Current state of transplant surgery

[spikemd13]

I was just hoping to get a feel for what people thought about the current state of transplant surgery and fellowships. Most of the posts on here seem to be a few years old at least. I've seen the data on the ASTS website but I also feel that there's typically a lot of behind the scenes info that might not be out there for public knowledge, maybe any red flags, etc.

My situation is this...I'm going to be starting third year of gen surg residency next month in a community/academic-affiliated Midwest program. Currently we only do kidney transplants in town, other than the heart/lung stuff that the CTS guys do. While scrubbed the other day with one of the kidney guys, he mentioned that the current transplant director is close to retiring and they do not have anyone else board certified as a transplant surgeon-one of those old school practices that still does everything and the current director was grandfathered in. I do have a significant interest in staying in town and would love to join that practice, and this guy mentioned that if I was to pursue a transplant fellowship then they would be very interested in signing me on. I had never given much thought to transplant before, but am definitely considering it now. I realize that those 2 years of fellowship won't be easy by any means but if it means being able to join that practice then it may be worth it. Because of family restraints, personal choice etc I've come up with a preliminary list of potential programs I'd be interested in listed below. Please feel free to throw your two cents in about the situation, specific programs, or all of the above. Any information would be welcome at this point. Thank you

Cedars-Sinai in LA
Medical College of Wisconsin
Northwestern
UCLA
University of Colorado
University of Illinois at Chicago
Pittsburgh
University of Southern California
Univeristy of Wisconsin
University of Michigan
Henry Ford Hospital

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[doc05]

don't take this the wrong way, but your reasoning - do a transplant fellowship in order to join a very specific practice in a small town - is absurd. you'd also have to be crazy to expect them to hold a position for you while you finish residency and then do 2 years of fellowship.

keep in mind that transplant is very demanding - both in terms of technical challenge, as well as lifestyle. not everyone can do it.

also keep in mind that there aren't many transplant jobs available. as with any super-specialized field, you will not have your choice of location/city/etc once you're done with fellowship. Some grads have been known to forgo a transplant career, and just do general surgery, because of these very real limitations.

 

[thedrjojo]

don't take this the wrong way, but your reasoning - do a transplant fellowship in order to join a very specific practice in a small town - is absurd. you'd also have to be crazy to expect them to hold a position for you while you finish residency and then do 2 years of fellowship.

keep in mind that transplant is very demanding - both in terms of technical challenge, as well as lifestyle. not everyone can do it.

also keep in mind that there aren't many transplant jobs available. as with any super-specialized field, you will not have your choice of location/city/etc once you're done with fellowship. Some grads have been known to forgo a transplant career, and just do general surgery, because of these very real limitations.

From the ASTS winter symposium, like 95% of graduating us grads get a job, only 50% of fmg's, and about 50% end up doing livers.

My buddy just went thru the interview process and I'm going thru it next winter... I have some opinions from the trail/rumors, and have some direct knowledge of ucla (one of the graduating chiefs was a coresident) and Henry Ford (one of my attendings graduated 2013) but I'd probably rather not say on the open forum, since it's a small community

 

[DoctwoB]

From the ASTS winter symposium, like 95% of graduating us grads get a job, only 50% of fmg's, and about 50% end up doing livers.

I'm surprised that 50% do livers. Isn't the volume of kidneys an order of magnitude higher?

 

[thedrjojo]

I'm surprised that 50% do livers. Isn't the volume of kidneys an order of magnitude higher?

Most jobs outside the northeast are liver/kidney jobs, so something like 80% are doing kidneys, but most ppl going into it are striving for liver jobs, thus why I highlighted that half or so get it (this is 22-25 fellows graduating a year, so it's 12-13 liver jobs a year...)

 

[Gastrapathy]

Not specific to this situation, but I had a practice wait 3 years for me to finish my military obligation. The old partner would have retired but waited until I could join them (or it was only a few months away really). It does happen. When you find someone you want to go into business with, that can be worth a great deal of inconvenience. That said, I wasn't ever quite sure they were going to do as promised until the day I started and the OP will need to quietly formulate a back up plan if he takes this path.

 

[Psai]

Not specific to this situation, but I had a practice wait 3 years for me to finish my military obligation. The old partner would have retired but waited until I could join them (or it was only a few months away really). It does happen. When you find someone you want to go into business with, that can be worth a great deal of inconvenience. That said, I wasn't ever quite sure they were going to do as promised until the day I started and the OP will need to quietly formulate a back up plan if he takes this path.

😱
i'm sad about the fact that this kind of human decency from doctors surprises me