Cardiothoracic surgery vs. Neurosurgery

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Scrubsy

Scrubsy

Gunner MD
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Anyone have any idea which is better in terms of lifestyle, variety of surgeries, future of specialty? I'm equally interested in both fields at this point. Just wondering what others think. Thanks!
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Lol at this. Everyone knows neonatalplastadermaneurosurgeons make the best money, work 30 hours a week, never do the same surgery twice, and will in the future be automatically elected to Congress upon retirement.
 
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Well, cardiothoracic surgeons and neurosurgeons both work on the most important parts of the body (in my opinion). Sometimes, heart and brain surgeries are urgent and you'll need to be on call for both probably. They're also very different in the way they're performed, so I guess it's your personal preference of which body system you like the best. In terms of lifestyle, I would say a heart surgeon has a better life but that's just me.
 
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I don't think lifestyle is usually a consideration with these.
 
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There is more room for the field of neurosurgery to grow than CT surgery. Especially considering the replacement of many open chest surgeries with minimally invasive surgeries like catheterizations.
 
ohhoneybear said:
Well, cardiothoracic surgeons and neurosurgeons both work on the most important parts of the body (in my opinion). Sometimes, heart and brain surgeries are urgent and you'll need to be on call for both probably. They're also very different in the way they're performed, so I guess it's your personal preference of which body system you like the best. In terms of lifestyle, I would say a heart surgeon has a better life but that's just me.
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Most neurosurgery isn't brain surgery.

OP, feel free to explore areas of medicine that interest you, but don't be surprised when people mock the naivety of this thread.

If you're really interested in exploring neurosurgery, read neusu's AMA thread and check out uncleharvey.com.
 
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Just do both
 
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there are 10 residency spots nationwide for cardiothoracic surgery fyi
 
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neurosurgery has the best lifestyle because it's awesome to be a 4th year resident and still be a low man on the totem pole

Honestly, neurosurgery probably has more in terms of a future of development of interesting surgeries and techniques, but I'd really love to hear your definition of "lifestyle"
 
both.png



Neurocardiac surgeon. Go for it bro, I think you have what it takes.
 
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:laugh: at this thread so far.

OP - keep in mind the job prospects of CT surgery, it can be quite unnerving.
 
The lifestyle that a neurosurgeon has can be summed up by what's between these parentheses


( )
 
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Scrubsy said:
Anyone have any idea which is better in terms of lifestyle, variety of surgeries, future of specialty? I'm equally interested in both fields at this point. Just wondering what others think. Thanks!
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bro. bro.
 
Scrubsy said:
Anyone have any idea which is better in terms of lifestyle, variety of surgeries, future of specialty? I'm equally interested in both fields at this point. Just wondering what others think. Thanks!
Click to expand...

I'm going to go ahead an make the blanket statement that there is a ton of bad info in the posts prior to mine. The fact that you are "interested in both fields at this point" means more than likely you have no idea what either specialty entails.

Lifestyle - Just like any surgical subspecialty, there is room for setting up your practice the way that you want. You will however complete a 6-7 year residency for either with relatively brutal hours compared to most other residencies. Your schedule for both will be heavier and less predictable than other subspecialties on average when you get into practice. There aren't a huge number of truly elective cases for either specialty.

Variety of surgeries - There are sub-specialties within each. Also, few people these days do everything within neurosurgery or everything within CT or CV. Variety is very much about what practices you can join and what you want to try to do.

Future of specialties - Definitely more changes and advancement in the Neurosurgery world. CV operations are very well tolerated and very fleshed out. Mortality for CABs is through the floor. If you have multiple per year, you are in serious trouble. In contrast to Neurosurgery where a lot of new technological advances are changing how they operate. There are some (like at the hospital I work at) in CV who are learning endovascular techniques, but they are the minority.
 
Hate to break the misinformation meme parade here, but here's a serious answer (admitted neurosurgical bias though I have rotated on both services).

Cardiac surgeons formerly were the kings of medicine. They performed ground-breaking research and have made many amazing advancements. Unfortunately, they missed the boat with respect to interventional and cardiology anymore is both the gateway to and has the treatment for patients with ACS, arrythmia, or structural cardiac issues. It is also important to realize that cardiothoracic training often is split in to one or another and thus the surgeons are limited to both one or the other and the diversity of procedures therein.

Neurological surgeons operate on the central and peripheral nervous system as well as associated structures (brain, skull, spinal cord, spine, peripheral nerves, carotid arteries). There is encroachment in to neurosurgery, especially by interventional radiologists/neurologists and radiation oncologists as well as procedural overlap with spine surgery from orthopaedics and peripheral nerve from orthopaedics and prs. That being said, the variety of cases in neurosurgery is vast and the demand for these procedures is high.

With respect to lifestyle, my impression is that as an attending in either field, life is pretty good. Certainly, some sub specialties in each have it worse (trauma, cerebrovascular, transplant). Nonetheless, either field is typically viewed as rigorous and intense training and possibly more hours as an attending than other specialties.
 
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Work on getting into med school first, bud.

It's good that you're thinking about lifestyle but until you gain some experience you really won't be able to take in much advice.
 
neusu said:
Hate to break the misinformation meme parade here, but here's a serious answer (admitted neurosurgical bias though I have rotated on both services).

Cardiac surgeons formerly were the kings of medicine. They performed ground-breaking research and have made many amazing advancements. Unfortunately, they missed the boat with respect to interventional and cardiology anymore is both the gateway to and has the treatment for patients with ACS, arrythmia, or structural cardiac issues. It is also important to realize that cardiothoracic training often is split in to one or another and thus the surgeons are limited to both one or the other and the diversity of procedures therein.

Neurological surgeons operate on the central and peripheral nervous system as well as associated structures (brain, skull, spinal cord, spine, peripheral nerves, carotid arteries). There is encroachment in to neurosurgery, especially by interventional radiologists/neurologists and radiation oncologists as well as procedural overlap with spine surgery from orthopaedics and peripheral nerve from orthopaedics and prs. That being said, the variety of cases in neurosurgery is vast and the demand for these procedures is high.

With respect to lifestyle, my impression is that as an attending in either field, life is pretty good. Certainly, some sub specialties in each have it worse (trauma, cerebrovascular, transplant). Nonetheless, either field is typically viewed as rigorous and intense training and possibly more hours as an attending than other specialties.
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Thanks for the insight!
 
Anigma07 said:
Work on getting into med school first, bud.

It's good that you're thinking about lifestyle but until you gain some experience you really won't be able to take in much advice.
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Already accepted to med school.
 
I would guess neurosurgery has a better outlook. It is less susceptible to encroachment from other fields, although there is some (interventional neurology, interventional radiology). It's just that the sub-fields being encroached on aren't necessarily a huge percentage of the caseload. Converse that to CT, where balloning and stenting did take a huge amount of caseload away from them. I have often heard the some graduating CT fellows have difficult times finding jobs. I have never heard about a similar thing going on in Neurosurgery. (PS I am biased towards NS, so...)

I wouldn't worry about this stuff now. Maybe try to find a mentor after a few months into medical school.
 
Interesting how you only consider two fields with high salaries.
 
mcloaf said:
So everyone should just go FM/peds?
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Not everyone, but people should at least consider them. Medicine is too money driven. Luckily the salaries of both neurosurgery and cardiothoracic are going down. Peds and FM are going up. Hopefully more equal salaries will prevent people from choosing based on financial incentives.

Edit: Allow me to elaborate.

I do not think that neurosurgery and cardiothoracic surgeons deserve less money. I don't think they are bad careers. I don't think that the people in those careers are money driven. Neither do I think people shouldn't aspire to be them. My main concern is with people who choose specialties based on salary. And the fact that the OP

1. Expresses no indication of interest in any non-high paying specialties.
2. Chooses two high paying fields that aren't related whatsoever.

is very concerning to me. It leads me to believe that his goal, ultimately, is to make a lot of money.
 
Last edited:
nysegop said:
1. Expresses no indication of interest in any non-high paying specialties.
2. Chooses two high paying fields that aren't related whatsoever.

is very concerning to me. It leads me to believe that his goal, ultimately, is to make a lot of money.
Click to expand...

I am going to take issue with point #2. Different organ systems, yes, but very similar in lifestyle and education. Both require tons of weekly surgical time, both require extensive training, both have associated levels of prestige, both are very high stress and can have amazing or very poor outcomes, and ,yes, both are high paying.

I myself came into medical school interested in CT surg and NS due to how similar the lifestyles are (lots of OR time, high stress life or death some of the time, very specialized).
 
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nysegop said:
Not everyone, but people should at least consider them. Medicine is too money driven. Luckily the salaries of both neurosurgery and cardiothoracic are going down. Peds and FM are going up. Hopefully more equal salaries will prevent people from choosing based on financial incentives.

Edit: Allow me to elaborate.

I do not think that neurosurgery and cardiothoracic surgeons deserve less money. I don't think they are bad careers. I don't think that the people in those careers are money driven. Neither do I think people shouldn't aspire to be them. My main concern is with people who choose specialties based on salary. And the fact that the OP

1. Expresses no indication of interest in any non-high paying specialties.
2. Chooses two high paying fields that aren't related whatsoever.

is very concerning to me. It leads me to believe that his goal, ultimately, is to make a lot of money.
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Lots of concern for for a stranger asking a question about two specialties neither know a thing about.
ConcernTrollisConcerned.jpg

lol at neurosurgery and lilfestyle being in the same paragraph. Our neurosurgery residents are vocal about how proud they are about being the only specialty with a resident work hour exemption. It just self selects for folks that really want to work like the surgeons of yore. After residency, you might, just maybe, be able to figure out how to not be ground into a pulp if you're in a metro area and can find a non-emergent niche, but damn that residency.
 
tiedyeddog said:
I am going to take issue with point #2. Different organ systems, yes, but very similar in lifestyle and education. Both require tons of weekly surgical time, both require extensive training, both have associated levels of prestige, both are very high stress and can have amazing or very poor outcomes, and ,yes, both are high paying.

I myself came into medical school interested in CT surg and NS due to how similar the lifestyles are (lots of OR time, high stress life or death some of the time, very specialized).
Click to expand...

I see your point.

prado said:
Guys, he's still in high school. Don't waste your time.
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Would you care to entertain me with an elaboration on why I'm "a waste of time"?
 
nysegop said:
Would you care to entertain me with an elaboration on why I'm "a waste of time"?
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I don't think anyone means it in a detrimental way. It's more that there is a lot to experience in college and the vaaaast majority of pre-meds do not end up applying to med school and go another route. Of those that do even take the MCAT, most don't get the combo of scores, grades, and ECs to gain an acceptance.

From there, you have to secure research, dominate your boards, and be in the top of your class to land those residencies. That is all 8 years away. Most people will tell you its too early. I understand where you're coming from... I'm going to med school to do surgery. I wouldn't have applied if I didn't have that possibility. At your stage, relax and enjoy the ride. Worry about specialties later.
 
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DrEnderW said:
I don't think anyone means it in a detrimental way. It's more that there is a lot to experience in college and the vaaaast majority of pre-meds do not end up applying to med school and go another route. Of those that do even take the MCAT, most don't get the combo of scores, grades, and ECs to gain an acceptance.

From there, you have to secure research, dominate your boards, and be in the top of your class to land those residencies. That is all 8 years away. Most people will tell you its too early. I understand where you're coming from... I'm going to med school to do surgery. I wouldn't have applied if I didn't have that possibility. At your stage, relax and enjoy the ride. Worry about specialties later.
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True, true.
 
I think taking on 300k in debt will certainly make higher paying specialties appealing.
 
NontradCA said:
I think taking on 300k in debt will certainly make higher paying specialties appealing.
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Unfortunately. If medical education were free, things would be a whole lot different.
 
mimelim said:
Different, yes, but it wouldn't drastically change anything. People will always go for the higher paying specialties.
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I guess, but it shouldn't be that way. I wish all specialties payed exactly the same amount depending on the number of years in residency and fellowships get an extra amount per year.

Here's my plan:

Residency-
3 Years: $215,000
4 Years: $250,000
5 Years: $350,000
6 Years: $400,000
7 Years: $550,000


For each year of fellowship, add $40,000
 
nysegop said:
I guess, but it shouldn't be that way. I wish all specialties payed exactly the same amount depending on the number of years in residency and fellowships get an extra amount per year.

Here's my plan:

Residency-
3 Years: $215,000
4 Years: $250,000
5 Years: $350,000
6 Years: $400,000
7 Years: $550,000


For each year of fellowship, add $40,000
Click to expand...

You should probably learn how physicians get paid before you start trying to come up with alternatives. You can't simply mandate how much people get paid.
 
nysegop said:
I guess, but it shouldn't be that way. I wish all specialties payed exactly the same amount depending on the number of years in residency and fellowships get an extra amount per year.

Here's my plan:

Residency-
3 Years: $215,000
4 Years: $250,000
5 Years: $350,000
6 Years: $400,000
7 Years: $550,000


For each year of fellowship, add $40,000
Click to expand...

By your logic someone who spent 3 years in residency will have made $5M after 25 years as an attending while someone who spent 7 years in residency will have made $14M after 25 years as an attending.
 
nysegop said:
I guess, but it shouldn't be that way. I wish all specialties payed exactly the same amount depending on the number of years in residency and fellowships get an extra amount per year.

Here's my plan:

Residency-
3 Years: $215,000
4 Years: $250,000
5 Years: $350,000
6 Years: $400,000
7 Years: $550,000


For each year of fellowship, add $40,000
Click to expand...

Interesting concept but betrays your lack of understanding of market forces and what goes into physician compensation.

No matter whether anyone likes it, there will always be a premium on specialties which let people live decent lives outside of medicine. People don't want to throw themselves on the altar of physicianhood and sacrifice any more of their personal lives than they already have to in education and training.

I have a friend who used the "yolo!" argument for why she went into general surgery, a traditionally demanding specialty which embitters many of its physicians. I can point to several people who used the same argument for why they wouldn't touch general surgery programs with a ten foot pole.
 
I'm disappointed. You know what sucks about posting anything on this forum? Its that many times your met with ridicule, slander, and harassment. I came to this site to get quality information from some of the caring people in medicine that would like to help our future generation of upcoming physicians. However, I post a legitimate question and I'm met mostly with immature responses trying to put me down. Really? Who are you to tell me what I can and cannot be interested in? What the f**k does it matter if my interests are related or not? Does it personally affect you? I doubt it! I have nothing to prove to anyone. However, the mentality on this site is one of immaturity. Go ahead and talk s**t about me and see what I care. WTF! We are all striving for the same damn goal....to help others. I don't care who you are, how smart you are, what school you went to, what year you are....there should be no one on this site trying to make another feel badly about a question they have. Grow up!! The few of us that have made it this far now represent the profession of medicine....a profession that is highly valued in society. No matter what school, specialty, year, etc..., we should be helping and encouraging and supporting one another! I'm tired of this bulls**t. Those of us that have made it to medical school and beyond have been given a unique opportunity. An opportunity not only to make you mark on medicine, but an opportunity to aid and nurture the future of medicine. For those who feel the need to come on this forum and ridicule people and put them down....I hope you either change professions or get your s**t together! We are healthcare, we are a family. Each of us as healthcare professionals has a responsibility to take care of each other. Not belittle each other for picking one specialty over another. Not to attack someone for not knowing something. Not to come down on a young aspiring doc for trying to be a small part of our world. This is not a game. Not a contest. This is medicine. Lets be proud of who we are and stand tall. It doesnt matter if you are a tech or an attending. Lets make a positive impact instead of a negative one.
 
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Scrubsy said:
I'm disappointed. You know what sucks about posting anything on this forum? Its that many times your met with ridicule, slander, and harassment. I came to this site to get quality information from some of the caring people in medicine that would like to help our future generation of upcoming physicians. However, I post a legitimate question and I'm met mostly with immature responses trying to put me down. Really? Who are you to tell me what I can and cannot be interested in? What the f**k does it matter if my interests are related or not? Does it personally affect you? I doubt it! I have nothing to prove to anyone. However, the mentality on this site is one of immaturity. Go ahead and talk s**t about me and see what I care. WTF! We are all striving for the same damn goal....to help others. I don't care who you are, how smart you are, what school you went to, what year you are....there should be no one on this site trying to make another feel badly about a question they have. Grow up!! The few of us that have made it this far now represent the profession of medicine....a profession that is highly valued in society. No matter what school, specialty, year, etc..., we should be helping and encouraging and supporting one another! I'm tired of this bulls**t. Those of us that have made it to medical school and beyond have been given a unique opportunity. An opportunity not only to make you mark on medicine, but an opportunity to aid and nurture the future of medicine. For those who feel the need to come on this forum and ridicule people and put them down....I hope you either change professions or get your s**t together! We are healthcare, we are a family. Each of us as healthcare professionals has a responsibility to take care of each other. Not belittle each other for picking one specialty over another. Not to attack someone for not knowing something. Not to come down on a young aspiring doc for trying to be a small part of our world. This is not a game. Not a contest. This is medicine. Lets be proud of who we are and stand tall. It doesnt matter if you are a tech or an attending. Lets make a positive impact instead of a negative one.
Click to expand...

Woah! Calm down. This is SDN. What did you expect?

You should prepare, for at the very minimum, this amount of "badgering" if you plan on going into a surgical specialty like CTS or NS. 2 fields that are probably most well-known for their "personalities." The attendings and residents in these fields are the straight forward, no coddling, no bull**** type and you need to be able to deal with that.
 
Scrubsy said:
I'm disappointed. You know what sucks about posting anything on this forum? Its that many times your met with ridicule, slander, and harassment. I came to this site to get quality information from some of the caring people in medicine that would like to help our future generation of upcoming physicians. However, I post a legitimate question and I'm met mostly with immature responses trying to put me down. Really? Who are you to tell me what I can and cannot be interested in? What the f**k does it matter if my interests are related or not? Does it personally affect you? I doubt it! I have nothing to prove to anyone. However, the mentality on this site is one of immaturity. Go ahead and talk s**t about me and see what I care. WTF! We are all striving for the same damn goal....to help others. I don't care who you are, how smart you are, what school you went to, what year you are....there should be no one on this site trying to make another feel badly about a question they have. Grow up!! The few of us that have made it this far now represent the profession of medicine....a profession that is highly valued in society. No matter what school, specialty, year, etc..., we should be helping and encouraging and supporting one another! I'm tired of this bulls**t. Those of us that have made it to medical school and beyond have been given a unique opportunity. An opportunity not only to make you mark on medicine, but an opportunity to aid and nurture the future of medicine. For those who feel the need to come on this forum and ridicule people and put them down....I hope you either change professions or get your s**t together! We are healthcare, we are a family. Each of us as healthcare professionals has a responsibility to take care of each other. Not belittle each other for picking one specialty over another. Not to attack someone for not knowing something. Not to come down on a young aspiring doc for trying to be a small part of our world. This is not a game. Not a contest. This is medicine. Lets be proud of who we are and stand tall. It doesnt matter if you are a tech or an attending. Lets make a positive impact instead of a negative one.
Click to expand...

If you can't take the heat, get out of the fire, OP. People who post something equivalent of a naval cadet debating whether they should choose to fly tomcats or a hornet when they're a fighter pilot are putting the horse before the cart's even built. It's kind of a dumb question and smacks of arrogance. The posters on this forum are trying to indicate that to you. Maybe not in the nicest way, but a quick perusal of the posts here should tell you the tone. This is a sarcastic forum. Deal with it.
 
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