Cardio/Thoracic Disappearing?

[LSUTiger18]

I have heard rumors tht CT surgery will eventually be combined into an invasive cardiology/CT surgery hybrid specialty. I will be graduating in 2009 and I find CT surgery very interesting. My question is:
- Will (and if so when) this change take place and how will that effect those who have just completed CT surgery training. I am particularly concerned whether or not this will happen soon and how that could effect my career choice and job outlook.

Any input would be greatly appreciated.

Thanks

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[Blade28]

Whoa, slow down there. You've recently been accepted into med school - so relax, finish college, have fun! Keep CT surgery on the back burner, but go into med school with an open mind. You can then see what happens to the field in the next 4 years or so. I'm also very interested in CT surgery, but have to enter residency with a likewise open mind since the field is in so much flux right now.

 

[Bo Hurley]

Geez, every couple of weeks some ill-informed person comes on here making doomsday predictions about the end of cardiothoracic surgery. Listen, they've been saying this kind of crap since the mid 1980's when CABG cases first started decreasing. That CT surgery will disappear off the face of the earth, that CT surgeons will be left without a job and go homeless, blah, blah, blah. And 20 years later CT surgeons are still among the highest paid doctors around. Cardiologists can only do so much and they'll never replace CT surgeons. The world will still need CT surgeons even if cardiologists do manage to completely corner the market on ischemic heart disease (who's going to do the redo operations when the stents fail ) There is much more that a CT surgeon does that cannot be taken over by a non-surgically trained specialist. Not to mention the whole THORACIC part of CardioTHORACIC surgery.

 

[medicine1]

 

[dr.evil]

There's no doubt that the field of Cardiothoracic surgery is evolving and rightfully so. Many predictions have been made about the direction of the specialty.

Some say it will become akin to vascular in 10-15 years where the family practice/IM doc orders a MR coronary angiogram, notices coronary stenosis, and sends them to the CT surgeon who performs 2 stents and a MIDCAB with the mammary. This may be a little naive and optimistic but not out of the realm of reality.

This is of course all about the almighty CABG and it's evolution. They do have percutaneous valves although that's still not perfect and if the CT surgeons are agressive, could do these.

The esophagus and lungs are still in the chest don't forget. Predictions here are earlier detection of lung ca and more operations. Some are pushing to operate on small cell (at least early stage which is a rare finding).

LVAD's, Ventricular remodeling, Atrial fibrillation surgery, and the future of an "artificial heart" are all the future.

So CT surgery will be here to stay but it will not look like the CT surgery of 20 years ago.

CT surg is going through changes not unlike many specialties. Vascular has really adapted nicely to change. General surgery has stepped up to the laparoscopic age and lack of gastric surgery. Ent has evolved and do very few T&A's now do to excellent antibiotics.

Specialties change. Granted, I may be operating on sicker, older patients but we don't usually do too many hearts on 30 year old marathon runners now. If you don't like sick old people then you question is a moot point.

Pick what you like and go with the flow.

Reminds me: My mom is/was a nurse in the early 1980's and the talk to her then was that she shouldn't do nursing because of the predicted glut of nurses and the difficulty in finding a job. Guess it goes to show you...

 

[Gerota]

CABG's may be down, but Heart transplant is the wave of the future

Plus you think a cardiologist is going to look at a Type A Aortic dissection and not cringe in fear.

People go into cardiology because they like quoting esoteric studies not because they like to be arms deep in someones mediastinum.

CT is here to stay, they will evolve and survive

 

[PairODocs]

Hey, let LSU go nuts on the CT surgery thing. My experience is those folks practically spring from the womb wanting to do CT. Dated a sophomore in college who wanted to do CT and I thought surely he would change his mind. I mean, who wants to do 12 plus years of grad training just to do three operations? (And what nut would be crazy enough to marry him and go along for the ride?)

Well, thirteen years later, he's about to start his CT fellowship and no amout of my begging has changed his mind.

Are we worried about CT surgery's future? Actually, all of the fellows we have talked to have seemed optimistic about the future, and the new technology (robotics, etc) is constantly evolving. Plus, we are in the South, so multiple-vessel disease is a way of life down here.

 

[v-tach]

Plus, we are in the South, so multiple-vessel disease is a way of life down here.

Sounds like what you need, then, is more preventive cardiology!

 

[14022]

CT Surgeons are too smart and innovative to let the field go anywhere...

go look up (1) Maze surgery (2) Dor procedure

2 new innovative procedures for treatment of chronic a-fib and CHF

Also, do not forget that a cardiologist cannot treat esophageal cancer, lung cancer, hiatal hernia, and all of the other diseases of the thorax. It seems that most people forget about the "T" in CTS.

 

[Da Surgeon]

Say it with me. Cardiologists are not surgeons. If they wanted to cut people open and have their hands in someone's chest every day, they would have become surgeons. There will always be a need to cut, so there will always be a need for surgeons.