I'm not sure about Ped Cardiac Surg, but I suspect it's Cardiothoracic surgery followed by a Ped fellowship.
Basically, I believe all ped surg specialties are fellowships following a residency in their adult counterpart. I seriously considered ped surg and have a friend who's planning on doing it, so that's where my info comes from. 🙂
Since surgeons need to operate on big people before little people, they all start in the adult counterpart as TexasRose said.
For peds cardiac surgery, you start with 5 years gen surgery residency followed by 2 years cardiothoracic surgery fellowship followed by 1 or 2 years peds cardiac surgery fellowship.
The most competitive is general pediatric surgery as there are only about 30-40 fellowship positions in the US annually with many many applicants. A lot of applicants end up doing other things to make themselves more competitive, such as a couple years of research before applying. It makes it for a long road to being a gen peds surgeon.
For the surgical subspecialties that have their own residencies (eg, ortho, ENT, plastics, urology, ophtho, etc.), getting into residency initially is the toughest part. The peds fellowships in these specialties are relatively easy to get. Being a peds surgeon in these fields usually pays less and may limit you professionally and geographically since you will likely have to practice in an academic medical setting in a larger city. But if you love kids and love surgery, these fields are great. Plus you will still get paid better than any pediatric medical subspecialist (eg, cards, GI, heme-onc, etc.). And a lot of them, especially urology and ENT, have a good portion of medicine and surgery, making them good choices for people who like both aspects of patient care.
