Cardiothoracic Surgery...How Competitive?

[[email protected]]

---

Members don't see this ad.

How difficult (competitive) is it to be accepted into a cardiothoracic surgery fellowship? I was also confused when a general surgery resident goes about applying to such a fellowship. Is it during the residency or near the end? What is the general proceedure that one follows?

Thanks
Jason Wells

 

[droliver]

Cardiothoracic has become one of the least competative specialty matches with a signifigant # more spots than applicants for several years now. Traditionally you apply during your 4th year of residency in the spring.

Of note: last December, the governing body for CT surgery dropped the completion of general surgery as prerequisite for sitting for your board exam. This was a move to clear the way for planned "integrated cardiothoracic" residencies, much in the way Plastic surgery is at a number of places. Vascular surgery is also going to do this in the next few years.

 

[[email protected]]

Thanks for the info. Do you know typically how many hours/wk a CT surgeon works? How does this compare to other surgical specialties?

 

[Roentgen]

How many hours? Too many.

Compared to other surgical specialties? More.

 

[Voxel]

If you look at their life after fellowship, I would not wish that on anyone, especially if you are the only cardiothoracic surgeon in town. I know a guy who makes bank, but is tied to his beeper and has not taken a vacation in 5 years. He comes in to work at 5:30AM to round on all his CSICU patients and leaves around 8pm every day as an attending. This is assumes there are no emergencies at night such as a thoracic aortic aneurysm repair. It may be slightly better in bigger cities and with more partners to cover you, but the regular hours are still similiar. They have one of the highest rates of divorce in the medical profession (probably b/c they are never around and the sechedule is unpredictable with emergency surgery call). You should also know that their income has dropped about 20-50%, that includes increasing the number of procedures in the face of declining reimbursements. This all depends on where one practices and the penetration of managed care. There were CT surgeons making over a million before 1995ish who are making half that today. Only do this because you love it to the exclusion of almost everything else in life.

 

[droliver]

While cardiac surgery is not my interest, I don't think its quite as bad a field as some feel. Yeah, they have taken a pay cut by about 1/3 over 10 years, but they still make a very good living. The same can be said about just about every procedural field in surgery, medicine, & IR over that period of time. The schedule for private practice CT is probably more regular than in years past (fewer emergency CABG's as the angio/stent techniques have improved) but the patients are an older,sicker lot due to selection bias. With large groups, your call is pretty infrequent. Cardiologists are also frequently the ones fielding calls post op except those re. bleeding.

That being said, I would be miserable doing the same operation (CABG) over & over

 

[hosskp1]

I am very interested in the field-- maybe it is a good thing for me that there are many opportunities for fellowships after residencies.

 

[jargon124]

DrOliver,

Wow that's interesting about the integrated CT surgery residency prospect. Any idea when that will be available? I will be entering medical school this fall. Do you think I will be able to apply? Thanks for the imput...

 

[droliver]

The first few of the combined CT residencies could emerge in the next 2-3 years. Vascular surgery is in a more preliminary phase of this same movement. I got this information from the recent past president of the Amer. board of Surgery who is one of my professors

 

[dr.evil]

Yeah, you apply in the spring of your 4th year of residency usually. It's much like the match process to get into residency in the first place.

CT surgery is often an area that you usually love and want to do it, or realize that CT surgeons have a difficult time balancing work and play so you do something else. I agree that CT surgery is extremely interesting and unbelievable in its advances but too many CABG's would hurt me. I'd definitely want to do a lot of thoracic cases.