Research required for transplant surgery???

[salsasunrise123]

Hello, I realize that txp fellowships are rather easy to land these days if you went to MD school in USA, but do you still need 1-2 years of research to get accepted? How reasonable is it to finish a txp fellowship at top program (Minnesota, NYP, UCLA, Penn) as a PG-7? Also, what are the job prospects like for txp surgeons fresh out of fellowship? Is it as bad as CT surgery? Thanks.

---

Members don't see this ad.

 

[Smurfette]

Based on knowledge from my residency program (which had several people do transplant fellowships over my 5 years, n=5 or 6):

You don't need to do two years of research to match in transplant. I know someone who went to one of the programs you mentioned without doing any research. Finished fellowship as a PGY7. Only one person from my program did research and went on to do transplant. All the others just did 5 years.

Job prospects are a bit tough from what I understand; two former grads had to do general surgery for a short time until they found a transplant job. One found a job fairly quickly and the other didn't really seem too motivated to find a txp job right away (FWIW). The others got jobs right out of fellowship.

 

[thedrjojo]

My program experience over the past few years shows that research doesn't hurt (in the past few years we sent one to NYP with 2 years of research, he is now an attending there, and another just matched UCLA to start 2013, also with 2 years research). From what I have heard, liver transplant jobs are hard to come by, but Kidney jobs are apparently plentiful. We have several other residents at my program (current party included) looking at Transplant, and pretty much all of us have done or are currently doing 2 years of research.

 

[BamaFlip]

As a current transplant fellow in his second year, I would say the answer is both yes and no. It is true that there are more spots than there are US grads/people willing to train and put up with our unpredictable lifestyle. I am at what many perceive as one of the top fellowships. While I had little to no research, I did have tons of former fellows call on my behalf which helped me to land my spot. This truly is a small field and everybody knows everybody.

The job issue is tricky as well. My fellowship has never had any trouble landing a position for a graduate. If you train at a known fellowship and have others vouch for you, you are assumed to be a low risk product/commodity. Transplant patients are very complex on multiple levels (both medically and surgically) and the last thing that a program wants is someone from a program that does not have a reputation of putting out quality trainees. Liver jobs are more difficult to find but there are tons of kidney and kidney/pancreas jobs. What gets you hired nowadays is your ability to do K/P and lap donors as well as vascular access.

By the way, I would not necessarily consider many of the programs that you listed as top fellowships in the current era. I would look more into UCSF, UCLA (only if you want to livers and nothing else), Emory, and Wisconsin. Many others are good programs but some have serious red flags for trainees if you have a chance to talk to current/past fellows.

 

[europeman]

How are the fellowships in NYC? Columbia, Sinai, etc?


European

 

[biophysicianai]

Bump!

Also interested. I know NYP is traditionally considered a powerhouse, but looks like BamaFlip says there may be unseen negatives. Care to share what you've heard?

What about Miami, or Northwestern? Both seem to have solid numbers

 

[pandoraone]

How is Mayo Transplant?

 

[Sarr]

How is Mayo Transplant?

They perform more txp's each year than New Zealand ..., Running full 3 OR's everyday (at least)

 

[biophysicianai]

How is Mayo Transplant?

Rochester, Florida, and Arizona all have their own programs. If you haven't already, check out http://www.srtr.org/ for program numbers.

Numbers aside, as previously noted, some high-volume centers may not actually be great places to train (for reasons that are unclear to me - autonomy?). If anyone knows more about this, do tell!

 

[thedrjojo]

I'll be presenting a poster at American transplant Congress and, if funds are all good, at the International liver transplant Congress (Australia baby) so hopefully research helps fellowship placement😀

 

[BlondeDocteur]

I'm in a transplant research fellowship and really love the specialty, I think it's a very cerebral specialty, with a great deal of complicated medicine and fascinating basic science. It makes sense that anyone seeking to become an academic transplant surgeon would enjoy research, either clinical or lab-based.

Like you said, the lifestyle makes it such that anyone with a pulse can walk into a fellowship. Not a great fellowship, but a spot. But it never hurts, always helps, to do good-quality research, esp if you want a good fellowship.

 

[biophysicianai]

I'm in a transplant research fellowship and really love the specialty, I think it's a very cerebral specialty, with a great deal of complicated medicine and fascinating basic science. It makes sense that anyone seeking to become an academic transplant surgeon would enjoy research, either clinical or lab-based.

Definitely one of the things that really interests me about transplant. It seems to give a pretty balanced combo of surgery, inpatient medicine, and ambulatory care, and the science is amazing.

Like you said, the lifestyle makes it such that anyone with a pulse can walk into a fellowship. Not a great fellowship, but a spot. But it never hurts, always helps, to do good-quality research, esp if you want a good fellowship.

What are the fellowships to shoot for these days? The old guard seems to be UCSF, UCLA, NYP, Pitt, Miami, and Minnesota, but it appears from above comments that times have changed. Would you care to shed some light on that?

BlondeDocteur and Dr. Jojo, both of you may be a little less anonymous than others here on SDN, so if you're uncomfortable erring criticism publicly, I'd really appreciate a p.m. 😉

Thanks!

 

[thedrjojo]

Definitely one of the things that really interests me about transplant. It seems to give a pretty balanced combo of surgery, inpatient medicine, and ambulatory care, and the science is amazing.



What are the fellowships to shoot for these days? The old guard seems to be UCSF, UCLA, NYP, Pitt, Miami, and Minnesota, but it appears from above comments that times have changed. Would you care to shed some light on that?

BlondeDocteur and Dr. Jojo, both of you may be a little less anonymous than others here on SDN, so if you're uncomfortable erring criticism publicly, I'd really appreciate a p.m. 😉

Thanks!

I'd love to comment if I had the info, but besides what I've heard via hearsay, I'm in the same spot of trying to figure out what programs are the best ones out there. One of my chiefs who just went thru things is going to UCLA next year, so I'll be able to pick his brain in a few years on just what is it like to transplant 200 livers a year (or whatever obscene number they are doing there)... another of our grads finished NYP a few years back (fellow there 2009-2011), and then became an attending there briefly, and had nothing but good things to say about the fellowship, from what I heard, but again, hard to know how objective some of this data is going to be. We just hired a new attending straight outa fellowship, and I'm about to start in a project with him so I might get a chance to pick his brain some too, particularly about his program, but we shall see.

BlondeDocteur, you going to ATC this year? Half your attendings are presenting there it seems I'm more excited about ILTS though...

 

[thedrjojo]

I'm in a transplant research fellowship and really love the specialty, I think it's a very cerebral specialty, with a great deal of complicated medicine and fascinating basic science. It makes sense that anyone seeking to become an academic transplant surgeon would enjoy research, either clinical or lab-based.

Like you said, the lifestyle makes it such that anyone with a pulse can walk into a fellowship. Not a great fellowship, but a spot. But it never hurts, always helps, to do good-quality research, esp if you want a good fellowship.

yeah, i'm gonna echo these sentiments. There is also a ton of research opportunity out there, and a ton of advances to be had. Plus, the procedures (when you get them) are out of this world crazy and intense... this time in the lab focusing only on transplant has just reaffirmed my desire to put myself through the pain of transplant fellowship...

 

[biophysicianai]

I'd love to comment if I had the info, but besides what I've heard via hearsay, I'm in the same spot of trying to figure out what programs are the best ones out there. One of my chiefs who just went thru things is going to UCLA next year, so I'll be able to pick his brain in a few years on just what is it like to transplant 200 livers a year (or whatever obscene number they are doing there)... another of our grads finished NYP a few years back (fellow there 2009-2011), and then became an attending there briefly, and had nothing but good things to say about the fellowship, from what I heard, but again, hard to know how objective some of this data is going to be. We just hired a new attending straight outa fellowship, and I'm about to start in a project with him so I might get a chance to pick his brain some too, particularly about his program, but we shall see.

Looking at SRTR, it seems that in addition to the programs I already mentioned, Northwestern, Penn, Sinai, and Tampa General all have solid volume. Northwestern in particular has a pretty high pancreas volume, on top of a solid liver and kidney numbers. I feel like I never hear these names brought up, though.

Dr. Jojo - you're further along than I am down this path, but maybe I'll seeya out there 😀

 

[Danbo1957]

One of the oldest, largest in volume, research heavy:

http://www.baylortransplant.com/

 

[biophysicianai]

Northwestern has had a fellow quit for the past 2 years...huge red flag

I see. I wonder why. Dr. Abecassis wrote an op-ed about keeping transplant exciting and innovative the way it was in the "good ol' days," in which he mentioned that some potential fellows have pulled out after rethinking entering the field. I didnt realize fellows were quitting after already starting. I wonder if there are problems specific to the program, or if its just related to how rough the transplant "lifestyle" is. Do you have more info?

One of the oldest, largest in volume, research heavy:

http://www.baylortransplant.com/

Thanks for the tip, Danbo. I passed this over, as there are multiple hospitals affiliated with Baylor, but no single one has a high volume. Collectively, it makes for a very high-volume program, assuming fellows are involved with all of the affiliated centers.

 

[fattycakes]

We don't have a transplant department in my med school so I don't know too much about the lifestyle. Can anyone comment on it and compare to other surgical subspecialties?

 

[SLUser11]

We don't have a transplant department in my med school so I don't know too much about the lifestyle. Can anyone comment on it and compare to other surgical subspecialties?

Lifestyle for transplant has potential to be very, very bad, as there are many unplanned evenings in the OR. Also, many places have a policy that once a patient is seen by the transplant service (for transplant or for HD access), that patient belongs to transplant, even for general surgery issues.

Of course, it all depends on how many surgeons are in the call pool with you...

 

[Winged Scapula]

Lifestyle for transplant has potential to be very, very bad, as there are many unplanned evenings in the OR. Also, many places have a policy that once a patient is seen by the transplant service (for transplant or for HD access), that patient belongs to transplant, even for general surgery issues.

Of course, it all depends on how many surgeons are in the call pool with you...

Or even for non-general surgery issues.

Our TXP surgeons wanted to know and be consulted any time the patient presented to the ED or was hospitalized, even for non-surgical issues.

 

[Winged Scapula]

We don't have a transplant department in my med school so I don't know too much about the lifestyle. Can anyone comment on it and compare to other surgical subspecialties?

1. read all the threads here about Transplant Surgery
2. realize that lifestyle <<<<<<<< any other surgical specialty

 

[Buzz Me]

Remember there's also a big difference between renal transplants, where cold ischemia time can often be > 18 hours (hence no middle-of-the-night transplants), and liver transplants, with much shorter cold ischemia times.

Then there's heart and lung transplants. Totally different beast.

 

[KLPM]

Remember there's also a big difference between renal transplants, where cold ischemia time can often be > 18 hours (hence no middle-of-the-night transplants), and liver transplants, with much shorter cold ischemia times.

Then there's heart and lung transplants. Totally different beast.

What about corneal transplant, hair transplant or bone marrow transplant? Are those good surgical lifestyles?

 

[thedrjojo]

Remember there's also a big difference between renal transplants, where cold ischemia time can often be > 18 hours (hence no middle-of-the-night transplants), and liver transplants, with much shorter cold ischemia times.

Then there's heart and lung transplants. Totally different beast.

I'm in my research year, and im in the or (not scrubbed 🙁) at 3am (or started at 1:30)... Definitely the worst hours of any research resident. The sporadic schedule is balanced by probably a lower operative volume then your general surgeons... Not to say you don't have to be working when you aren't rounding. These are sick as feck pts (probably the sickest) and it's a lot of medicine, clinic, and paperwork. Not for the faint of heart. But the cases are some of the most complex and imo it's the most fascinating pathophysiology. So, if you are attracted to it, you don't mind the unpredictability (it's somewhat exciting still)... Just make sure the family buys in as well