Cardiothoracic surgery

[Premedtomed]

How does one go about applying for cardiothoracic surgery??

Also, what is it like compared to other subspecialties?

---

Members don't see this ad.

 

[TxMed]

How does one go about applying for cardiothoracic surgery??

Also, what is it like compared to other subspecialties?

ct surg is done as a fellowship after general surgery. these fellowships are fairly easy to get at the moment (i believe there were more spots than applicants last year). Ct surg is currently in a transitional period because many patients are opting for (or being guided into) less invasive procedures done by intervnentional cardiologists. if the trend continues, academic practice will be the mainstay of ct surgeons.

as far as comparing to other specialties...
1.the training is very demaning and will take up a fairly significant portion of your life (5+2yrs minimum at the moment...3+3 programs or variants of that may be on the horizon)
2. salaries are decreasing due to the lack of patients
3. will always be needed for congenital abnormalities, peds ct surg will always have patients
4.definitely not a "lifestyle" field. long hours, hard work, etc
5.nobody else gets to hold a pt's heart in their hands and then carry on a convo with the same patient hours later.

-tm

 

[ironmaiden]

That there are no jobs out there right now. It's just awesome to do all that training, build up hundreds of thousands of dollars in educational debt, and come out unable to find a job. Fun times.

 

[zinjanthropus]

That there are no jobs out there right now. It's just awesome to do all that training, build up hundreds of thousands of dollars in educational debt, and come out unable to find a job. Fun times.

i think this is an overemphasised point....even if you come out of your CT fellowship and can't immediately get a job, you aren't going to starve by doing general surg for a little bit.

not too mention the fact that the Ct jobs will be there since no one is going into it right now and the mean age of ct surgeons is getting up there.

 

[Premedtomed]

I thought that the new Robotics technology is making it attractive?

 

[TxMed]

I thought that the new Robotics technology is making it attractive?

only for the robots.


tm

 

[ironmaiden]

i think this is an overemphasised point....even if you come out of your CT fellowship and can't immediately get a job, you aren't going to starve by doing general surg for a little bit.

not too mention the fact that the Ct jobs will be there since no one is going into it right now and the mean age of ct surgeons is getting up there.

Why don't you come over to my house and give this speech to the PGY-8 q2 call CT fellow who occasionally resides here and see how well it goes?

You don't go through 2-3 years of sheer hell in CT fellowship so you can chase stool in the OR all day.

And while the old guys are old, they are neither dying nor retiring.

 

[ironmaiden]

only for the robots.

so true! Most of them are sitting in the corner gathering dust! Million dollar dust catchers! Wish I could design a POS like that and build a career off it.....

 

[TxMed]

so true! Most of them are sitting in the corner gathering dust! Million dollar dust catchers! Wish I could design a POS like that and build a career off it.....

preach!

 

[Premedtomed]

How about Vascular surgery?

Is it dying too?

 

[RxnMan]

...You don't go through 2-3 years of sheer hell in CT fellowship so you can chase stool in the OR all day...

Of the Da Vinci surgical robots I've seen, they are all only used ~10-12 times/year

 

[njbmd]

How about Vascular surgery?

Is it dying too?

Not exactly. I haven't even started fellowship and I am getting very generous offers. My fellowship training will include both surgical and endo repairs of various pathology. Since the incidence of peripheral vascular disease in this country is increasing and not decreasing, I don't see vascular surgery dying and I am not worried about having a job. Keep in mind that I am at the end of my surgery residency and heading for fellowship.

I did not choose my specialty based on future career aspirations and need but on what I like and do well. The guys that have graduated from the CT fellowship where I will be doing my vascular fellowship have all found jobs and are doing well. The guys coming out this year all have job offers.

If you anticipate doing a fellowship, you have four years to figure out what you want to do and what you are good at. Most people who finish general surgery residency hate vascular and hate do perform vascular surgery procedures. I don't see that changing anytime soon. I was just the opposite. Vascular surgery was my first rotation in my residency and I have loved doing vascular more than anything else.

 

[johnny_blaze]

I thought that the new Robotics technology is making it attractive?

Yes and no. With future improvements and advances in technology it might be more useful. At the moment it's only really used for IMA to LAD bypass in patients with single vessel disease, which are more likely to be stented anyway. Double and triple vessel disease make up the majority of the CABG case load nowadays and although it may be possible to use robotics in these cases, manipulation of the apex and aortic control are better achieved in open procedures.

 

[Mr. McDuck]

Of the Da Vinci surgical robots I've seen, they are all only used ~10-12 times/year

This guy has done almost 200 beating heart TECAB using the da Vinci robot since 2002 I think. He's also done like 30-some-odd multivessel procedures. This really is a cool procedure.

http://www.or-live.com/alliancehospital/1736/event/webcast.cfm?

 

[miler]

1. Are the job prospects for peds ct surgery as limited and in as much of a downward trend as adult ct surg?

2. Also, wouldn't the incidence of triple vessel dz be increasing? If so, wouldn't there still be a decent patient load for ct surgeons? I think I read in an earlier post the # of patients is decreasing????

3. Have any programs started the 3+3 yet? If so, where? If not, who is thinking about doing it?

Thanks for feeding my curiousity.

 

[Pilot Doc]

2. Also, wouldn't the incidence of triple vessel dz be increasing? If so, wouldn't there still be a decent patient load for ct surgeons? I think I read in an earlier post the # of patients is decreasing????

The thing to keep in mind is that the current CT workforce was largely created to carry the ENTIRE coronary artery disease treatment workload. Used to be, everybody who had an MI got a CABG. They all get stents now. Yes, some of them go on to develop triple vesse diseade, but many more go on to die of something else. It's as if the demand for all Chevy trucks dropped 90% but Corvette demand increased 100%. Still a bad situation. If the CT surgeons can get it together to close most of their training programs, this will sort itself out in 20 years.

 

[RxnMan]

This guy has done almost 200 beating heart TECAB using the da Vinci robot since 2002 I think. He's also done like 30-some-odd multivessel procedures. This really is a cool procedure.

http://www.or-live.com/alliancehospital/1736/event/webcast.cfm?

Fine - my point was that a $1 million dollar machine used 10 times a year for $10k procedures (my SWAG) does not pay for itself. If you argue about the 'level of care' increase it provides, you need to know about the number needed to treat (with the machine) before you save a life or save money (faster procedures, fewer complications as measured by average length of stay, or fewer resulting lawsuits and settlements).

I know almost nothing about medicine, but I'll tell you that you that you have to be booking that machine close to 24/7 to work off that million dollar price tag. I haven't heard of that happening (on the whole). Newer does not always mean better for the patient or the hospital.

 

[Winged Scapula]

1. Are the job prospects for peds ct surgery as limited and in as much of a downward trend as adult ct surg?

3. Have any programs started the 3+3 yet? If so, where? If not, who is thinking about doing it?

Thanks for feeding my curiousity.

1. The job prospects for Pediatric CT surgeons aren't as dire as for adults because most of the pediatric CT problems still require surgery (as opposed to stenting and lifestyle changes). However, there is not as much of a need for Pediatric CT surgeons, so you must be in a fairly sizeable market with a Children's Hospital.

3. None that we are aware of have actually started yet.