Cardio/Thoracic Surgery Disappearing?

[LSUTiger18]

I will be starting medschool this fall. I am pretty interested in CT surgery, but have heard rumors that this field may be combining with invasive cardiology to make a new specialty. I wanted to know if any of you have any insider scoop from department heads or others of these changes. I am particularly interested in how this will effect those CT surgeons who may get caught in the middle of the "switch".

Thanks

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[Joel Fleischman]

Its not dying out, but will change a bit. CT surgeons used to live off of CABG surgeies. These have gone down a ton since the invasive cardiologists started putting in stents. However, the efficacy of stents is a bit up in the air but it seems as if they may reduce mortality if placed in 24hr after the heart attack: otherwise they MAY reduce some of the pain and suffering afterward. They still arent efficacious with the sickest patients who still need a bypass graft.
There was probably a lot of abuse of CABG in the mid 80's.... It made a lot of people a lot of money, were probably a fair number of unnceccairy procedures.
Valve repair is still going strong. Some claim that invasive cards will eventually be able to put in stents through a cather. From what I hear from friends on the industrial side, dont count on it being much more than a band-aid to put off surgery (at least in the near future).
Dont forget artifical hearts, transplant, and pediatric heart surgery. All of which will maintain a presence.
One thing I would speculate would be...
The mortality at community medical centers is much lower for stents of there is a CT surgeon on staff ... i.e. incase the cardiologist screws up royally.
Most (read: all that I know of) academic centers wont run their cath lab unless there is a CT surgeon on duty. I would speculate that perhaps CT programs may start to train their folks to do some cath lab stuff... may make them more employable to community hospital, and then t he hospital wouldnt have to train to have two people on duy.

Do a seach at SDN, this topic is debated fairly frequently and theres probably other argumetns I cant think of

 

[doc05]

CT surgery is changing, but it's not dying out and certainly won't combine with invasive cardiology.

 

[12R34Y]

One of the lecturers during my surgery rotation last fall gave us a two hour talk on chest surgery (he has been a cardiothoracid surgeon since late 70's) and he stated that CT surgery is a dying field. he said that the transplant rate has been constant forever and it is a fixed number of organs for a rising number of people so that won't keep most CT surgeons in business at all. His big thing was that 20 years ago nobody thought that cardiology would be able to do what it has done (he remembers thinking that) and he says just give him another 20 years and he's convinced they'll be able to do just about anything percutaneously.

Then one of the chief residents in general surgery stood up and completely agreed with him and talked about how CT surgery is definately changing. They both stated that if you aren't trained in robotic surgery that you would be obsolete soon.

I have no idea if all of this is true and frankly don't care i'm an EM guy, but just thought it would be interesting conversation fodder for those interested.

later

 

[dynx]

Ive looked into this quite a bit and I think it is a dwindling, but not dying field. They will always need surgeons if something goes wrong in the cath lab, transplants will always be a factor, and congenital defects will always be there. CABGs I think you can realistically predict will all but dissapear eventually as will valve repairs and replacements at a much slower rate. That said, I like the field so much I am thinking of just sayng f-it and doing it anyway...there will always be something to do, and I'd rather make less money and do something I like, hell I might get some time off.

 

[JAMMAN]

Ive looked into this quite a bit and I think it is a dwindling, but not dying field. They will always need surgeons if something goes wrong in the cath lab, transplants will always be a factor, and congenital defects will always be there. CABGs I think you can realistically predict will all but dissapear eventually as will valve repairs and replacements at a much slower rate. That said, I like the field so much I am thinking of just sayng f-it and doing it anyway...there will always be something to do, and I'd rather make less money and do something I like, hell I might get some time off.

Don't worry, CT surgery is not going anywhere any time soon. CABGs will not disappear. You will have an excellent career in CT surgery should you choose it.

 

[Fermi]

Don't worry, CT surgery is not going anywhere any time soon. CABGs will not disappear. You will have an excellent career in CT surgery should you choose it.

I agree that stents are not the end-all yet. But even if CT surgery isn't going to die out "soon," you have to remember that an incoming med student is 12+ years away from a real paying job as a CT surgeon, which really means there has to be a good, robust job market at least 20-25 years out for the educational investment to pay off. I don't know if I see the field supporting that.

 

[Fantasy Sports]

People seem to forget that technological innovation and understanding of disease progress rapidly over any decade-- ie the amount of time for CT training.

No doubt there will be superior transplant methodologies or perhaps a new almost infallable heart transplant that all the "Greatest Generation" granddads and grandmoms will line up for.

Of all the specialties, surgical subspecialties are the least likely to become irrelevant. If anything medical subspecialties are more in danger by computing/telemedicine, etc, and even they aren't nearly as vulnerable as future radiologists.

So I wouldnt worry, CT surgeons will be around for a long time. Its just the nature of the work they do will completely change as technology progresses.