Neurosurgery - Cardiac Surgery Combined

[cke11]

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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.

Then why are you hoping to apply and practice in the states???? I don't think what you want to do is impossible, but I would agree with what everyone else is saying. Focus your attention on one of the two and become the best you can. I think you need a little reality check to be honest.

 

[bluepink21]

In return for the joy that reading this thread has brought me, and with the hopes that it will never die, I will continue on with further serious concerns about your plan.

Let's say 6 years for MD/PhD, 15 years for your combined residencies/fellowships/subfellowships (+/-, we don't really know since it's never been done), you're done at age what, 43? I can tell you that even after congenital cardiac surgery fellowship, most of them go and become junior attendings to gain more experience before becoming primary.

So now you're in your 40s, and you're assisting other surgeons in 2 fields. And it's going to take longer to gain experience because you're getting it at half the rate that other people who focus on one specialty are getting it. How long until you're completely independent? 5, 7 years? So now you're finally independent at age 50? Then you have maybe 10 years before your skills start deteriorating and you start shifting into a supervisory role?

What's the benefit to your patients? To your department? There isn't any. Nobody is saying, "Man, I wish our amazing skull base surgeon could have less experience doing skull base surgery so he can be a mediocre congenital cardiac surgeon in addition." Literally the only reason to do this would be an ego stroke for you. I promise you, if you become a top-shelf subspecialized neurosurgeon or congenital cardiac surgeon, there will be plenty enough ego-stroking as is...

Cheers for that. Good reply. I understand now that Neuro/CC would be impractical, and damaging to patients. But due to a combination of admittedly ego and a love of the renaissance man, I can give up the idea of a multi-trained surgeon. What about speciality, directly related to neurosurgery, like ENT/plastic/optho, who work directly with neurosurgeons anyway.

Also. Would you have any pros and cons for neurosurgery and congenital cardiac surgery. On their own obviously.

 

[cke11]

Then why are you hoping to apply and practice in the states???? I don't think what you want to do is impossible, but I would agree with what everyone else is saying. Focus your attention on one of the two and become the best you can. I think you need a little reality check to be honest.

EDIT: I read the whole thread, I commend you for realizing how far fetched it could be and wanting to actually argue and discuss different ideas. That's something a lot of people around here don't know how to do. They think they're right and block out a lot of what they don't want to hear.

 

[bluepink21]

EDIT: I read the whole thread, I commend you for realizing how far fetched it could be and wanting to actually argue and discuss different ideas. That's something a lot of people around here don't know how to do. They think they're right and block out a lot of what they don't want to hear.

Cheers. I got a lot of flak for debating points i didn't agree with. People think im a troll, but I do understand and accept the points that were made, but I never simply accept something told to me completely without further probing. I have to admit though, I probably shouldn't have made such fuss about sarcastic comments, and insults. That was counter productive.

 

[NeuResurgens]

Cheers. I got a lot of flak for debating points i didn't agree with. People think im a troll, but I do understand and accept the points that were made, but I never simply accept something told to me completely without further probing. I have to admit though, I probably shouldn't have made such fuss about sarcastic comments, and insults. That was counter productive.

I had to learn this, it's a hard lesson on the internet. There will always be someone who snarks with you (and don't get me wrong, it's fun - I've done it to people too), but if you're sincere you just need to make like a duck and let it roll off your feathers instead of ruffling them.

 

[bluepink21]

I had to learn this, it's a hard lesson on the internet. There will always be someone who snarks with you (and don't get me wrong, it's fun - I've done it to people too), but if you're sincere you just need to make like a duck and let it roll off your feathers instead of ruffling them.

Nice analogy. Does juxtapose you tag line 'dogs of war' though. 🙂

 

[NeuResurgens]

Nice analogy. Does juxtapose you tag line 'dogs of war' though. 🙂

I have it there because I thought it was awesome when frank underwood quoted it 😉

 

[WholeLottaGame7]

Cheers for that. Good reply. I understand now that Neuro/CC would be impractical, and damaging to patients. But due to a combination of admittedly ego and a love of the renaissance man, I can give up the idea of a multi-trained surgeon. What about speciality, directly related to neurosurgery, like ENT/plastic/optho, who work directly with neurosurgeons anyway.

Also. Would you have any pros and cons for neurosurgery and congenital cardiac surgery. On their own obviously.

You don't have to give up the idea of a multi-trained surgeon, but the fields need to be related. Like if you do gen surg then cardiac you could probably find some places where you could do some of both. At the VA where I trained there was a cardiac surgeon who would do trachs, G-tubes, etc, for his patients. But these are likely to be smaller, rural places, not the prestigious places you seem drawn to.

The problem is, if you want to stay at a prestigious academic institution, you have to be super sub-specialized rather than a generalist, for the reasons others have mentioned.

Take for example complicated skull base/facial reconstruction surgeries. Most places probably have a team consisting of ENT, neurosurgery, and plastics (maybe OMFS) that work together, rather than one person who does the whole thing.

Take your mystical 30,000 number. Wouldn't you rather have 3 surgeons who each have 30,000 cases of their specialty under their belt rather than 1 who has 10,000 of each? You can't just say, "Well I'll do 90,000 cases!" Surgeons are already pushed to the brim. That would be like a sprinter saying, "Well I'll just work really hard and run a 9 second 100yd dash."

 

[235009]

😆

This thread has been the most amusing thing I've read all week...by far. OP should get the SDN lifetime achievement award for naivete.

I'll follow this up with another serious reply for no reason other than my own amusement...what about becoming board certified in neurosurgery?! With this ridiculous plan you wouldn't qualify to be board certified....ever. It looks like you are required to be the primary surgeon on 150 cases in 18 months to even be eligible. On top of that you must finish the whole board certification process within 5 years of completing training...or if you pass the written exam and don't complete the process you have to start all over again and this time you only have 3 years.

I'm sure CT surgery has equally stringent and burdensome requirements but I'll leave that to you to look up.

OP, get over this pathologic attitude and if necessary, get help.

reference for those who are bored:
http://www.abns.org/Board Certification/Certification Process/Neurolog.aspx/
http://www.abns.org/Board Certification/Certification Process/Credentials.aspx/

 

[Levo]

Also. Would you have any pros and cons for neurosurgery and congenital cardiac surgery. On their own obviously.

The job market for any cardiac surgery, much less congenital cardiac surgery, is abysmal (which brings us to another reason why training in multiple specialties is a horrible idea, it would be nearly impossible to find a hospital that has job openings in both at the same time!). I don't think neurosurgery is quite as bad, but it's still not great. I personally know a neurosurgeon who had to move to the middle of nowhere for his first job, because that was the only opening at the time. It doesn't matter how good you are, if a given hospital/practice/university doesn't have enough money to hire another surgeon and enough work available to justify doing so, they're not going to hire.

Edit: OP, even if you feel like you don't care about having to live in the middle of nowhere, it SHOULD matter to you, because if you do get a job as a surgeon at Middle of Nowhere Community Medical Center, you'll quickly realize that they don't do most of the crazy cutting-edge surgeries that drew you to the field in the first place at that hospital.

 

[NeuResurgens]

I don't think neurosurgery is quite as bad, but it's still not great.

I definitely have not heard this about neuro.

 

[WedgeDawg]

I definitely have not heard this about neuro.

Yeah from what I've heard nsgy job market is pretty good, esp if you're fellowship trained

 

[Matthew9Thirtyfive]

Yeah from what I've heard nsgy job market is pretty good, esp if you're fellowship trained

None of the neurosurgeons I worked with ever had a problem getting a job or making plenty of bank.

 

[BurghStudent]

Cheers for that. Good reply. I understand now that Neuro/CC would be impractical, and damaging to patients. But due to a combination of admittedly ego and a love of the renaissance man, I can give up the idea of a multi-trained surgeon. What about speciality, directly related to neurosurgery, like ENT/plastic/optho, who work directly with neurosurgeons anyway.

Also. Would you have any pros and cons for neurosurgery and congenital cardiac surgery. On their own obviously.

I say this knowing you are reconsidering.

Have you looked at da Vinci's art? Read Sir Arthur Conan Doyle's stories?

Forget them, here is a drawing of the motor cortex by neurosurgery's father, Harvey Cushing:

There are more things to do in life that two unrelated surgeries. Explore your artistic abilities. Read. Write. Experience people, love, and loss.

The way you are approaching your passions is artificial, to be blunt. You couldn't determine which was more sexy, cardiothoracic surgery or neurosurgery. So you thought you could do both. I urge you instead to dig deep and find what your actual passion is. Cushing's passion was brain, and brain surgery. Day in day out. He was informed of his son's death mid-surgery, and he simply nodded and carried on. It was his persistence in the singular goal to open this black box to mankind that has earned him his place in history.

Find your passion, and pursue it to your heart's content.

You can be a jack of all trades, but a master of none. Be a master.

 

[Levo]

Yeah from what I've heard nsgy job market is pretty good, esp if you're fellowship trained

Fair enough. I just know anecdotes of neurosurgeons having a tough time finding work in my area of the country. Maybe those stories weren't representative. I'd certainly be glad if they're not. I'd feel awful if my friends going into neurosurgery spent 7 years in training to then struggle finding work.

 

[Terry Toma]

Someone can correct me if I'm wrong, but I'm pretty sure that programs receive reduced funding for second residencies. Why is a general surgery program going to pick you over a fully funded resident?