What made you go into cardiology?

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DarkProtonics

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Hi! I'm a 17 yr old Cerritos College chemistry major interested in persuing a career in medicine, and considering cardiology as my specialty. I'd like to know what made you go into cardiology, as well as these questions:

Why are cardiologists and cardiac surgeons so respected and highly paid?

Why is cardiac surgery a fellowship of general surgery; they don't have anything to do w/ each other!

Would this diet be effective for a sedentary, overweight, hypertensive, hyperlipidemic male who had several angioplasties and will go into heart failure unless something is done, such as:

1. An adequate calorie diet consisting of
53% lean protein
37% MUFAs
10% low glycemic load carbohydrates
2. Daily aerobic and resistance exercise
3. An angiotensin-II receptor antagonist plus a statin

My theory behind the diet is this: According to Dr Richard Veech of the NIH, the heart muscle works 25-30% more efficiently when burning ketones for fuel as compared to burning glucose, according to this paper: http://www3.interscience.wiley.com/journal/117878767/abstract?CRETRY=1&SRETRY=0. Also, MUFAs have been proven to raise HDL, lower LDL, and lower cholesterol: http://www.peanut-institute.org/images/1009-1015-Kris-Etherton.pdf. In addition to lowering blood pressure: http://jama.ama-assn.org/cgi/content/abstract/294/19/2455. Basically, by reducing carbohydrate intake to a minimum and increasing the percentage of MUFAs in the diet to the maximum effective dose, it forces your body to burn the fat in your diet and stored in your body, inducing the mild ketosis that Veech has found to increase cardiac efficiency, as well as causing loss of excess body fat; the MUFAs themselves lower blood pressure, and improve serum lipids. W/ regular exercise and the medication, it gets even better.

What's the lifestyle of an interventional cardiologist/EP? I suppose on Mondays and Fridays it's office consults, Tuesdays-Thursdays it's in the cath/EP lab, and Saturdays and Sundays you're on-call. There's probably research mixed in their too, I bet.

Would it be advantageous, after general cardiology fellowship and interventional cardiology advanced fellowship, to do another advanced fellowship in EP or critical care medicine?

Do they offer rotations in interventional cardiology/EP or cardiac critical care medicine to third and fourth year med students? What about observerships to pre-med students?

Thanks so much!!!

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You're 17 and live in cali, why are you on this site and not at the beach?
 
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You're 17 and live in cali, why are you on this site and not at the beach?

B/c I'm on break between my chem lecture and lab, and my community college is too far from the beach. Now that we've got that out of the way....
 
Cardiologists and cardiac surgeons are highly paid mostly because they do medical procedures that insurance companies have thus far been willing to reimburse at a high rate. Also, there is a steady and high demand for their services, due to an aging population and the typical American diet (i.e. high amount of McDonald's food, etc.).

Cardiac surgery is a fellowship of general surgery because historically all surgical fellowships branched off from general surgery. You may think they are "totally unrelated" but really they are based on the same principals, and one needs to learn at least SOME general surgery to be able to do cardiac surgery. Whether one needs 5 years of surgery residency first I think could be argued. You'd have to ask a surgeon (I'm not one).

You cannot do interventional cardiology (as you had proposed/mentioned) after doing a surgical residency and/or fellowship. An interventional cardiology fellowship would be a 1 or 2 year fellowship that you do after 4 years med school, 3 years internal medicine residency, 3 years of a cardiology fellowship.

As far as the diet you mentioned, there are many, many fad diets (such as the one you are describing) that claim to be helpful for those with cardiovascular disease. You'll find that most medical doctors aren't nutrition experts, but we do have access to peer reviewed literature, including studies on diet and mortality, etc. A low fat, low cholesterol diet has been shown to reduce the risk of heart attack and stroke. Dean Ornish (who I believe is in California) showed that it is possible to cause atherosclerosis to regress by following a very low fat diet - problem is that most people won't stay on such a diet. I have seen no evidence that a diet such as you propose would be very helpful in heart disease. There are lots of diets (or other things) that might work "in theory" but don't work so well in the human body, which is a complex organism. Also, regardless of what type/mix of calories/food one eats, there is evidence that being obese is harmful. Fat produces substances in the body that promote inflammation, for example. So one of the main things a person can do is not eat too many calories, and maintain a healthy weight.

Similarly, there are many medicines that are helpful in heart disease. I don't think a statin + angiotensin receptor blocker alone would be adequate for someone with several heart failure. What other meds he/she would need would depend on what the mechanism/cause of the heart failure was, and other factors. Would let his/her doctor handle those recommendations.

I think you are worrying too much about the "nuts and bolts" of how to become a certain specialty and not enough about finding what you are good at and just getting through undergrad w/flying colors. Don't worry too much about what field of medicine to do - just decide if medicine is for you, and then do what is necessary to get in med school. The rest will come.
 
Cardiologists and cardiac surgeons are highly paid mostly because they do medical procedures that insurance companies have thus far been willing to reimburse at a high rate. Also, there is a steady and high demand for their services, due to an aging population and the typical American diet (i.e. high amount of McDonald's food, etc.).

Cardiac surgery is a fellowship of general surgery because historically all surgical fellowships branched off from general surgery. You may think they are "totally unrelated" but really they are based on the same principals, and one needs to learn at least SOME general surgery to be able to do cardiac surgery. Whether one needs 5 years of surgery residency first I think could be argued. You'd have to ask a surgeon (I'm not one).

You cannot do interventional cardiology (as you had proposed/mentioned) after doing a surgical residency and/or fellowship. An interventional cardiology fellowship would be a 1 or 2 year fellowship that you do after 4 years med school, 3 years internal medicine residency, 3 years of a cardiology fellowship.

As far as the diet you mentioned, there are many, many fad diets (such as the one you are describing) that claim to be helpful for those with cardiovascular disease. You'll find that most medical doctors aren't nutrition experts, but we do have access to peer reviewed literature, including studies on diet and mortality, etc. A low fat, low cholesterol diet has been shown to reduce the risk of heart attack and stroke. Dean Ornish (who I believe is in California) showed that it is possible to cause atherosclerosis to regress by following a very low fat diet - problem is that most people won't stay on such a diet. I have seen no evidence that a diet such as you propose would be very helpful in heart disease. There are lots of diets (or other things) that might work "in theory" but don't work so well in the human body, which is a complex organism. Also, regardless of what type/mix of calories/food one eats, there is evidence that being obese is harmful. Fat produces substances in the body that promote inflammation, for example. So one of the main things a person can do is not eat too many calories, and maintain a healthy weight.

Similarly, there are many medicines that are helpful in heart disease. I don't think a statin + angiotensin receptor blocker alone would be adequate for someone with several heart failure. What other meds he/she would need would depend on what the mechanism/cause of the heart failure was, and other factors. Would let his/her doctor handle those recommendations.

I think you are worrying too much about the "nuts and bolts" of how to become a certain specialty and not enough about finding what you are good at and just getting through undergrad w/flying colors. Don't worry too much about what field of medicine to do - just decide if medicine is for you, and then do what is necessary to get in med school. The rest will come.

Yes, I do understand I need to transfer to my four-year uni before contemplating med school. And I'm acing chemistry,which is one pre-med req out of the way.

I do know that interventional cardiology is a subspecialty of cardiology, not cardiac surgery; guess it just didn't come out that way.

But, did you read the studies in the links? And I'm also saying to exercise, so that you burn more calories then you take in. Then you'll lose weight --obviously I understand that obesity is bad for you--. The low carb diet just makes that easier, b/c there's less glycogen to go through before you get to the fat. And MUFAs have been proven to raise HDL and lower LDL and total cholesterol; I'm saying to replace the use of saturated fats, which have been linked to higher incidences of cardiovascular disease, w/ unsaturated fats, which have been linked to lower incidences of cardiovascular disease. Please read those two papers I linked to, and get back to me.

I believe you'd also need a diuretic for CHF, to treat the edema.

Cardiac surgery should only require a one-year rotating surgical internship, just like non-IM specialties require a one-year rotating IM internship.

Would asking to observe a general internist or cardiologist one day/week at the local hospital be a good extracurricular activity?
 
I realize this is not common but if you are interested in surgery and interventional cardiology:

http://www.columbiasurgery.org/news/si/2007_cardiology.html

A general surgery -> CT surgery -> interventional cardiology training path.

I've heard about that guy before; must be very useful guy to have; he can attempt an angioplasty, and if it doesn't work out, switch to a MIDCABG, w/o having to find a CT surgeon. Or something like that.
 
*singing* ...the thorax is connected to the abdomen, the esophagus is in the mediastinum. the esophagus is connected to the stomach, the thoracic aorta is connected to the abdominal aorta....

diaphragmatic repairs, Belsey fundoplications, rooting around for donor sites, carotids. You should know the ins and outs of general surgery before you do cardiothoracic.

Similarly, you need to board in Internal medicine before you can become a cardiologist.

A strong foundation is the key to just about anything.
 
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