Practice for General Thoracic Surgeon?

[islandinthesun]

I know that in the spectrum of painful to least painful surgical lifestyles, CT is considered to be one of the worst. In most of the large academic centers however, Cardiac and General thoracic are pretty much separate entities within the same division...

with that, does anyone have any input on the practice, call, lifestyle, bread&butter, for a general thoracic surgeon who does NO cardiac at all? did a search and every thread ive found on CT lifestyles seems to be referring to a cardiac surgeon... thanks

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[SocialistMD]

does anyone have any input on the practice, call, lifestyle, bread&butter, for a general thoracic surgeon who does NO cardiac at all? did a search and every thread ive found on CT lifestyles seems to be referring to a cardiac surgeon... thanks

In general, lifestyle has to do with how many "surgical emergencies" you have to take care of and the rate at which your patients develop complications that require urgent or emergent re-exploration.

With that in mind, general thoracic isn't usually nearly as bad as cardiac, as there are very few thoracic emergencies and most of your patients will not have complications that require emergent re-exploration (relatively speaking). Your lifestyle will most commonly mimic that of a surgical oncologist, as that is essentially what you have become (specializing in cancers of the chest). Yes, you will do some operations for benign disease of the lung and esophagus, but most of the procedures you perform are for cancer.

The one way to complicate your life is to work in a practice where you perform lung transplants, as that brings the lifestyle way down for the days you are on transplant call.

 

[LIDO]

Unrelated question:

How does one specialize in thoracic surgery without the cardiac portion?

Aren't most residency programs combined? Can you get a job at a hospital without the cardio portion? Is that something that would most likely happen later in ones career?

....any explanation would be appreciated. Thanks.

 

[Buzz Me]

There are combined cardiothoracic surgery fellowships, and "thoracic track" fellowships that are thoracic-heavy. Some are 2-year programs, some are 3.

 

[SocialistMD]

There are combined cardiothoracic surgery fellowships, and "thoracic track" fellowships that are thoracic-heavy. Some are 2-year programs, some are 3.

In addition to the above, it is possible to just say "I'm only doing thoracic" as a CT surgeon. Will that go over well with the hospital administration? Probably not, unless you are in an academic environment where the two are separate. However, if you are asking if there is a way to do simply thoracic and not cardiac, the answer is no, as in order to sit for CT boards now, you must have both components. There is no "thoracic surgery" board certification.

 

[islandinthesun]

thanks for the input. one thing that i had no idea was that trying to cater a practice around only gen thoracic would not go over well with hospital admin folk...i guess it is because all of my exposure to surgery is at academic institutions where the C and T are kept pretty distinct...

i would have thought that in the community setting, hospitals would want docs who are uber-specialized IE only cardiac or thoracic...but i guess non-academic places prefer docs who are more versatile a la the general surgeon who does a little of everything in the rural areas.

 

[SocialistMD]

i would have thought that in the community setting, hospitals would want docs who are uber-specialized IE only cardiac or thoracic...but i guess non-academic places prefer docs who are more versatile a la the general surgeon who does a little of everything in the rural areas.

For hospitals that employ physicians, it makes a lot more sense to hire one person instead of two. For practice groups, it makes more sense to hire a surgeon who can be inserted in both calls instead of just the lighter one.

 

[JackADeli]

...i would have thought that in the community setting, hospitals would want docs who are uber-specialized IE only cardiac or thoracic...

For hospitals that employ physicians, it makes a lot more sense to hire one person instead of two. For practice groups, it makes more sense to hire a surgeon who can be inserted in both calls instead of just the lighter one.

I guess it is a regional thing... But, there does seem to be a trend moving towards seperation of the two (Card/CV & General thoracic) at the community level. I remember reading more recent articles finding better outcomes in cancer when there is a seperation.

I think the community folks that try to keep the two combined are probably the cardiac folks that want to keep the side revenue of the general thoracic business while at the same time getting another body for the call coverage.

 

[Smurfette]

At the academic and community hospitals I've rotated at, there are "thoracic" attendings and "cardiac" attendings. Are they trained in both? Yes. But most that I have seen do predominantly one or the other.
In CT fellowships, you can choose to be "thoracic track", which means that you still need a minimum number of heart cases, but can have more emphasis (and requirements) in thoracic (i.e. more esophagus cases, lobectomies, etc.)