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Discussion in 'Surgery and Surgical Subspecialties' started by RNtoDO, Dec 19, 2005.
what does the future look like for vascular surgeons??
This is just my opinion, so take it with a grain of salt, but I think it looks very good. Not only do they have the surgery part, but now they dominate a large, if not most of the endovascular stuff. The two put together makes vascular very appealing.
I think the future looks good for a few reasons:
1) The baby-boomers are aging so there should be lots of vascular problems within the next 20+ years.
2) General surgery programs dont teach as much vascular surgery as they did 20 years ago so todays general surgeons arent going to be as proficient in it.
3) Many procedures are going endovascular (so the vascular surgeon may have to fight with the interventional radiologists, cardiologists, and neurosurgeons for some procedures) However there will always be things that only a surgeon can do.
4) There are a lot of newer technologies that are quick and easy to do (like varicose vein surgery) which you could do.
Also, I dont believe that vascular is a very competitive fellowship but im not quite sure.
Here's a thread on it: Vascular Surgery FUTURE
Most good general surgery residency programs teach a good deal of vascular surgery. Vascular is a very main rotation under general surgery residency and you spend lots of time rotating on vascular at many different levels. When you are finished with your general surgery training, you are proficient in the basic vascular techniques and will be comfortable with most vascular procedures even the endovascular stuff.
The thing about vascular is that most general surgery residents loathe their vascular rotations and most general surgeons loathe vascular surgery. The newer partners in most general surgery group practices end up doing the vascular work because you either love vascular or hate it and most general surgeons fall under the latter.
There is little competition between interventionalist and vascular surgeons except in the minds of people who do not do either. Since the payout for stents beyond the first one is lower these days, many patients who need more than one stent are winding up in the hands of vascular surgeons. Most vascular surgeons have more work than they can do and are very busy. The great thing about vascular is that you can do it all. You can do the surgery, you can do the stenting and you can do the repairs when the interventionalists have a problem. I can't tell you how many pseudoaneurysms I get called on after cardiac caths and interventions. When the interventionalists are busy, so are the vascular surgeons.
Vascular is one of those things that you either love or hate. If you do not love it, you are going to be one miserable person job outlook notwithstanding. Vascular surgery also has one of the highest malpractice rates of the surgical specialties because of the high risk procedures.
Aging baby boomers may provide work but a fair amount work now being done by the vascular folks is on the heavy smoking Generation Xers and access for hemodialysis. There is also a good deal of post-trauma work in some areas too. You can do varicose vein work but overhead is very high in the beginning and like cosmetic surgery, the insurance companies do not reimburse for this work meaning most people learn to live with very ugly varicose veins.
If you love vascular, it can be quite rewarding but do not choose any fellowship based on what you believe the job outlook will be. If you love vascular, no matter what the job outlook, you are going to have plenty to do because you will do it well.
I'd disagree 100% with this. Competition is fierce in for the AAA & carotid stenting business. Witness the billboards(!) you see now advertising this. There are still many places with fierce turf battles are still going on b/w the radiologists, vascular surgeons, and cardiologists. To some degree even Neurosurgery & Neurology and involved with the carotid stents.
I agree that peripheral endovascular work is and will remain a major turf war. The vascular surgeons at my institution have ceased referring diagnostic angios to IR. I can't think the radiologists appreciate that.