buzz Me or anyone heard anything about this? I am going to copy and paste the section I am referring to in case no one wants to go to the site. As always, thanks for any responses. I quoted the wrong post from earlier. I edited the post and copied my quote I was originally trying to cite. Very sorry.

In the recent past, alternative methods to obtain training in cardiothoracic surgery have emerged. A new pathway to a residency in cardiothoracic surgery is to first complete a training program in vascular surgery, followed by two or three years of training in cardiothoracic surgery. There are now several training programs that offer, within the same institution, a 4+3 plan, so that during the four years of general surgery training, a resident has the opportunity to spend some time on cardiothoracic surgery rotations. Upon completion of training, the resident is then eligible to become certified by both the
American Board of Surgery and the American Board of Thoracic Surgery. In addition, some institutions now offer an integrated six-year clinical program that will match medical students directly into a cardiothoracic pathway. It is anticipated that more six-year integrated programs will emerge in the near future.

 

[Buzz Me]

"A year or so ago I ran across an article that mentioned an alternate route to CT surgery being: 5 year vascular integrated + 2 year CT fellowship. Here recently I searched for that pathway track, but I am coming up empty. Does such an option an exist? Is this a path that any take if it does exist? Is it feasible, frowned upon, etc...? Or am I mixing this up?

Interesting...I'll ask around but I've never heard of such a pathway. I wonder what type of "integrated" curriculum the first 5 years would have - how much of it is Gen Surg, and how much Vascular?

 

[Dan Plainview]

Okay, I have some more:

1) Care to comment on any of the 3 year programs you thought were good? I know it isn't a 3 year program, but thoughts on Columbia?

2) Any programs that should be avoided in terms of malignant behavior from faculty?

3) It seems as if work-life balance (in terms of having a family, children, etc) is possible, though more difficult than a specialty such as colorectal, endocrine, etc. Thoughts?

If you would prefer to answer 1) and 2) via PM, I understand.

Thanks!

 

[zippyziggy]

-do you have kids and if so, how often do you see them? do you have colleagues who've successfully managed the work-life balance and how did they do so? do you recommend this specialty for someone who highly values family or a life outside of medicine?

-can you comment on the diversity or routineness of your procedures, especially in relation to other surgical specialties like plastics, general, ENT, uro, ophtho, etc.? do you find your job to be creative enough/are you ever bored by your procedures?

very much appreciate you doing this, thanks!

 

[Dr.Forssmann]

How do you manage your time?

 

[Buzz Me]

1) Care to comment on any of the 3 year programs you thought were good? I know it isn't a 3 year program, but thoughts on Columbia?

2) Any programs that should be avoided in terms of malignant behavior from faculty?

3) It seems as if work-life balance (in terms of having a family, children, etc) is possible, though more difficult than a specialty such as colorectal, endocrine, etc. Thoughts?

(1) Generally speaking, or ones that where I actually interviewed? Can't be too specific about my location since I'm trying to stay anonymous here.

(2) See above.

(3) Not to be too rude about it, but there really isn't any comparison between colorectal and endocrine fellowships, and cardiac surg fellowships. Those are considered "lifestyle" fields (at least in the world of surgery), with few nighttime/weekend emergencies. In our field, be prepared to work until late each night, almost every single day. And then take lots of call. And have lots of sick patients and emergencies.

 

[Buzz Me]

-do you have kids and if so, how often do you see them? do you have colleagues who've successfully managed the work-life balance and how did they do so? do you recommend this specialty for someone who highly values family or a life outside of medicine?

-can you comment on the diversity or routineness of your procedures, especially in relation to other surgical specialties like plastics, general, ENT, uro, ophtho, etc.? do you find your job to be creative enough/are you ever bored by your procedures?

(1) No kids. I do have colleagues who have children - I have no idea how they manage it. We spend so much time in the hospital so I think a supportive, understanding spouse/family support system is crucial.

I highly value family and a life outside of the hospital as well. I just happen to love CT Surg.

(2) Please see my other posts on typical caseloads and procedure variety. There are just so many things you can tackle in the chest - everything from cardiac to cancer, from foregut to transplant, from vascular to VADs.

Nope, I'm never bored.

 

[Buzz Me]

How do you manage your time?

I'm very, very busy.

You know how things feel when you're trying to take o-chem, physics and calculus all at the same time? And also study for the MCAT? And you know how the first couple years of med school are even busier since you're trying to constantly cram for tests? And then how you get less and less sleep during your third year rotations? And how residency is even worse?

Cardiac surgery fellowship is even busier than that.

I'm a strong believer that this field self-selects for people who can get by without the requisite 8 hours of sleep a night - there's just no way you can possibly get that much sleep every single night. On a good week we may get home at 8 or 9 each night, and since we have to be back at work by 5 or 6 the next day...well, you do the math. I luckily don't need that much sleep.

You have to be super-efficient at everything you do. Sleeping, studying, exercising, etc. If you have a spouse/family, this is even more important.

 

[GandalfTheWhite]

when did you get to perform surgeries where you took the lead instead of an attending or senior resident ?

How many surgeries do you perform on a given day?

Are there procedures that you absolutely abhor?

 

[Buzz Me]

when did you get to perform surgeries where you took the lead instead of an attending or senior resident ?

How many surgeries do you perform on a given day?

Are there procedures that you absolutely abhor?

(1) For cardiac, towards the end of the year. For thoracic, almost from the beginning.

Edit: by "senior resident," I'm assuming you mean the chief fellow. We almost never double-scrub, so it's always just me and the attending.

(2) For cardiac, 1-2 (3 on a rare day). For thoracic, 2-4 (5 on a rare day).

(3) Anything re-op is painful.

 

[GandalfTheWhite]

(1) For cardiac, towards the end of the year. For thoracic, almost from the beginning.

Edit: by "senior resident," I'm assuming you mean the chief fellow. We almost never double-scrub, so it's always just me and the attending.

(2) For cardiac, 1-2 (3 on a rare day). For thoracic, 2-4 (5 on a rare day).

(3) Anything re-op is painful.

Were you able to perform any surgeries instead of only assisting as a resident?

 

[yehhhboiii]

what are your thoughts on the other doctors that you work with, particularly cardiologists and anesthesiologists. i noticed you talked about things like cabg vs pci previously in the thread but i'm curious as to how you interact with them and how well you work together.

 

[Umyo]

Profiled for later reading

 

[Buzz Me]

Were you able to perform any surgeries instead of only assisting as a resident?

With the attending in the room but not scrubbed? For cardiac, this would only be small cases - sternal debridements and pacemakers.

For thoracic, yes, quite a few cases are like this.

If you're asking if I'm actually doing the case? That is, standing on the right-hand side of the table with the attending acting as assistant? That's the vast majority of cases.

 

[Buzz Me]

what are your thoughts on the other doctors that you work with, particularly cardiologists and anesthesiologists. i noticed you talked about things like cabg vs pci previously in the thread but i'm curious as to how you interact with them and how well you work together.

In cardiac, we have a very close relationship with the cardiologists (who refer the majority of our patients to us)...and in the OR, you work VERY intimately with the anesthesia and perfusion teams in a way that isn't done in Gen Surg.

In thoracic, you'll work (outside of the OR) a lot with Med Onc, Pulm and Radiology.

 

[GandalfTheWhite]

With the attending in the room but not scrubbed? For cardiac, this would only be small cases - sternal debridements and pacemakers.

For thoracic, yes, quite a few cases are like this.

If you're asking if I'm actually doing the case? That is, standing on the right-hand side of the table with the attending acting as assistant? That's the vast majority of cases.

Yes that is what I was asking. I just wanted to know if you get to actually get to run point on the cases. And it seems that you do.

Thanks.

 

[yehhhboiii]

In cardiac, we have a very close relationship with the cardiologists (who refer the majority of our patients to us)...and in the OR, you work VERY intimately with the anesthesia and perfusion teams in a way that isn't done in Gen Surg.

In thoracic, you'll work (outside of the OR) a lot with Med Onc, Pulm and Radiology.

Would you mind going into more detail? Ive seen a few ct surgeries as a shadow student and it seemed like people tended to keep to their side of the drapes.

 

[Buzz Me]

Would you mind going into more detail? Ive seen a few ct surgeries as a shadow student and it seemed like people tended to keep to their side of the drapes.

Lots of communication goes on between the Cardiac Surg team, Anesthesia and perfusion, especially when going on bypass or coming off bypass. When there are issues intra-op you'll hear lots of chatter back and forth. And if it's a complicated case (deep hypothermic circulatory arrest, etc.) then even more so.

I never had that much communication with Anesthesia during Gen Surg, except for in airway cases.

 

[Buzz Me]

Yes that is what I was asking. I just wanted to know if you get to actually get to run point on the cases. And it seems that you do.

Thanks.

It happens much more quickly than in Gen Surg residency. And it has to - your fellowship is only 2-3 years long, versus a 5-year Gen Surg residency.

It's much easier to start doing the thoracic cases since (presumably) everyone's had thoracic training during residency. Many people haven't had much cardiac OR exposure.

 

[GandalfTheWhite]

It happens much more quickly than in Gen Surg residency. And it has to - your fellowship is only 2-3 years long, versus a 5-year Gen Surg residency.

It's much easier to start doing the thoracic cases since (presumably) everyone's had thoracic training during residency. Many people haven't had much cardiac OR exposure.

I thought for a CT surg, you have to do an initial year or two of gen surg and then specialize in CT?

 

[MedicallyEnthused]

In your experiences what would you say the demand for a CT surgeon is? How competitive is it?

The only reason i am asking this is that, as i was shadowing a orthopedic surgeon last week, and i asked him about CT surgeons, and what he told me that it is a declining surgical specialty with only 12 fellowships given out each year.

looking forward to a response,
Thanks.

 

[zippyziggy]

how would you describe the typical temperament of a CT surgeon?

 

[Dan Plainview]

(1) Generally speaking, or ones that where I actually interviewed? Can't be too specific about my location since I'm trying to stay anonymous here.

(2) See above.

(3) Not to be too rude about it, but there really isn't any comparison between colorectal and endocrine fellowships, and cardiac surg fellowships. Those are considered "lifestyle" fields (at least in the world of surgery), with few nighttime/weekend emergencies. In our field, be prepared to work until late each night, almost every single day. And then take lots of call. And have lots of sick patients and emergencies.

(1) In general

(2) Okay

(3) No offense taken. I know that cardiac (among others) is one of the worst fields in terms of lifestyle. I should have been more clear. Regarding this post:

[

4) Lifestyle can be bad. Lots of emergencies. But even the busiest guys don't work 90-100 hours a week. One of the busiest guys here operates four days a week, has clinic the fifth day. If you figure 7a-8p on the four operative days, 8a-4p on the clinic day...even if he rounded for 4 hours each day on Saturday and Sunday and came in for a 6-hour takeback for bleeding once a week, that's still only 74 hours a week. And that's a grossly overexaggerated, overly busy schedule.

Is said overexaggerated schedule really that common? That's what I'm really driving at.

 

[Buzz Me]

I thought for a CT surg, you have to do an initial year or two of gen surg and then specialize in CT?

There are abbreviated programs (integrated) - see my earlier posts for descriptions of these. These are in the minority, though.

Most people do 5 years of Gen Surg residency (more if they take time off to do research years), then a 2-3 year CT Surg fellowship.

The only reason i am asking this is that, as i was shadowing a orthopedic surgeon last week, and i asked him about CT surgeons, and what he told me that it is a declining surgical specialty with only 12 fellowships given out each year.

I've been hearing the same for the past 15 years.

He needs to stick to Ortho and not answer questions that he is clueless about. There are over 100 fellowship spots per year. New York state (the state with the most fellowship programs) alone has 10.

 

[Buzz Me]

how would you describe the typical temperament of a CT surgeon?

Compared to what?

I see you're a pre-med...so you may be in for a little shock when you see how rude/arrogant/outlandish some of the personalities in medicine are. It's nothing like most college professors. Among surgeons, some of the cardiac guys tend to be VERY loud, obnoxious, arrogant (of course these are generalizations). The thoracic guys tend to be more "normal." Is this a product of their work environment (stress)? Does cardiac surgery attract a certain type of personality? Hard to say.

Is said overexaggerated schedule really that common? That's what I'm really driving at.

Are you talking about life as a fellow, or life as an attending?

As an academic attending, yes, the above schedule is unusually busy...most (here) work around 60 hours a week.

As a fellow? Officially? 80 hours a week. Unofficially? Closer to 100-130.

 

[zippyziggy]

Compared to what?

I see you're a pre-med...so you may be in for a little shock when you see how rude/arrogant/outlandish some of the personalities in medicine are. It's nothing like most college professors. Among surgeons, some of the cardiac guys tend to be VERY loud, obnoxious, arrogant (of course these are generalizations). The thoracic guys tend to be more "normal." Is this a product of their work environment (stress)? Does cardiac surgery attract a certain type of personality? Hard to say.

compared to...a normal person?

yeah i understand cardiac surgeons have a reputation for being rude, arrogant, etc. - but how common exactly is that type of personality? if you're not one of those guys, is there any room for you in CT? i'd figure most of the more mild-mannered people would self-select out, but say you were dead-set on CT, would you be able to thrive in that environment? be ranked lower during residency interviews? work well in that kind of team? (i understand these questions are person-specific, but from your experience, what have you seen?)

 

[tiedyeddog]

I know you might be biased here and may lack insight into other fields, but in your opinion, what speciality has the most arduous training? Neurosurgery or CT surg?

I am not planning on CT, I am just wondering what your thoughts are.

 

[ferning]

Whats with the new territory spat with cardiologists? an attending mentioned some study thats bringing CT surgeons back into the black.

And whats the job market like for you guys anyway, do u have to live in a certain size city or certain distance from other CT surgeons?

 

[Buzz Me]

I know you might be biased here and may lack insight into other fields, but in your opinion, what speciality has the most arduous training? Neurosurgery or CT surg?

I will preface this by saying my experience with NSGY is working along side them as interns (they do a year of Gen Surg), then our frequent shared patients during trauma.

Arduous as defined by what?

Length of training? The NSGY residents I worked with had a 6-year pathway - 5 years clinical, 1 year research. I'm on the 10-year plan for CT. If you're in an integrated program, this can be as short as 6 years (3+3)...if you did research in residency and are doing a traditional fellowship, this can be as long as 9-11.

Hours worked per week? I think the NSGY guys worked around 80-100 hours a week. 90-100 hours a week is a GOOD week for me now.

Malignant personalities? Beatdowns by attendings? Yelling during M&M? Both fields probably have a lot of that. But (and of course I'm biased), cardiac surgery is one of the fields that first comes to mind when you think of arrogant jerk attendings.

Amount of work that needs to be done (studying) while at home? Probably a toss-up. Research? I'd say they do more.

Longer, more painful cases? Both fields have this.

Busy call nights, lots of emergency cases in the middle of the night? Again, both fields have this.