Best General Surgery Program Type For CT Surgery

[Sirach38]

Got it. That makes sense. So it's not a huge deal to not be able to do gen surg cases. In fact, it's probably a plus in terms of headaches and lifestyle.

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[doc05]

I have a question that relates more to the integrated vascular surgery but can really apply to many of the other integrated surgery subspecialties. So now that the 5+0 programs are becoming more popular and an increasingly number of vascular surgeons will not be board certified in general surgery, what will these surgeons do when they run into a general surgery problem during a big vascular operation. At the institution that I am rotating through, the vascular surgeons do all of their own general surgery. For example, if they knick the bowel or need to do a splenectomy during a big open AAA repair, they would do the splenectomy themselves or repair the bowel. They all have privileges to do general surgery cases and take care of pretty much any intraabdominal problem that they run into during a vascular operation. Now, the new generation of vascular surgeons may not have these privileges since they are not board certified. Does this mean that they will need to call in a general surgery to do a splenectomy, bowel repair, etc.? I imagine that urologist have to call in a general surgery if they get into non-urological trouble in the abdomen so I would imagine that future vascular surgeons may be the same way. Does this now mean that if you are in private practice doing open vascular procedures you would then have to have general surgeons on call for back up in case you need a splenectomy etc.? Seems like this would make you less marketable and would be a huge downside of going integrated. Any thoughts?

Not really a downside. My vascular attendings were all trained in the old days, and NONE of them did any general surgery. it's easy enough to call a colleague if needed. And ps, you shouldn't need to do a splenectomy or bowel repair during aortic surgery.

 

[dienekes88]

Not really a downside. My vascular attendings were all trained in the old days, and NONE of them did any general surgery. it's easy enough to call a colleague if needed. And ps, you shouldn't need to do a splenectomy or bowel repair during aortic surgery.

Eh. Not sure I agree about the splenectomy.

I learned how to do all abdominal aortic surgery coming through a retroperitoneal, which would hypothetically have a low incidence of bowel injury, as opposed to a transperitoneal approach. I imagine if a patient has had intraabdominal surgery previously and then you're coming back from a transperitoneal approach, then you might have some issues. I would not be excited about repairing bowel that is sitting directly over my dacron.

 

[Sirach38]

Not really a downside. My vascular attendings were all trained in the old days, and NONE of them did any general surgery. it's easy enough to call a colleague if needed. And ps, you shouldn't need to do a splenectomy or bowel repair during aortic surgery.

We had to do a splenectomy during a renal artery bypass but you're right, it wasn't an aortic case. Thanks for the replies!

 

[Sirach38]

Another question related to the integrated vascular and CT specialties. One of the vascular surgeons at my institution does a ton of international work. I assume most of this work is general surgery related since he is GS boarded. If one is not boarded in general surgery because one went through the integrated CT or vascular programs, does this cut out much of the opportunities to do global health work? I guess my question is, how much need is there for vascular surgeons in international work if they don't possess the general surgery skills? How about for CT?