Thoracic vs. vascular

[Idiopathic]

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For someone who is leaning towards congenital heart surgery as a career, would thoracic or vascular be the appropriate course of resdency? Also, should the integrated 6 year CT residency become reality, would that be the right choice?

 

[droliver]

Unless you matriculate in another 4-5 years, you prob. are a little premature discussing the integrated CT pathways. It's going to be awhile for that to filter in & I imagine many programs won't do it at all.

For your interest in peds CV, you'd do CTS not vascular.

 

[Idiopathic]

I start MS2 in the fall...i havent seen any listing for CTS residencies or felloships on any of the listing sites (scutwork, etc.) anyone know of a resource? or perhaps an alternative name? (is it simply "Thoracic surgery" or is there a "Cardio-thoracic surgery"?)

 

[maxheadroom]

Cardiothoracic Surgery and Thoracic Surgery are more or less interchangeable. While some CT Surgeons only do hearts and some only do non-cardiac stuff, the training is the same. That being said, WashU has a cardiac track and a general thoracic track. While you do the full spectrum of CTS, you get a little more exposure in the area that you prefer.

You won't find CTS on scutwork. That's mainly a site for the most common residencies. It doesn't even touch on the fellowships like CTS, Vascular, SurgOnc, etc. You can look up CTS programs using FREIDA, but I don't see much point, besides just plain curiosity. While everyone says that the CTS integrated programs are going to start opening "like, next year" no programs actually exist at this moment. Word is that WashU will probably be the first, but that doesn't jive with their inability to maintain an integrated Plastics residency (although they just restarted a combined program).

If CTS is what you really want, talk to a student friendly academic CT Surgeon and ask them where you should go for GenSurg to position yourself to be competitive for the top CTS fellowships. Also, I'll repeat the mantra that CTS is a dying specialty. PCI and its ilk have decreased the numbers of CABGs and related procedures tremendously. Sure, congenital malformations, valves, and really bad CAD still require surgical intervention, but the overall demand for CTS is dropping. This will help you, since the most competitive GenSurg graduates are going into other fields, leaving more CTS fellowship positions available for a declining applicant pool.

I'll also advise you that as a starting M2, you've got lots of experiences coming that may change your vision of what you want to do, so be open to other specialties. I think three people in my class started out saying that they wanted to do CTS and now none of them are aiming for it. One wants to do transplant, one is doing RadOnc, and one planning on Trauma/Critical Care. Heck, I thought I would be an orthopod.

 

[ArrogantSurgeon]

Here is the info on this year's match statistics for CT surgery:

http://www.nrmp.org/fellow/match_name/thoracic/stats.html


And here's some info on the structure of the proposed integrated curriculum:

http://www.tsda.org/curriculum/entry.htm

 

[njbmd]

Originally posted by Idiopathic
For someone who is leaning towards congenital heart surgery as a career, would thoracic or vascular be the appropriate course of resdency? Also, should the integrated 6 year CT residency become reality, would that be the right choice?

Hi there,
Here in Charlottesville, the CT fellowship puts the fellows rotating in both Thoracic and CV. Many of the fellows have an interest in just doing thoracic but will go through the CT fellowship. Our attendings sort along the same lines. We have two attendings who do thoracic cases only and several who do Cardiac surgery only with a couple who do both Cardiac and Vascular. (Vascular is now a seperate fellowship but it was included with CT when these guys graduated).

This year, one of our graduating chiefs wants to do primarily Thoracic but will do a CT fellowship at Penn starting next year. For pediatric cases, our pediatric surgeons do all of the Thoracic work except the congenital hearts which are done by a CT surgeon who has completed a pediatric Cardiac fellowship.

The integrated CT fellowship and residency is probably going to become the norm but if you want to do pediatric thoracic, you are probably going to have to do either a pediatric surgery fellowship or a peds Cardic fellowship above your CT. A vascular fellowship is pretty much AAAs and dead feet so you don't want to go there. Not too many kids with either of these problems. Good luck

njbmd

 

[LuckyMD2b]

On Hopkins' website they already claim to be accepting 2 residents/year in an "integrated Cardiac Surgery Track" -- involving 1.5years research, 4.5 years gen surgery training and then CT surgery.

http://www.hopkinsmedicine.org/surgery/education/index.html

Does anyone know anything about this or similar programs?

 

[droliver]

Hopkins has had that program for a while, but it really is not an "integrated" program in the sense that some plastic surgery programs are & its not the same model proposed by the Amer. Board of Thoracic Surgery for the new type of training coming in the future. It's essentially taking a general surgery residency with a guarenteed position in CTVS tacked on @ the end, it doesn't shorten your training as the whole thing (lab time + clinical) ended up @ nearly 10 years

 

[ArrogantSurgeon]

Duke has a similar program to Hopkins that takes around 10 years to complete, but I'm not sure if they have it anymore. They used to refer to it as "Decade with Dave"...referring to Dave Sabiston.