CT Surgery Questions

[sykosomatik]

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How does one become a CT surgeon?

I'm assuming you have to go through general surgery, and then apply for some kind of CT fellowship? Am I completely wrong?

Why doesn't CT surgery have its own dedicated route like NS?

Also, what credentials are these programs looking for? (can someone give me Step 1 scores for CT?) What kind of personality traits do they want?

One last thing, CT's deal with the heart, but do they also have to work with lungs? I only am interested in heart surgery

So many questions, but I'd appreciate it if anyone who is interested in CT and knows a lot about it (or if there is a CT resident here) could answer these questions.

Sue me if my spelling and grammer is wrong...

 

[H_Caulfield]

Yes...finish a 5-year general surgery residency and then apply for a 3-year fellowship in thoracic or cardiovascular surgery. As of now, you must complete the 5-year residency first; this is because they have yet to decide that a cardiac surgeon can be competent without getting through all of general surgery first. They may have a point, since you actually open the sternum and enter the chest; interesting to note that integrated programs...otolaryngology, neuro, ortho and plastics....don't involve entering the thoracic or abdominal cavities. There are rumors of a 6 or 7-year integrated track, but don't hold your breath.

You can be strictly a cardiac surgeon, so long as you don't screw up and give someone a pneumo- or chylothorax, in which case you can't really sit around and wait for anyone to arrive and take over for you.

 

[Winged Scapula]

There are probably dozens of threads herewith which deal with CT surgery; if you do a search you may find some more interesting threads.

But as noted above, as of this date, you are required to do a full 5 year general surgery residency before starting a CT fellowship. Integrated programs have been talked about for quite some time but none have started matching people yet.

Step 1/2/3 scores are not relevant for matching into a CT fellowship; your ABSITE scores (American Board of Surgery In training Examination) during residency will be more important.

While you can find lots of conventional wisdom about the personality traits of a CT surgeon, at this point, with 3 + positions for every applicant (which may very well change by the time you get to the point of applying), just having a pulse may be enough at most programs! 😉 I wouldn't worry about having the right personality for a certain field - regardless of what you choose, being able to work with others (especially cardiologists and anesthesiologists), be kind to your patients, doing well on ABSITE and having good technical skills are more important than being the right personality - which is hard-driving, Type A, PITA or so it has been reputed for CT surgeons!

I know of no CT fellows who regularly post here but there are some surgery residents with some interest who can perhaps offer more information.

 

[johnny_blaze]

Why doesn't CT surgery have its own dedicated route like NS?

It does... but not in the U.S unfortunately. Canada and the U.K (and probably other places as well) train cardiac surgeons separately from general surgeons. I dont know why cardiac surgeons have to train in general surgery in the states... I guess it's to make you a more well rounded surgeon... or maybe it's just a waist of time. who knows?

One last thing, CT's deal with the heart, but do they also have to work with lungs? I only am interested in heart surgery
:

There is a trend for cardiothoracic surgeons to specialize. Cardiac surgery deals primarily with myocardial revascularization, valve replacement, surgery for the thoracic aorta, congenital defects, and transplantation. Thoracic surgeons operate on the lungs, oesophagus, mediastinum, and chest wall.
There are still a few that do both, however, as each area advances, more specialized surgeons are more desirable.

 

[Blade28]

I dont know why cardiac surgeons have to train in general surgery in the states... I guess it's to make you a more well rounded surgeon... or maybe it's just a waist of time. who knows?

From my thoracic rotation last month, general surgery was important when doing Heller myotomies, Ivor Lewis/transhiatal/minimally invasive esophagectomies (with J-tube placement), laparoscopic Nissen fundoplications, and TE fistulas.

 

[Dr JPH]

As a follow up (I do not mean to hijack the thread) but is there information as to the long term job outlook for CT surgeons?

No matter how fancy wires get you cant do everything through the femoral vessels.

Of course...this is 9 years away for me, but just wondering!

 

[H_Caulfield]

Hmm...I was wondering the same thing. Anybody? Such a great/exciting field, if it sticks around. It's a shame that those "vascular surgeons" had to go and decide that the vascular part warranted its own specialty.

(can't knock cardiologists, though; more power to them if they can solve everything with little metal rods and tubes).

 

[reglan]

The level of insight of JP HAZELTON and H.CAUFIELD is highly questionable. Please disregard their comments henceforth. These are obviously two people who are ill qualified intellectually and otherwise to pursue medicine much less general surgery. I would challenge them to submit both their step 1 and class ranks as proof (additionaly whether they are in allopathic schools).

BLADE28, KIMBERLICOX, and JOHHNY_BLAZE have valuable advice and insight.

The comments of the two above members are not only inane but uninformed. FOR INSTANCE: "so long as you don't screw up and give someone a pneumo- or chylothorax, in which case you can't really sit around and wait for anyone to arrive and take over for you."

This is an insultingly ignorant statement. Please place a dozen subclavian central lines first.

Don't pay any attention to these *****s.

 

[Dr JPH]

The level of insight of JP HAZELTON and H.CAUFIELD is highly questionable. Please disregard their comments henceforth. These are obviously two people who are ill qualified intellectually and otherwise to pursue medicine much less general surgery. I would challenge them to submit both their step 1 and class ranks as proof (additionaly whether they are in allopathic schools).

BLADE28, KIMBERLICOX, and JOHHNY_BLAZE have valuable advice and insight.

The comments of the two above members are not only inane but uninformed. FOR INSTANCE: "so long as you don't screw up and give someone a pneumo- or chylothorax, in which case you can't really sit around and wait for anyone to arrive and take over for you."

This is an insultingly ignorant statement. Please place a dozen subclavian central lines first.

Don't pay any attention to these *****s.

Excuse me?

The entire point of my statement was to develop conversation towards the future outlook for CT surgeons regarding scope of practice. The entire reason I asked was because I dont know very much about CT surgery and I felt that this would be an appropriate venue to gather more information.

I wasnt trying to offer ANY insight...I was asking a question.

Pretty strong words from someone who is in the process of interviewing for GS spots as well.

🙄 🙄 🙄


BTW....yellow card for you for calling H_Caulfield a *****. Pretty juvenile way of handling yourself in a professional forum.

 

[Dr JPH]

(additionaly whether they are in allopathic schools).

By the way...Philadelphia College of OSTEOPATHIC Medicine

D.O. and proud of it. 👍

 

[Pilot Doc]

is there information as to the long term job outlook for CT surgeons?

Basically ... no.

The job outlook depends on 1) how many procedures need to be done and 2)how many CT surgeons exist

#1 depends on population growth, payer funding decisions, techniological progress and how new procedures split between CT and all other physicians

#2 depends on how many CT surgeons quit/retire early and what adjustments training programs and trainees make

It's a complex equation and the end result means the difference between standing in water that's 2 inches below your nose versus 2 inches above.

As it stands right now, CT surgery represents a less favorable work/reward ratio that other medical specialties. Fast forward 10 years - anybody's guess.

 

[H_Caulfield]

The level of insight of JP HAZELTON and H.CAUFIELD is highly questionable. Please disregard their comments henceforth. These are obviously two people who are ill qualified intellectually and otherwise to pursue medicine much less general surgery. I would challenge them to submit both their step 1 and class ranks as proof (additionaly whether they are in allopathic schools).

BLADE28, KIMBERLICOX, and JOHHNY_BLAZE have valuable advice and insight.

The comments of the two above members are not only inane but uninformed. FOR INSTANCE: "so long as you don't screw up and give someone a pneumo- or chylothorax, in which case you can't really sit around and wait for anyone to arrive and take over for you."

This is an insultingly ignorant statement. Please place a dozen subclavian central lines first.

Don't pay any attention to these *****s.

Wow...calm down, bro. Put the 'roids on the table and take three steps back. Sensitive issue for you, eh? All apologies...didn't realize that particular joke would be analyzed so thoroughly and subsequently graded. Meant no offense, and will keep it in mind next time I tell a hand surgeon to avoid cutting off the fingers (lest I be taken seriously and called an idiot).

 

[2ndyear]

My limited gas resident view: if CT gets into the CHF business and also into percutaneous coronary interventions it will be hot. CAD is stable, but you have one field controlling the stents. CHF, however, there you have a whole bunch of patients with only medical therapy currently. Transplant numbers are miniscule. If ventriculoplasty is refined and VAD's get smaller and less problematic there is a whole world out there to operate on. VAD technology is evolving pretty rapidly and could revolutionize the field. Or maybe not, who knows.

 

[tcdulin137]

(can't knock cardiologists, though; more power to them if they can solve everything with little metal rods and tubes).

until they create problems theyre not equipped to fix i.e. perfing the circumplex, etc.

 

[njbmd]

You can't really predict the future for a specialty. As someone said above, it only takes one new thing and suddenly the whole field is hot. There are new techniques and new procedures coming out all of the time.

The other thing to keep in mind is that something that might not be too competitive or in demand when you start medical school may end up competitive and quite in demand by the time your are ready for residency. That happened with anesthesia. When I started medical school, anesthesia residency slots were going unfilled and when I graduated, a significant portion of my class went into anesthesia.

Specialties go up and down. You have to choose what you love and what you can get into. If you are good at what you do, the jobs will be there for you.

 

[johnny_blaze]

Specialties go up and down. You have to choose what you love and what you can get into. If you are good at what you do, the jobs will be there for you.

The question about what ct surgery will like in the future is very common here on SDN. I think every one should just copy the above statement and paste it whenever anyone asks if any of us can predict the future. Njbmd has answered it perfectly.

I have been told by countless amounts of people to avoid CT surgery because “you’ll never get a consultant post”. What they actually mean is that you wont be able to charge 30k for a CABG and drive a fast sports car home to your big big house like the CT surgeons used to 15 years ago, so there’s no point going into it. It’s obvious that a lot of people would only go into CT surgery for the wrong reasons. If this is the case then yes… you’ll never get a consultant post… at least not in the private sector. However if you are truly interested in it then there are opportunities for someone who is willing to work hard, especially in academics.

 

[SheerZan]

Originally Posted by njbmd "Specialties go up and down. You have to choose what you love and what you can get into. If you are good at what you do, the jobs will be there for you." The question about what ct surgery will like in the future is very common here on SDN. I think every one should just copy the above statement and paste it whenever anyone asks if any of us can predict the future. Njbmd has answered it perfectly.

I have been told by countless amounts of people to avoid CT surgery because “you’ll never get a consultant post”. What they actually mean is that you wont be able to charge 30k for a CABG and drive a fast sports car home to your big big house like the CT surgeons used to 15 years ago, so there’s no point going into it. It’s obvious that a lot of people would only go into CT surgery for the wrong reasons. If this is the case then yes… you’ll never get a consultant post… at least not in the private sector. However if you are truly interested in it then there are opportunities for someone who is willing to work hard, especially in academics.

...yougans, please do heed these wise words of Johnny_blaze. Oh, how true they ring. And he (?) is absolutely right w. njbMD's quote as well.

Honestly, would you ever doubt someone named 'hawkeye'? ...I sure wouldn't 😉

So where are ya Johnny?

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