Endocrine Surgery

[bunnybear]

Hey guys, I know this thread is not going to sound too smart, however i don't know much about the process.
Lets say one decides to do a fellowship in Endocirne surgery, now, for the residency does she/he have to do Internal medicine or General surgery??
Does anyone know how hard it is to get into an Endocine Surgery Fellowship?
I know its quite limited, for example in CA UCSF is the only one that offers it, In IL Rush University is the only school and so on.., And there are two foreign fellowships as well, one of them is in Sydney I believe.
Could you help me out
Thanks a lot

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[Doc Ivy]

I could be wrong but if you want to be an Endocrinologist and manage these conditions medically then you do Internal Medicine and Endo fellowship thereafter. If you want to do Endocrine surgery, you do a General Surgery residency, don't think there are a lot of Endocrine surg fellowships per se, which might be why you're having a tough time finding programs. After a Gen Surg residency you're basically qualified to do a lot of basic GI/Endocrine cases.

 

[Winged Scapula]

There ARE Endocrine Surgery fellowships but there aren't many. A grad of my former program did one in NYC a couple of years ago; despite the lack of programs I do not believe they are very competitive.

As noted by Doc Ivy, if you want to medically manage these patients you do an Endocrine/Metabolism fellowship after IM residency. If you want to be a surgeon and surgically manage these patients, you completed a General Surgery residency followed by the Endocrine Surgery fellowship.

Here is the link to the Association of Endocrine Surgeons...

http://endocrinesurgery.org/fellowships/fellowships.html

 

[tussy]

As others have said - surgical endocrinology is a 1-2 year fellowship after completing a full residency in general surgery (5-7 years). The major procedures done by a surgical endocrinologist would include thyroid and parathyroid surgery and adrenal gland surgery. There are some rarer tumours in the pancreas (eg neuroendocrine tumors) and GI tract (carcinoid tumours) which would also be in the domain of the surgical endocrinologist.

Medical endocrinology would be a fellowship done after an internal medicine residency. It is totally different and focuses on the medical management of endocrine disorders.

There are only a few fellowship programs, but as others have said, it should be that competative. Getting thru the gen surg residency is the first hurtle though!

 

[flashman]

One of the finer points of specialization is relavant here. As a general surgeon you will have trained for all of the cases for endocrine. This is also true for several other fellowships as well, e.g. surgical oncology, breast, colorectal, etc. One real value of doing a fellowship though is that you will be able to limit your practice to those cases. One way that this becomes possible is that you will get the referrals.

I have lately been wondering this about endocrine surgery. In my experience it seems that though all the surgeons in town will have been trained to perform these cases they typically only get referred to one or two guys in town who do a lot of them. I wonder if in the future these guys will be the ones who have endocrine fellowships. It does seem like a good way to get these referals. If you move to a medium/arge sized city as a new guy there is no way you will get these cases. If however the endocrinologists know that you have a fellowship they might be more likely to refer to you.

Do other people think that this will be a trend?

By the way... endocrine cases are considered a treat: a thyroid is nice, technical surgery, no midnight referals, reimberces really well, and patients go home the next day.

 

[aashiq]

The surgeries, an endocrinology surgeon will be doing are like thyroid, parathyroid, Adrenals, MEN 1etc which are already being done in abundance by general surgeons.
In the future, I think patients will have a more selective approach and an endocrinology surgeon can do well

 

[toxic-megacolon]

Do other people think that this will be a trend?

I'm really curious about this too. If one completes a fellowship in endocrine surg, can you survive purely as an endocrine surgeon, or will you have to do general cases too? In otherwords, is endocrine surgery recongized by enough endocrinologists and internists to monopolize referrals?

 

[Doc Ivy]

I'm really curious about this too. If one completes a fellowship in endocrine surg, can you survive purely as an endocrine surgeon, or will you have to do general cases too? In otherwords, is endocrine surgery recongized by enough endocrinologists and internists to monopolize referrals?

At my school, the endocrine surgeons take general surgery call, so when appys, acute choles etc come into the ER, they do them. All the elective stuff they do is endocrine

 

[boston]

I'm really curious about this too. If one completes a fellowship in endocrine surg, can you survive purely as an endocrine surgeon, or will you have to do general cases too? In otherwords, is endocrine surgery recongized by enough endocrinologists and internists to monopolize referrals?

My impression is that you set up your practice how ever you like it -- with the caveat, however, that you can generate enough referrals. One attending here does only thyroids and parathyroids, probably 6-7 a week and takes no general surgery call. However, he is in his 70s and probably going to retire soon. He gets patients referred by endocrinologists from neighboring states. It's sweet -- all elective cases and no call.

It's probably unrealistic to expect to be doing exclusively endocrine cases fresh out of fellowship, but if you stay at a tertiary academic center and become well-known in the field, you could probably generate enough referrals to do so eventually.