Congenital Cardiac vs ENT vs Neuro

[denathak]

Hi All,

Ive read SDN for ages now, the forums have really helped inspire me to be a surgeon. Im currently pre-med and so know Ive got a bit of time to decide, but as the title suggest I can't decide/would like some advice on the following surgical specialities: Congenital Cardiac, Neurosurgery & Otolaryngology. Sorry if its going to be a long post, but Ive looked around the forums and Ive found bits and pieces, but nothing really that answers my questions. Cheers in advance to anybody that takes the time.

Neurosurgery (NS)

• Love the brain. Centre of consciousness ... you get the idea.
• But this is more passion of neuroscience.
• Highly complex surgeries
• Very high stakes. Slight slip and death, or worse (not many specialities can put a patient into a lifelong coma)
• The cerebrovascular/skull-base fascinates me, but
• Functional, stereotactic, radiosurgery etc. is interesting academically, but (to me at least) doesnt seem "exciting" from a surgical perspective.
• Am I right in thinking NS is moving towards functional etc. fields?
• How varied actually is NS compared to the other 3?

Congenital Cardiac Surgery (CCS)

• Something incredible about remodelling a child's heart. Fixing nature is quite poetic.
• More hands on than the function, stereo. side of NS.
• But possibility of cardiologists taking procedures (am I right in saying this isn't nearly as relevant for pediatric CT).
• Again how varied is Congenital Cardiac. I know there are 200+ defects in innumerable combinations, but on a day-to-day basis what is it like.
• Absolutely no brain/spine/nervous.

Otolaryngology (ENT)

• H&N oncology, reconstructions, microsurgery interesting.
• Includes some skull base/neuro work.
• Im thinking its very varied. Maybe not as many different procedures, but each one is more different to each other. How varied is ENT?

So basically, at the moment I'm thinking CCS and hopefully do neuroscience research (if that's possible post-residency/fellowship. I know to get a CCS fellowship you need really good research pubs, and cardiac research will look much better. But possible when attending?). I think the main thing I am asking is which is the more varied specialities, and for NS and CCS how will the field change.

Plus how complex are the surges for each speciality. You get a lot of this and that, but are they all pretty similar if complexity?

Note: Not really interested in lifestyle answers, not fussed about the residency years, the on-call time, attending work-hours etc, just the fields themselves.

Again, cheers for replies.

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[Hangry]

Yeah...

There's not really a question here. You're post reads like a starry eyed premed, which you are (and most of us were too). All these career paths go through medical school, so just work on that goal for now and save this decision making for when you have the appropriate information to make it (re: have done 3rd year of medical). Keep dreaming about these different specialties if you want because that can be enjoyable but don't lose any real sleep trying to figure any of this out now.

Sorry that this isn't a satisfying answer, but it's the right one.

 

[doc05]

Please don't get too caught up in considering a specialty at this point. You haven't even started Medical school.

Also, you aren't good enough to do congenital cardiac surgery. Nobody is.

 

[denathak]

Please don't get too caught up in considering a specialty at this point. You haven't even started Medical school.

Also, you aren't good enough to do congenital cardiac surgery. Nobody is.

Is this purely a joke, or also an indicator that CCG is the most difficult and complex of the three specialities.

 

[denathak]

Yeah...

There's not really a question here. You're post reads like a starry eyed premed, which you are (and most of us were too). All these career paths go through medical school, so just work on that goal for now and save this decision making for when you have the appropriate information to make it (re: have done 3rd year of medical). Keep dreaming about these different specialties if you want because that can be enjoyable but don't lose any real sleep trying to figure any of this out now.

Sorry that this isn't a satisfying answer, but it's the right one.

It may not be vital for me to know now, and Im not "losing any real sleep", Im just interested in the fields and would like to have some questions answered by the best online community of doctors.

 

[denathak]

Starry-eyed Premed (sung to the tune of "Vincent" by Don Mclean)
vincent don mclean - YouTube

Starry-eyed Premed
Dreaming of a Top 5 school
Then he will begin to drool
With thoughts of neuro-surgery
How can this not be?

Hasn’t taken MCAT yet
But Harvard bound, and you can bet
A first choice residency

Now I think I know
Must get into med school first
Better watch out or my dreams will burst
Fill out those secondaries

Starry-eyed Premed
Twenty-seven applications sent
Secondary money all's been spent
Waiting for an interview invite
Is there one in sight?

Maybe add some mid-tier too
And a DO school or two
Perhaps Family Med aint so bad

Now I think I know
Must get into med school first
Don’t dream too big or you'll be cursed
One step at time

People always seem to do this. I am simply interested in what I want to do in the future. I am asking for advice on surgical specialities. Im not staying awake for hours wracking my brain, Im just asking the best MD forum for some advice. Can you not just answer the question?!?!?!

 

[Matthew9Thirtyfive]

People always seem to do this. I am simply interested in what I want to do in the future. I am asking for advice on surgical specialities. Im not staying awake for hours wracking my brain, Im just asking the best MD forum for some advice. Can you not just answer the question?!?!?!

If you do a search here you will see that many starry-eyed premeds dream of being a neurosurgeon (with or without pediatrics) and/or a congenital heart surgeon. Most of these people probably never end up even applying to med school.

Neurosurgery is exceptionally competitive, and unless you have a background you're not mentioning that gives you insight into the specialty, you have no idea what it's like. You need research from the get go, amazing board scores, and the grades to even have a shot. And, you may not even like it. I can tell you from personal experience that cranis are cool AF, but even as cool as they are, standing in one spot for 8-10 hours all the time is rough. And spine is boring AF (my opinion obviously).

Congenital heart surgery is a field that very, very few people enter. I'd venture that the vast majority of people interested in this field get thrown off by choice or by force at some point along the way of med school, residency, adult CTS, and then peds CTS (plus the years you have to spend as a junior attending since no one will trust you to do your own cases after just a couple years of fellowship). Even those who make it all the way through, you kill a few kids and your career is over. Most people aren't Roger Mee.

You need to focus on getting into med school and then doing really well in med school if you have any hope to do any of these specialties. All the interest in the world won't get you matched if your board scores point you towards primary care.

 

[gyngyn]

People always seem to do this. I am simply interested in what I want to do in the future. I am asking for advice on surgical specialities. Im not staying awake for hours wracking my brain, Im just asking the best MD forum for some advice. Can you not just answer the question?!?!?!

We actually can't answer your question at this time.
A validated preference for a particular specialty is developed in a series of steps.
It cannot reasonably progess until precedent steps have been completed.
Exploration is good. Experience evolves as you progress.

 

[sliceofbread136]

Have you ever been in an OR? Hard to know if you even like surgery without that experience. Try shadowing in those fields and form your own opinions.

 

[Lawpy]

People always seem to do this. I am simply interested in what I want to do in the future. I am asking for advice on surgical specialities. Im not staying awake for hours wracking my brain, Im just asking the best MD forum for some advice. Can you not just answer the question?!?!?!

1. Get into medical school first
2. Do well on the boards
3. Dominate the clinical years
4. Develop the best possible application for residency
5. ????
6. Profit

 

[thrudheim]

Have you shadowed any of these specialties?

 

[ScottTenorman54]

People always seem to do this. I am simply interested in what I want to do in the future. I am asking for advice on surgical specialities. Im not staying awake for hours wracking my brain, Im just asking the best MD forum for some advice. Can you not just answer the question?!?!?!

I think the reason you're having trouble getting a straight answer is because you're asking the wrong questions to the wrong community. People don't choose specialties based on the "complexity" of procedures, or how poetic and awe-inspiring it is to saw into some kid's heart. Or how "high stakes" it is..which you have in your NS column, as if that's somehow not an issue for congenital freaking heart surgery.

For your more relevant questions like where a field is trending etc, you're asking the wrong crowd, but there are indeed answers...in the other forums. For example, here's one from the neurosurg forum that's all about where the field is going: Is Neursurgery a dying field?
A Big Q&A on CT surgery: A list of questions about Cardiothoracic Surgery
Of course, shadowing is probably where you'll get the most bang for your buck.

 

[Hospitalized]

Congenital heart surgery is downright lunacy. Judging by this post, your marbles are probably a little mixed up, but individuals going into this field have an unfortunate mix of insanity, intelligence, servitude, and dexterity. I'm just going to wager and say you don't fall into this category. Sorry, but neither is anyone else on these forums to my knowledge. Nor is 99% of the medical field.

Last time I heard of this specialty we had a kid with his heart on the wrong side, practically upside down with only one ventricle. The surgeon operated but created a iatrogenic shunt. Probably hurt the kid more than it helped, but this kid at no chance at surviving anyway. Died at 5 weeks old in front of me, cyanotic as all can be. So yeah, this surgeon trained for 15+ years and still couldn't help.

Once you grow up, I'm sure you'll have a change of heart. But I'll take a guess and say you won't be changing others' hearts.

 

[NotASerialKiller]

People always seem to do this. I am simply interested in what I want to do in the future. I am asking for advice on surgical specialities. Im not staying awake for hours wracking my brain, Im just asking the best MD forum for some advice. Can you not just answer the question?!?!?!

Keep in mind that people aren't giving you the "Pshh, don't worry about it kid" answer because they're jerks. I mean this is SDN so we're all jerks, but that's not what this is about.

There is so much to consider when you're choosing a specialty. Part of it is interest in the topic, but there are a million of other things that are just as important. If waking up at 4am and getting to the hospital so you can stand in the OR for hours on end makes you want to die, then maybe you'll realize surgery isn't actually for you. If you do your first psych rotation and you realize you love trying to connect with patients on a deep personal level, then that opens up a whole host of other specialties. In a handful of years you might find a stronger desire to spend time with family and ultra-competitive specialties might be less appealing. The point is that it's totally fine for you to do research on what different specialties are like, but you can't really expect people on a forum to help you figure out what specialty is for you when everything you experience in the next 5-6 years is very likely going to change your priorities, not to mention your areas of interest as well.

So pshh, don't worry about it kid.


edit:

Sorry but it's also really, really funny to see a pre-med write:

Note: Not really interested in lifestyle answers, not fussed about the residency years, the on-call time, attending work-hours etc, just the fields themselves.

That quote is super SDN. So outrageously SDN.

 

[Lawpy]

I mean this is SDN so we're all jerks, but that's not what this is about.

but i thought i'm a good boy

 

[Matthew9Thirtyfive]

but i thought i'm a good boy

 

[Endoxifen]

this popped into my head this morning with @Hangry comment about a Starry-Eyed Premed

Starry-eyed Premed
(sung to the tune of vincent don mclean - YouTube)

Starry-eyed Premed
Dreaming of a Top 5 school
Then he will begin to drool
With thoughts of neuro-surgery
How can this not be?

Hasn’t taken MCAT yet
But Harvard bound, and you can bet
A first choice res-i-den-cy

Now I think I know
Must get into med school first
Better watch out or my dreams will burst
Fill out those secondaries

But they're not listening
they did not know how
perhaps they'll listen now


Starry-eyed Premed
Twenty-seven applications sent
Secondary money all's been spent
Waiting for an interview invite
Is there one in sight?

Perhaps add some mid-tier too
And a DO school or two
Maybe Family Medicine aint so bad

Now I think I know
Must get into med school first
Don’t dream too big or you'll be cursed
One step at a time

But they're not listening
they're not listening still
perhaps they never will

Have you considered signing on to Simon Cowell's record label? I think you could be a star.

 

[mmmcdowe]

Functional is a tiny pinpoint of the field of neurosurgery. The real question is if you want to do spine, because that's what the majority of neurosurgery is.

 

[aalamruad]

Functional is a tiny pinpoint of the field of neurosurgery. The real question is if you want to do spine, because that's what the majority of neurosurgery is.

How much of peds is spine? Also the majority?