Peds CT and Adult CT Question

1) Does anyone one know the avg salary of a ped CT surgeon? 2) Are there fast track/combined programs out there in gen surg/adult ct surgery? if so, which schools offer them? If you choose this fast track program, can you still apply for a peds CT fellowship? 3)How does the field of ped CT compare to adult CT, as far as the changes adult CT has gone through?

1.) Well, if you're doing ped CT you'll most likely be salaried at an academic institution. I get the impression that the ped CT surgeon I'm friends with makes about the same as adult CT; however, as always issues of salary are touchy to talk about and are fairly variable depending on the hospital and involvement with technology companies and research. He's associate professor, so I would say probably makes an extra 50K over the assistant professor (250-300K). 2.) From what I hear there is going to be a 6-year program for CT, but it has yet to be implemented. I get the impression that its still another 3 or 4 years in the making, but I am not entirely sure about the status of that discussion. I would look on the STS website or CTSnet.org for info on the status of that trasition. 3.) I'll take your last question to mean how does the recent decline in adult CT relate to ped CT. Unless cardiologists start doing aortic stenting and CABGs on kids, I think ped CT is going to remain just as it is: congenital 😛

PCT said:

1) Does anyone one know the avg salary of a ped CT surgeon? 2) Are there fast track/combined programs out there in gen surg/adult ct surgery? if so, which schools offer them? If you choose this fast track program, can you still apply for a peds CT fellowship? 3)How does the field of ped CT compare to adult CT, as far as the changes adult CT has gone through?

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Its a very long road for Peds CT.

5 years Gen Surg residency
2 years research
2-3 years of Adult CT (with research)
1-3 years of Peds CT
2-4 years as junior faculty to gain additional surgical experience

The people who go into this field are extremely dedicated to an academic career, as this practice cannot be supported as a private practitioner.

But it is an extremely interesting field as the correction of congenital malformations often requires surgical remodeling of the heart. Rather than working on the exterior surface of the heart such as the more common work of adult CT, but of course that is changing as well with many institutions developing new surgical interventions for acquired adults cardiac diseases.

You will find your experience in peds CT quite different to adult CT, as I have. In peds CT you deal with a different type of pathology and peds CT doesn’t necessarily mean that you only operate on kids. Most peds CT surgeons I’ve met deal with congenital cardiac abnormalities in the adult, as some procedures need revision work in later life (ie. conduits for fallot’s). Some are even involved in transplant. In terms of changes compared to adult CT, there probably isn’t going to be much of a decrease in the demand for peds CT. However, peds CT is very specialized and there aren’t that many consultant spots available in the first place.

The only school that I know of with a Adult CT "track" is Johns Hopkins.

PCT said:

1) Does anyone one know the avg salary of a ped CT surgeon?

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CT surgery from a few sources I've seen makes around 400K depending on area of the country (this according from the AMGA survey)
Ped CT should be around this, if not a little more since there's additional training (this is my assumption, no figures to back this up)

2) Are there fast track/combined programs out there in gen surg/adult ct surgery? if so, which schools offer them? If you choose this fast track program, can you still apply for a peds CT fellowship?

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The ABTS (Amer Bd Thor Surg) rolled out 3+3 programs (3 years Gsurg, 3 years CT surg) to get boarded in adult CT (saves 1 year as compared to categorical 5 year Gsurg, followed by 2 year adult CT fellowship)
The new way means one is not boarded in Gsurg. I believe you would be still eligible to apply for a ped CT fellowship since they are equivalent).

3)How does the field of ped CT compare to adult CT, as far as the changes adult CT has gone through?

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This is one advantage for ped CT over adult. Aside from some of the simpler defects such as some (not all, just some) ASD's and VSD's, most of the procedures are virtually guarranteed to be immune from cardiologist takeover like adult has been with ballooning and stenting.

Let's just put it this way, it's a pretty safe assumption nobody will be figuring out a way to set up a Fontan Pathway or do an Arterial Switch interventionally anytime soon.




In terms of the field itself, it's a fantastic field. The congenital defects are absolutely amazing. And there's so much variety. You never see the same thing twice (as compared to adult CT, which is bypass after bypass after bypass (with VR sometimes added) and the occasional AAA).

There's something like 100-150 defects. But these can occur in conjunction with one another. So if you do the permutations and combinations, the possibilities of what you see in each heart are endless.

We had a baby a bit ago that had 5 defects in his heart if I remember correctly...oh yeah, with dextrocardia thrown in on top of that for good measure...

As Roger Mee said in the book Walk on Water..."Every heart belongs in it's own category."




A note about training. It's definitely long, although the training varies. There are definitely plenty of people who have done 10+ years of training with research and clinical time.

However, it varies. The attending ped CT surgeon on the PICU I work on did 8 years straight (5 Gsurg, 2 CT surg, 1 Ped CT fellowship).

But from researching the profiles of various Ped CT surgeons around the country, I've found this to be the exception rather than the rule. Most people had a year or two of research.

That's what lengthens it-the research. From my research, many of the top programs seem to have 1 year fellowships.

Boston Children's, Philadelphia Children's, USCF children's, Mott Children's all have 1 year fellowships.
(Boston Children's has a 6 month fellowship for CT surgeons who are going to be mainly adult CT surgeons, with only doing simpler Ped CT stuff in adult patients)

However, one has to wonder the chance of getting a fellowship at Boston or Philly Children's and so on without doing a year or two of research... 🙄



How's this for a ridiculous amount of training...A guy I saw I believe at Cinncinati Children's was training in both Pediatric CT surgery AND Pediatric Surgery....
It was something ridiculous like 14 years from the time he finished med school to the time the last fellowship listed was over... 😱


PS - the attending I mentioned loves his job and told me he'd do it again without a doubt, which always is a good indicator of the career... 😀

Every time I read about these incredibly long training programs, it solidifies it more and more in my mind that this is a totally self-selecting process. The guy who puts in the extra 14 years will most likely say he would do it again, because the personality fit is just that way. Even basic Gen Surgeons are not really "normal". You go to 4 years of college, 4 of med school, 5 of Gen Surg training, which puts you about 9-11 years at least above even your friends from college, which in itself is an amazing feat of dedication. Surgeons toil for "80" hours a week in residency, often even after residency, just to be able to help people, train others, and serve the community in the end. That's not normal, we self-select and every time I take a step back to just see what every surgeon does, I'm blown away by the sheer quality and dedication of most of the people.

Getting off my soapbox now 😀

cardsurgguy said:

In terms of the field itself, it's a fantastic field. The congenital defects are absolutely amazing. And there's so much variety. You never see the same thing twice (as compared to adult CT, which is bypass after bypass after bypass (with VR sometimes added) and the occasional AAA).

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Hmmm, I’ll agree that paeds CT is varied, but I don’t really agree that adult is that repetitive. There are a lot of CABGs but I’ve noticed that those who repetitively do it have a strong research interest in its relation (i.e. off pump work, arterial grafts, myocardial protection, ect). To maintain a varied list, some consultants maintain a thoracic surgery interest or do aortic work, the latter usually taking up a whole OR list with a single case.

johnny_blaze said:

Hmmm, I’ll agree that paeds CT is varied, but I don’t really agree that adult is that repetitive. There are a lot of CABGs but I’ve noticed that those who repetitively do it have a strong research interest in its relation (i.e. off pump work, arterial grafts, myocardial protection, ect). To maintain a varied list, some consultants maintain a thoracic surgery interest or do aortic work, the latter usually taking up a whole OR list with a single case.

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I'm a fan of any type of CT surgery, and I'm not by any means saying adult is boring.

I was speaking more relative, as in comparing the two. On a scale, I would say adult is certainly more repetitive than congenital. Although adult does have its variety (especially with some of the end stage before transplant stuff like LVAD's and what not that are being used->pretty cool stuff if you ask me...)

Not to mention, I was assuming a person who did only cardiac work, no general thoracic.

I was told cardiac surgery would be repetitive and i believed it... until i actually got proper exposure to it. For example, i'm looking at an OR list at the moment. 3 consultants are operating and every single one of them is doing a CABG. The difference is that one is doing it off pump with a radial and long saph. graft. The other is doing the same thing but on pump and the third one is doing it with bilateral radial and IMA grafts. CABGs are by no doubt a routine operation for cardiac surgeons, but each one is quite different. The reason why some consultants seem to do nothing but CABGs is because their research needs numbers. The more numbers you have the more significant your results can be.

johnny_blaze said:

I was told cardiac surgery would be repetitive and i believed it... until i actually got proper exposure to it. For example, i'm looking at an OR list at the moment. 3 consultants are operating and every single one of them is doing a CABG. The difference is that one is doing it off pump with a radial and long saph. graft. The other is doing the same thing but on pump and the third one is doing it with bilateral radial and IMA grafts. CABGs are by no doubt a routine operation for cardiac surgeons, but each one is quite different. The reason why some consultants seem to do nothing but CABGs is because their research needs numbers. The more numbers you have the more significant your results can be.

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True, off pump is indeed very different from on pump. That's a good example.

Just out of curiousity, is CT surgery what you're planning on johnny?

cardsurgguy said:

True, off pump is indeed very different from on pump. That's a good example.

Just out of curiousity, is CT surgery what you're planning on johnny?

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Hmmm not really sure yet if cardiac is for me. I really enjoy it but right now CT training in the U.K is undergoing changes to meet with the decrease in demand. All the training spots have been frozen to ensure that no one is left without a consultant job once training is complete. It’ll still be a while until I apply for a registrar post so hopefully by then a balance will have been achieved. My main interest is aortic surgery and the aortic root, arch, and thoracoabdominal work in CT is really good. My other option is vascular surgery, which would offer more aortic work but in a slightly different anatomical location.