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Different cardiac specialties

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mustang

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What's the diffenece between cardiothoracic, cardiovascular, endovascular, or just a cardiac or vascular surgeon by itself? I know that vascular deals with the blood vessels and thoracic with chest wall, lungs, etc. But how are these degrees obtained? Does a surgeon have to study cardiothoracic and then vascular surgery seperate in order to be a vascular and cardiothoracic surgeon is this a joint study. How many more years does each entail?
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Winged Scapula

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Both CT and Vascular Surgeons do a general surgery (5+ years) residency followed by the appropriate fellowship. Vascular Surgeons may further do Endovascular training after their primary Vascular fellowship. To do both CT and Vascular you must train in both; I am not aware of any combined programs.

General Surgery residency training is 5 years with some additional laboratory/research years possibly being required (program dependent). Both CT and Vascular Fellowships are 2 years in length. Vascular will be going to a 3+3 integrated program sometime in the future (ie, 3 years of Gen Surg, 3 years of Vascular, match out of medical school).

A Cardiac surgeon has generally trained at a program without thoracic training, but most residencies are combined Cardio and Thoracic.

Hope this helps.
 

droliver

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kimberli,

- carolina's medical center has a 3 year combined CT/Vascular program

- there are a # of non-cardiac thoracic fellowships around, but as yet there is no board-certification for this (independent of cardio-thoracic fellowships). In the future, there will likely be ABMS accredidation for this as a subspecialty
 

Winged Scapula

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Thank you very much droliver. I wasn't aware of that (that there is a combined CT/Vascular program, although I was aware that there were non-cardiac thoracic programs), apparently nor was our Vascular fellow (with whom I consulted on the above information). I'll add that info to my mental database! :D
 

Airborne

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How difficult is it to practice both CT and Vascular once the fellowship is completed?
 

mustang

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Is it true that the majority of thoracic surgeries are done by general surgeons? If this is true then are thoracic surgeons getting less and less cases? Also, there isn't a cardiothoracic abms certification, there is only a thoracic certification. So who sets the requirements for CARDIOthoracic residency?
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JScrusader

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In order to operate within the thoracic cavity, a surgeon needs certification. It is possible for a general surgeon to obtain such specialization, though it is rare. Procedures like a thoracotomy or an ascending aneurysm are reserved for CT surgeons or those with other certification. I have seen an instance where a vascular surgeon was denied a case by the anesth. department because he proposed to operate on the aortic without proper certification. But I have also seen a GS implant a pacemaker.
 

droliver

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JScrusader,

actually "certification" has nothing to do with it. If you have an MD liscence, you can do whatever a hospital will give you privledges to do at their facility. In practice, board-certification or eligibility is often used by hospitals to set privledge status for procedures. For some procedures normally considered outside of your field or that have high morbidity, you may have to demonstrate a certain # of cases during your training or with proctored cases by other physicians. In urban areas, for a general surgeon to get privledges for advanced vascular or ERCP, you will have to show some arbitrary # for the procedure. This is the same reason why in say, cosmetic surgery- Dermatologists, Oral Surgeons, or ENT's may not be able to get privledges to do many cosmetic procedures. (This does not prevent them from doing it in their office or independent surgery center however, but a # of states are proposing legislation that would strongly curtail this after a spate of deaths under these circumstances).

I also find it very unusual in your example that an anesthesiologist would be able to cancel a case unilaterally b/c he felt a surgeon was "not certified". He could personally refuse to staff it, but assuming the surgeon was not denied privledges for it by the hospital credentialing committee, the decision to allow the procedure would not be his. For pete's sake..... there are already Cardiologists & Radiologists who go around doing some ridiculous non-indicated endovascular procedures & they worry that a boarded vascular surgeon can't operate on the aorta?
 
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