by Shawn Vuong
Some time in the years 2002-2005, cardiothoracic surgery hit the wall.
The specialty’s big time claim to fame, the CABG (coronary artery bypass graft), surgery was on a huge decline. The field of cardiothoracic surgery became super saturated with over trained surgeons who were no longer in demand. The interventional cardiologist had come along and started stenting coronary arteries, saving patients from the chest opening surgery known as the CABG.
While this is good for patients, and heart health, this has wrecked the specialty of cardiothoracic surgery. In fact, a majority of cardiothoracic surgeons I have polled wouldn’t even recommend the specialty to their own kids, or anyone for that matter. And that’s not just a trend from here in South Dakota, this is a nation-wide ordeal.
The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, and Cardiothoracic Surgery Network are well aware of this problem. In fact, they are worried that as residents have complained that they are unable to get a job (rightfully so) that they will be scaring away the most talented and driven medical students. And this has already happened, most cardiothoracic fellowships go unfilled, and those that are filled, many of them are by IMGs who plan to go back to their home country to practice.
So, these groups have been trying to save the specialty. First, they have been changing the types of residency programs that they offer, with many different ways of becoming a cardiothoracic surgeon. Some new programs offering training in cardio, thoracic, vascular, and endovascular techniques. Also, they are making recruitment efforts to attract the most talented and driven students to the field. But they also admit that the poor job market back in 2002-2005 is the original problem, and if that isn’t rectified then they don’t stand a chance.
Well, it’s now 2010. What’s the update?
There will be a shortage of cardiothoracic surgeons by 2020. They believe that with the aging population, the lack of filling the current fellowship programs, and the length of time to train a fully fledged cardiothoracic surgeon, even with the reduction in CABG procedures, there will be a fairly large shortage by 2020. A criticisms of the study is that predictions of physician shortages or abundance have a notoriously bad history of being completely off the mark.
A more current study states that the sad truth is, job offers have not increased since 2006. However, more than 75% of graduating residents would recommend the specialty to others.
To conclude, the job market hasn’t gotten any better in CT surgery. But one study says that there will be a shortage and that CT surgeons will be in demand by 2020 (if you want to hang your hat on one study). And residents are becoming more positive about the specialty.
If you are interested in cardiothoracic surgery I would recommend following the advice of a wise retired OB/Gyn physician: “Just do what you’re interested in. If you like popping pimples, then become a dermatologist. If you like surgery, then become a surgeon. Don’t let people convince you that you won’t fit into a certain specialty because it doesn’t fit your personality, or it doesn’t make enough money, or it’s not prestigious enough. Just do what you love to do.”
Shawn Vuong is a medical student who blogs at Medically Mind Numbing.
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