Neurosurgery - Cardiac Surgery Combined

[Psai]

You guys are spending a ton of time on this kid. Very admirable.

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[bluepink21]

You guys are spending a ton of time on this kid. Very admirable.

Cheers. I am here you know.

 

[doc05]

You guys are spending a ton of time on this kid. Very admirable.

No, not admirable. Actually, it's even dumber than the original question.

 

[doc05]

This question will be an odd one, but please answer the question rather than inform me of the obvious - it'd be practically impossible to accomplish. However ...

I cannot decide between Neurosurgery & Congenital Cardiac Surgery. I am invested in and love both these surgical fields and wouldn't ever want to choose between the two. Would it be technically feasible (i.e. legal / allowed by medical group bylaws) to complete a Neurosurgery residency after medical school. And then complete a 3 year cardiothoracic surgery and 1 year congenital heart surgery fellowships after this to qualify as a Congenital Cardiac Surgeon and a Neurosurgeon. Between the two could be a few years of General Surgery training; but my question is whether it would be technically allowed for a hospital to allow me to enter a 3 year CT surgery fellowship after a Neurosurgery residency without the full 5 year General Surgery residency. An idea would be a plastic surgery fellowship, which you are allowed to complete after Neurosurgery. Would this be considered enough non-neuro surgery training to be allowed (not likely) to enter a CT fellowship.

Note: I will be completing an MD-PhD program, so I would have research experience on top of that in the Neurosurgery residency. Also, I know this question is purely is it possible and not feasible, but would getting a med degree from Harvard / Columbia for example and a top Neuro residency be an advantage?

No.

 

[bluepink21]

No.

That answer was established at the very start - kinder and more intellectually detailed I might add. The thread adjusted to answering whether it would be reasonable to train and practice Neurosurgery & Congenital Cardiac Surgery irrespective of the length of General Surgery training. So although I think I know your answer, what about Neuro+Integrated CT+Cong Cardiac?

 

[WedgeDawg]

Why would you want to do this? What would be the advantage for you? What would be the advantage for your patients? What would be the advantage for healthcare?

 

[deleted547339]

That answer was established at the very start - kinder and more intellectually detailed I might add. The thread adjusted to answering whether it would be reasonable to train and practice Neurosurgery & Congenital Cardiac Surgery irrespective of the length of General Surgery training. So although I think I know your answer, what about Neuro+Integrated CT+Cong Cardiac?

I love when people ask for someone's opinion then ignore it.

While not technically impossible, no one has done something like this for a reason - it's something only a kid could dream up. It's like saying you're going to be an airplane pilot, policeman and the president when you grow up.

But go ahead, kid. Why don't you do anesthesia, too. Then you could put the kid to sleep, fix his heart, then do his crani. If you do medicine, you could manage his long term hypertension as well.

 

[bluepink21]

Why would you want to do this? What would be the advantage for you? What would be the advantage for your patients? What would be the advantage for healthcare?

• Love both fields. Cant chose between. Psychological need to be successful.
• Enjoy it. Feel accomplished.
• Surgeon with a wider view of medicine (stretch). No specific benefit, but I would argue the "damage" would be negligible to bill
• Surgeon with a wider view... Medical research in both fields.

I love when people ask for someone's opinion then ignore it.

While not technically impossible, no one has done something like this for a reason - it's something only a kid could dream up. It's like saying you're going to be an airplane pilot, policeman and the president when you grow up.

But go ahead, kid. Why don't you do anesthesia, too. Then you could put the kid to sleep, fix his heart, then do his crani. If you do medicine, you could manage his long term hypertension as well.

A bit patronising dont you think. Im hardly 6 rattling of careers that i want to do. I have done research into the idea. And I dont think that id operate on a kids heart and brain at the same time. Im not stupid.

 

[Trauma Surgeon]

I love when people ask for someone's opinion then ignore it.

While not technically impossible, no one has done something like this for a reason - it's something only a kid could dream up. It's like saying you're going to be an airplane pilot, policeman and the president when you grow up.

But go ahead, kid. Why don't you do anesthesia, too. Then you could put the kid to sleep, fix his heart, then do his crani. If you do medicine, you could manage his long term hypertension as well.

I'm sure in one of the TV shows that my wife watches (Grey's anatomy maybe) the surgeons are all doers, going from the heart transplant to doing a whipple and ending their day of with a trauma laparotomy and amputation. So nothing is impossible, maybe OP should try to get an audition for next season of Grey's anatomy.

 

[WedgeDawg]

• Love both fields. Cant chose between. Psychological need to be successful.
• Enjoy it. Feel accomplished.
• Surgeon with a wider view of medicine (stretch). No specific benefit, but I would argue the "damage" would be negligible to bill
• Surgeon with a wider view... Medical research in both fields.

How do you know you love both fields? Have you scrubbed into a surgery before? Have you studied in depth the pathophysiology of surgical diseases of the brain and the heart in a way that allows you to clinically evaluate patients, understand why surgery is or isn't indicated, know the methodology of the procedure and what you need to keep in mind perioperatively, and understand how your decision to perform an operation (or not) influences the trajectory of the patient? Have you spent a significant amount of time doing what surgeons do, or at least being with them while doing it?

How do you know you will enjoy it? See above

Why do you argue the damage would be negligible? What evidence do you have to back that up (you've been given plenty of reasons by people far more knowledgable and experienced than me as to why your previous arguments don't hold water)?

On another note, why not just cerebrovascular neurosurgery?

 

[bluepink21]

I'm sure in one of the TV shows that my wife watches (Grey's anatomy maybe) the surgeons are all doers, going from the heart transplant to doing a whipple and ending their day of with a trauma laparotomy and amputation. So nothing is impossible, maybe OP should try to get an audition for next season of Grey's anatomy.

God the US medical system really is **** if Attending Physicians spend their time trying to insult undergrads on the internet with pathetic and immature sarcastic comments.

 

[deleted547339]

• Love both fields. Cant chose between. Psychological need to be successful.
• Enjoy it. Feel accomplished.
• Surgeon with a wider view of medicine (stretch). No specific benefit, but I would argue the "damage" would be negligible to bill
• Surgeon with a wider view... Medical research in both fields.

A bit patronising dont you think. Im hardly 6 rattling of careers that i want to do. I have done research into the idea. And I dont think that id operate on a kids heart and brain at the same time. Im not stupid.

No. I think my response was entirely appropriate because you are either 1) a moderately competent troll or 2) someone so dense that they ask for an opinion then ignore everyone telling you something that sounds idiotic actually is idiotic.

I thought my analogy was particularly apropos.

 

[deleted547339]

Mods, where you at? The madness needs to stop...

 

[bluepink21]

How do you know you love both fields? Have you scrubbed into a surgery before? Have you studied in depth the pathophysiology of surgical diseases of the brain and the heart in a way that allows you to clinically evaluate patients, understand why surgery is or isn't indicated, know the methodology of the procedure and what you need to keep in mind perioperatively, and understand how your decision to perform an operation (or not) influences the trajectory of the patient? Have you spent a significant amount of time doing what surgeons do, or at least being with them while doing it?

How do you know you will enjoy it? See above

Why do you argue the damage would be negligible? What evidence do you have to back that up (you've been given plenty of reasons by people far more knowledgable and experienced than me as to why your previous arguments don't hold water)?

On another note, why not just cerebrovascular neurosurgery?

Yes I fully accept that I may very well change my opinions when I get surgical experience in the future. I have taken on board the arguments that people are making. Im not a completely egotistical idiot. And the main argument on the patient damage front was that a patient would prefer somebody who was "uber qualified" in a certain procedure. And then I brought up DeBakey and Cooley to show that the numbers of overall surgies completed would lean towards my side of the argument ie. half go 60000(DeBakey) = 30000 (heart) + 30000(brain). Cooley did about 40000, only 10000 more.

Its a possibility, but my interest is my with the heart itself, rather than the cardiovascular system. And thank you for a productive and non judgemental response.

 

[bluepink21]

Mods, where you at? The madness needs to stop...

Explain.

 

[WedgeDawg]

Yes I fully accept that I may very well change my opinions when I get surgical experience in the future. I have taken on board the arguments that people are making. Im not a completely egotistical idiot. And the main argument on the patient damage front was that a patient would prefer somebody who was "uber qualified" in a certain procedure. And then I brought up DeBakey and Cooley to show that the numbers of overall surgies completed would lean towards my side of the argument ie. half go 60000(DeBakey) = 30000 (heart) + 30000(brain). Cooley did about 40000, only 10000 more.

Case numbers by themselves don't at all tell the whole story. You have been given information as to why this argument isn't a good one.

 

[bluepink21]

Case numbers by themselves don't at all tell the whole story. You have been given information as to why this argument isn't a good one.

Actually nobody replied to my DeBakey, Cooley argument.

EDIT: Sorry got avatars confused.

 

[bluepink21]

Mods, where you at? The madness needs to stop...

Quite a few people seem to be engaging in conversation, so why on earth should this thread be shutdown?

 

[bluepink21]

No. I think my response was entirely appropriate because you are either 1) a moderately competent troll or 2) someone so dense that they ask for an opinion then ignore everyone telling you something that sounds idiotic actually is idiotic.

I thought my analogy was particularly apropos.

And Im not a troll I have better things to do, or ignoring the arguments put forward. I can understand that people dont think that it would be possible, but what is wrong with conversation and debate. Im not ignoring what you say, for example I do understand that my opions are likely to change when I actually get to my surgical rotations & electives. What I do ignore is you snide comments about immaturity, trolling, stupidity, ignorance & making pathetic jokes that dont add anything to the conversation.

 

[WedgeDawg]

Actually nobody replied to my DeBakey, Cooley argument. And Im not a troll I have better things to do, or ignoring the arguments put forward. I can understand that people dont think that it would be possible, but what is wrong with conversation and debate. Im not ignoring what you say, for example I do understand that my opions are likely to change when I actually get to my surgical rotations & electives. What I do ignore is you snide comments about immaturity, trolling, stupidity, ignorance & making pathetic jokes that dont add anything to the conversation.

You posted in a forum that is geared towards practicing surgeons, surgical residents, and 4th year med students applying into surgery. You are posting without the level experience that everyone else here (me excluded) has. Just by asking extremely hypothetical and highly unrealistic questions, you aren't contributing anything of value to this particular forum, and are further wasting the time of people who are posting while trying to use their experience and expertise to show you why this isn't possible when you respond poorly to them. Most posters have been highly informative and respectful in their responses, but they are also being realistic, which is not at all synonymous with "snide comments about immaturity, trolling, stupidity, ignorance & making pathetic jokes that dont add anything to the conversation"

Thus, this is not the appropriate venue for this thread. I am going to move this to pre-allo and out of the surgical subspecialty forum. Generally, we do not encourage users to post threads "up" (i.e. a pre-med posting in a resident's forum), but we highly encourage more experienced members to share their wisdom "down" (i.e. an attending posting in pre-allo). Plenty of practicing surgeons and surgical residents frequent pre-allo, so you'll still be able to get responses and advice.

 

[bluepink21]

You posted in a forum that is geared towards practicing surgeons, surgical residents, and 4th year med students applying into surgery. You are posting without the level experience that everyone else here (me excluded) has. Just by asking extremely hypothetical and highly unrealistic questions, you aren't contributing anything of value to this particular forum, and are further wasting the time of people who are posting while trying to use their experience and expertise to show you why this isn't possible when you respond poorly to them. Most posters have been highly informative and respectful in their responses, but they are also being realistic, which is not at all synonymous with "snide comments about immaturity, trolling, stupidity, ignorance & making pathetic jokes that dont add anything to the conversation"

Thus, this is not the appropriate venue for this thread. I am going to move this to pre-allo and out of the surgical subspecialty forum. Generally, we do not encourage users to post threads "up" (i.e. a pre-med posting in a resident's forum), but we highly encourage more experienced members to share their wisdom "down" (i.e. an attending posting in pre-allo). Plenty of practicing surgeons and surgical residents frequent pre-allo, so you'll still be able to get responses and advice.

I understand why you moved it. However I think some commenters have been immature with laughing smiley face, jokes and unrealistic sarcastic analogies that aren't relevant. But I think thats irrelevant when compared with the content.

Could I ask you a question on why case numbers dont tell the whole story. I never got a reply to my DeBakey-Cooley argument and I do like to learn.

 

[WedgeDawg]

I understand why you moved it. However I think some commenters have been immature with laughing smiley face, jokes and unrealistic sarcastic analogies that aren't relevant. But I think thats irrelevant when compared with the content.

Could I ask you a question on why case numbers dont tell the whole story. I never got a reply to my DeBakey-Cooley argument and I do like to learn.

I am not in any way shape or form an expert on this so don't take my answer as gospel.

It's not just about the operations, but about decision to treat, perioperative management, and how frequently you do a procedure as well. If you spend 7 years doing neurosurgical procedures and being involved in neurosurgical management and decision-making and then spend 6 years (best case scenario) doing cardiothoracic procedures and management and decision-making (you have been told why you cannot do neurosurgery on the side while doing another surgical residency or vice versa), even though you may have done a certain number of procedures, you have gone over half a decade without doing them at all - your skills will have atrophied to the point where no one is going to hire you to do neurosurgery, and rightfully so.

That's probably not even remotely the strongest answer, but it's one that will definitively stop you from practicing both, even if you might (somehow) get technically licensed to do so.

Again, not an expert. The experts have already spoken.

 

[NotASerialKiller]

Someone can't decide if they're a Cristina or a Derek

 

[bluepink21]

I am not an expert on this so don't take my answer as gospel.

It's not just about the operations, but about decision to treat, perioperative management, and how frequently you do a procedure as well. If you spend 7 years doing neurosurgical procedures and being involved in neurosurgical management and decision-making and then spend 6 years (best case scenario) doing cardiothoracic procedures and management and decision-making (you have been told why you cannot do neurosurgery on the side while doing another surgical residency or vice versa), even though you may have done a certain number of procedures, you have gone over half a decade without doing them at all - your skills will have atrophied to the point where no one is going to hire you to do neurosurgery, and rightfully so.

That's probably not even the strongest answer, but it's one that will definitively stop you from practicing both, even if you might (somehow) get technically licensed to do so.

Cheers. My argument with DeBakey-Cooley though was that after that residency training period, the share of cases wouldn't be significant enough to reduce my skills in either area as shown by the numbers. Obviously Cooley was one of the best CT surgeons in history, but I am a very optimistic person. Would you agree.

I completely see people arguments that during the CT training my neuroskilsl would probably atrophy, so id have to find a way to prevent this. Not saying possible, but I like to be positive, while understanding the near impossibility.

 

[Matthew9Thirtyfive]

Not sure I anyone mentioned this amid the other very good reasons why this will never happen, but unless things have changed, you get funding for the number of years of the residency you match into. Which means you'll have to convince another program to take you for your second residency and eat the cost. Good luck with that when you admittedly want to only be 50% involved in that specialty (or in the case of surgery, almost zero since your plans are to not practice gen surg and move on to peds CT).

 

[bluepink21]

Someone can't decide if they're a Cristina or a Derek

What?

 

[bluepink21]

Not sure I anyone mentioned this amid the other very good reasons why this will never happen, but unless things have changed, you get funding for the number of years of the residency you match into. Which means you'll have to convince another program to take you for your second residency and eat the cost. Good luck with that when you admittedly want to only be 50% involved in that specialty (or in the case of surgery, almost zero since your plans are to not practice gen surg and move on to peds CT).

5 year general + cards unlikely. Integrated cardio residency.

 

[WedgeDawg]

Cheers. My argument with DeBakey-Cooley though was that after that residency training period, the share of cases wouldn't be significant enough to reduce my skills in either area as shown by the numbers.

No because you wouldn't get to perform any neurosurgical or cardiothoracic cases after residency because no one will hire you, so your case load for that specialty (whichever was first) would be 0.

 

[AdmiralChz]

This is hysterical. Cooley and DeBakey did tons of research, yes, but it was all directly related in THEIR fields. They didn't have a side business of lumbar laminectomies or suboccipital tumor resections - and if either were still alive I am sure they would either laugh you out of the room or scream at you for being so unreasonable. These are two completely different fields with completely different skill sets.

You brought up neurosurgeons doing research years - absolutely, but it is always in their area of interest and directly ties into their clinical work (i.e. brain tumor bench work), going on a sabbatical learning another completely unrelated skill set is unrealistic. Going through residency or fellowship and having a side practice in a different field also shows just how little you understand about surgical training (or really, medicine in general). No one cares if you are at Oxford, Harvard, the International Space Station, Area 51 or my moldy basement - the answer is still the same.

This is the classic SDN thread:

OP: "Hey, I have a fairly outlandish idea and am looking to get some feedback on it"
SDN: "Well, this isn't really realistic for such and such"
OP: "What do you know, I am smart and you lack compassion for my situation. Screw you all I am going to do it anyways and show you!"
SDN: *Sigh*

 

[Matthew9Thirtyfive]

5 year general + cards unlikely. Integrated cardio residency.

The integrated cardio residency still requires funding you wouldn't have. Same issue.

 

[bluepink21]

No because you wouldn't get to perform any neurosurgical or cardiothoracic cases after residency because no one will hire you, so your case load for that specialty (whichever was first) would be 0.

So consider this scenario. I complete NS residency at Columbia. Then I-6 CT at Columbia and Cong Card at Boston. I would be able to get an attending position in congenital cardiac surgery at Morgan stanley (hypothetically). Why would the Neuro Dep completely ignore my training that i completed with them. I am built back to complex cases over time, but why would the Chair, or vice chair I trained under and developed a relationship with just ignore his knowledge of my surgical ability. I accept that I wouldbt be able to go straight into the most complex skull base or functional procedures, but i dont understand why he/she would never allow me to operate in his department when he knows I have the neurosurgical skills to do so because he trained me in them.

 

[LutGholein]

I am invested in and love both these surgical fields

How? I shadowed radiologist, hematologist, pediatricians, and i'd be a fool to tell you that i'm deeply invested in any of these fields.

God the US medical system really is **** if Attending Physicians spend their time trying to insult undergrads on the internet with pathetic and immature sarcastic comments.

I admire the attendings/residents that have humored this long enough-- you're out of line for insulting people who have the experience trying to teach you something.

 

[bluepink21]

This is hysterical. Cooley and DeBakey did tons of research, yes, but it was all directly related in THEIR fields. They didn't have a side business of lumbar laminectomies or suboccipital tumor resections - and if either were still alive I am sure they would either laugh you out of the room or scream at you for being so unreasonable. These are two completely different fields with completely different skill sets.

You brought up neurosurgeons doing research years - absolutely, but it is always in their area of interest and directly ties into their clinical work (i.e. brain tumor bench work), going on a sabbatical learning another completely unrelated skill set is unrealistic. Going through residency or fellowship and having a side practice in a different field also shows just how little you understand about surgical training (or really, medicine in general). No one cares if you are at Oxford, Harvard, the International Space Station, Area 51 or my moldy basement - the answer is still the same.

This is the classic SDN thread:

OP: "Hey, I have a fairly outlandish idea and am looking to get some feedback on it"
SDN: "Well, this isn't really realistic for such and such"
OP: "What do you know, I am smart and you lack compassion for my situation. Screw you all I am going to do it anyways and show you!"
SDN: *Sigh*

Well thats completey unrepresentative of the situation. If I dont agree with something said, or dont understand Im not going to just give up and completey accept their arguments. I understand its outlandish, I understand I dont have any surgical experience, but I can respond nonetheless when i dont agree with something. And on your comment. I made no comment on Colley and DeBakey doing research. Or at least if I have done it wasn't my point with the two. I was using their number (D = 60000, C = 40000) of lifetime surgiers to show halving D = 30000 heart + 30000 neuro, would put the heart procedures at only 10k less than one of the best ct surgeons in history.

 

[Goro]

I was hoping you'd respond and stick a much needed scalpel in this idea.

It's completely unrealistic. That should be the end of the discussion really. Others have enumerated several of the many, many reasons.

That's not an "immature" response, by the way. The complete unwillingness to listen to voices of experience is the biggest sign of immaturity in this thread by far.

The only thing I would add to the above comments: in response to your comment that there are "plenty" of other hours in the week to practice your surgical skills outside of the 80ish hours required by one specialty - no, there are not.

-Logistically/regulatory-wise: The duty hour regulations (the 80 hr work week) are inclusive of any moonlighting or other clinical responsibilities. So any "practice" neurosurgery would be in violation of the duty hours and thus expressly forbidden by your general surgery and cardiac surgery programs.

-Practically speaking: What exactly time of the day would you be planning on throwing in those extra neurosurgery cases? To clarify, you wouldn't be in a training program in neurosurgery. So the only way this would work is if you were booking cases and doing them yourself, as an attending surgeon. That means you need predictable, scheduled hours, and a clinic. The 80 hours you work on cardiac wouldn't be somehow shoe-horned around an active clinical practice. Your general surgery/CT surgery program will be occupying basically every weekday from 5 or 6 am until 5 or 6 pm plus call and overnight duties. You going to be scheduling elective neurosurgery cases in the middle of the night during al of that free time?

-Realistically speaking: Respectfully, you have no clue what you're talking about. You have no idea how exhausting surgical training is. There is not time for a robust second career on top of the demands of a surgical training program. I don't really care about how few hobbies you have or your lack of interest in a social life. Surgery residency is grueling, exhausting, and the hours and time commitments unpredictable.

SDNers have a low tolerance for people who come here asking for advice when they really want to hear what they want to hear, and then proceed to snap at people giving realistic advice and not hugs and kisses.

I guess its the same with all forums: the anonymity provides a good shield for those who need advice. But on the other hand it can be used by those who just want to ridicule others who come to the forum asking honest questions.

 

[SouthernSurgeon]

Cheers. My argument with DeBakey-Cooley though was that after that residency training period, the share of cases wouldn't be significant enough to reduce my skills in either area as shown by the numbers. Obviously Cooley was one of the best CT surgeons in history, but I am a very optimistic person. Would you agree.

That argument was answered in part a long time ago

Heart transplants:CT surgery::rice krispies:cereal

Congenital CT:neurosurgery::apples:motorcycles

The fact that a CT surgeon hasn't done that many heart transplants is not that concerning because the anatomical and procedural overlap is extremely high.

As for comparing yourself to debakey/Cooley....well there are about a million problems with that comparison. The prime of both those surgeons' practices was fifty years ago. They invented many of the techniques they performed and much of the equipment used. Regulatory oversight was lower (Cooley literally stole an experimental mechanical heart and implanted it in a patient without approval from anyone). Outcomes (and monitoring of outcomes) were poorer. Plus both of them lived exceptionally long lives and practiced well into their senior years. And none of them tried to add neurosurgery into their regular practice, even back then when it would have maybe been at least a tiny bit feasible.

You also don't seem to have any awareness of how specific and narrow a field congenital is. There's no 30000 cases in a career there. That's not a career you do part time.

Like I said...there are huge, huge flaws with every part of your thought process. The comparison to wanting to be a cop and president and A pilot is really an apt one. That's how absurd this plan sounds to anyone with experience.

 

[bluepink21]

How? I shadowed radiologist, hematologist, pediatricians, and i'd be a fool to tell you that i'm deeply invested in any of these fields.


I admire the attendings/residents that have humored this long enough-- you're out of line for insulting people who have the experience trying to teach you something.

That was my point. Some, like WedgeDawg, have been reasonable and helpful, while others seem to have wasted their time making some relevant points but bracketing them with insults, sarcasm and animated laughing faces. Im not insulting anybody trying to teach me anything. Thank you to those who have responded honestly. And I was pointing out how some have not response honestly, but I think their feelings will be fine. I wasn't too harsh.

 

[DrBowtie]

So consider this scenario. I complete NS residency at Columbia. Then I-6 CT at Columbia and Cong Card at Boston. I would be able to get an attending position in congenital cardiac surgery at Morgan stanley (hypothetically). Why would the Neuro Dep completely ignore my training that i completed with them. I am built back to complex cases over time, but why would the Chair, or vice chair I trained under and developed a relationship with just ignore his knowledge of my surgical ability. I accept that I wouldbt be able to go straight into the most complex skull base or functional procedures, but i dont understand why he/she would never allow me to operate in his department when he knows I have the neurosurgical skills to do so because he trained me in them.

Because why would they waste any faculty funding (FTE) on you, someone 7 years removed from neurosurgery over their other recently graduated residents who are 100% dedicated to neurosurgery. Your perceived novelty is a liability, not an advantage.

 

[bluepink21]

That argument was answered in part a long time ago

Heart transplants:CT surgery::rice krispies:cereal

Congenital CT:neurosurgery::apples:motorcycles

The fact that a CT surgeon hasn't done that many heart transplants is not that concerning because the anatomical and procedural overlap is extremely high.

As for comparing yourself to debakey/Cooley....well there are about a million problems with that comparison. The prime of both those surgeons' practices was fifty years ago. They invented many of the techniques they performed and much of the equipment used. Regulatory oversight was lower (Cooley literally stole an experimental mechanical heart and implanted it in a patient without approval from anyone). Outcomes (and monitoring of outcomes) were poorer. Plus both of them lived exceptionally long lives and practiced well into their senior years. And none of them tried to add neurosurgery into their regular practice, even back then when it would have maybe been at least a tiny bit feasible.

You also don't seem to have any awareness of how specific and narrow a field congenital is. There's no 30000 cases in a career there. That's not a career you do part time.

Like I said...there are huge, huge flaws with every part of your thought process. The comparison to wanting to be a cop and president and A pilot is really an apt one. That's how absurd this plan sounds to anyone with experience.

I fully understand that congenital cardiac surgery is very specialised with a small number of very complex cases. I am also aware of the biographies of both Cooley and DeBakey, in fact I admire them greatly. Your points are valid. That is fine, I've moved on to other arguments. Attendings/Residents dont think it possible because the two specialities are so different. Okay I accept that, I understand. But I do disagree with the 6 year old career rambling analogy. But I can move past that.

 

[WedgeDawg]

So consider this scenario. I complete NS residency at Columbia.

Unlikely unless you went to Columbia for med school and nearly all of their international applications they take are from Canada, but okay fine, for the sake of the argument, sure.

Then I-6 CT at Columbia and Cong Card at Boston.

If you did neurosurgery at Columbia and the CT people were like why are you coming to CT now, you have no explanation for them that isn't damning to you in some way. Also it's essentially impossible to match I6 CT unless you're a graduating senior. Same thing if you decide to do CT first and then go for nsgy.

But let's pretend it happened even though it can't.

I would be able to get an attending position in congenital cardiac surgery at Morgan stanley (hypothetically).

sure whatever

Why would the Neuro Dep completely ignore my training that i completed with them.

because you peaced out 9 years ago when you decided to go CT

I am built back to complex cases over time

No you're not, because no one hired you to practice neurosurgery

but why would the Chair, or vice chair I trained under and developed a relationship with just ignore his knowledge of my surgical ability

Because you left for CT

I accept that I wouldbt be able to go straight into the most complex skull base or functional procedures, but i dont understand why he/she would never allow me to operate in his department when he knows I have the neurosurgical skills to do so because he trained me in them.

Columbia has the most hyperspecialized neurosurgical program in the country. The people who practice there LITERALLY do one thing each. There is no generalist neurosurgeon at Columbia. Both the chair and the vice chair do exclusively cerebrovascular. The PD does exclusively transsphenoidal approaches to pituitary tumors and skull base surgery. Why would they want someone who hasn't done neurosurgery in 9 years coming back and taking their patients who have access to people who literally spend their entire lives taking care of one extremely specialized area of neurosurgical care? Those patients would be crazy to take someone who hasn't touched a brain in nearly a decade over one of the Columbia attendings?

 

[bluepink21]

Unlikely unless you went to Columbia for med school and nearly all of their international applications they take are from Canada, but okay fine, for the sake of the argument, sure.



If you did neurosurgery at Columbia and the CT people were like why are you coming to CT now, you have no explanation for them that isn't damning to you in some way. Also it's essentially impossible to match I6 CT unless you're a graduating senior. Same thing if you decide to do CT first and then go for nsgy.

But let's pretend it happened even though it can't.



sure whatever



because you peaced out 9 years ago when you decided to go CT



No you're not, because no one hired you to practice neurosurgery



Because you left for CT



Columbia has the most hyperspecialized neurosurgical program in the country. The people who practice there LITERALLY do one thing each. There is no generalist neurosurgeon at Columbia. Both the chair and the vice chair do exclusively cerebrovascular. The PD does exclusively transsphenoidal approaches to pituitary tumors and skull base surgery. Why would they want someone who hasn't done neurosurgery in 9 years coming back and taking their patients who have access to people who literally spend their entire lives taking care of one extremely specialized area of neurosurgical care? Those patients would be crazy to take someone who hasn't touched a brain in nearly a decade over one of the Columbia attendings?

Cheers. 7 not 9. But i really dont think that matters. You've made great points, its not feasible or realistic. The specific example of Columbia is also helpful and educating. I will lay down my arms, something i really find difficult to do, and admit defeat (for 15 years anyway ) . Ill still respond to any replies, but let it be known I understand.

 

[onceawolverine]

So consider this scenario. I complete NS residency at Columbia.

Hm. Long way to go but I'm strapped in.

Then I-6 CT at Columbia and Cong Card at Boston.

Oh I had no idea it was that easy.

I would be able to get an attending position in congenital cardiac surgery at Morgan stanley (hypothetically).

Shaky, given that positions don't just ~*open up*~ for people like that, and shaky on the fact that your premise is already teetering.

Why would the Neuro Dep completely ignore my training that i completed with them.

Simple! Because you've taken 5 years off, they've since graduated ~10-15 residents since you, if any spots opened up in NSG they'd be hiring residents who are wholeheartedly dedicated to the field, not fueling an arrogant career wanderlust.

I am built back to complex cases over time, but why would the Chair, or vice chair I trained under and developed a relationship with just ignore his knowledge of my surgical ability. .

Do you know the chair?

I accept that I wouldbt be able to go straight into the most complex skull base or functional procedures, but i dont understand why he/she would never allow me to operate in his department when he knows I have the neurosurgical skills to do so because he trained me in them.

Because you're not really as special a snowflake as you think you are. Training in both of these fields makes you a liability to both, not an asset. It does no benefit to patients to pursue both, and chairmen (and medical school deans, frankly) would see right through that plan. Your best bet is to try to ground your passions in reality. As it appears that you are a very passionate person, if you were able to recalibrate your sense of reality and strive towards a realistic goal, you might be proud of yourself at the end of the day anyway!

 

[bluepink21]

@Trauma Surgeon is European, actually

Appropriate and helpful. Well done.

 

[bluepink21]

Hm. Long way to go but I'm strapped in.

Oh I had no idea it was that easy.

Shakey, given that positions don't just ~*open up*~ for people like that, and shakey on the fact that your premise is already teetering.

Simple! Because you've taken 5 years off, they've since graduated ~10-15 residents since you, if any spots opened up in NSG they'd be hiring residents who are wholeheartedly dedicated to the field, not fueling an arrogant career wanderlust.

Do you know the chair?

Because you're not really as special a snowflake as you think you are. Training in both of these fields makes you a liability to both, not an asset. It does no benefit to patients to pursue both, and chairmen (and medical school deans, frankly) would see right through that plan. Your best bet is to try to ground your passions in reality. As it appears that you are a very passionate person, if you were able to recalibrate your sense of reality and strive towards a realistic goal, you might be proud of yourself at the end of the day anyway!

Cheers for the last it. I do struggle with arrogance. I know Im not a "special snowflake", but I guess i wouldn't admit it.

 

[onceawolverine]

because you peaced out 9 years ago when you decided to go CT



No you're not, because no one hired you to practice neurosurgery



Because you left for CT

I like your style

 

[Dr. Stalker]

EDIT: Thanks to those who have answered with good advice. I take on the criticism, but to be honest it hasn't really deterred by ambitions (although I am yet to reach even med school). But to those who were either sarcastic, insulting, patronising or overly pessimistic "A butterfly is a caterpillar who never gave up on their dream to fly"

Kid, study for your MCAT and get admitted to your MD-PhD program before changing the realm of surgery. I say this with love cause I used to think about this kind of stuff and then I tanked my MCAT. Kind of put a halt in my neuro-ct-derm-radiology-peds-emergency medicine fusion attending.

 

[bluepink21]

Kid, study for your MCAT and get admitted to your MD-PhD program before changing the realm of surgery. I say this with love cause I used to think about this kind of stuff and then I tanked my MCAT. Kind of put a halt in my neuro-ct-derm-radiology-peds-emergency medicine fusion attending.

Cheers. I do tend to get ahead of myself. But then again I guess if in the 0.00000001% chance somebody was to become a Neurosurgeon/Congenital Cardiac Surgeon, they probably would have to be preparing this early. lol

 

[WedgeDawg]

honestly, might as well throw ENT or ortho into the mix too

 

[onceawolverine]

Cheers for the last it. I do struggle with arrogance. I know Im not a "special snowflake", but I guess i wouldn't admit it.

Start admitting it ASAP.
IMO, surgery demands self-confidence, but arrogance is a surefire way to send your career down in flames. Surgeons make mistakes, and its imperative that they admit it when they do. Arrogance goes hand-in-hand with an unwillingness to see flaws in oneself and accept responsibilities for one's shortcomings and failures.

I'm intentionally using an impersonal "one" here because I don't want to attack you, merely suggesting things for you to think about and consider. The best surgeons I know have humility.

 

[onceawolverine]

honestly, might as well throw ENT or ortho into the mix too

dont you dare bring ortho into this

 

[bluepink21]

Start admitting it ASAP.
IMO, surgery demands self-confidence, but arrogance is a surefire way to send your career up in flames. Surgeons make mistakes, and its imperative that they admit it when they do. Arrogance goes hand-in-hand with an unwillingness to see flaws in oneself and accept responsibilities for one's shortcomings and failures.

I'm intentionally using an impersonal "one" here because I don't want to attack you, merely suggesting things for you to think about and consider. The best surgeons I know have humility.

No no. Use you all you want. Its fine. I hold my hands up and admit I've been a bit of an idiot in tho thread. I couldn't accept what people were telling me because I think im special.