Article at a Glance
- Cardiothoracic surgeons focus their efforts on the organs, bony structure and tissues that form the chest cavity.
- Many years of schooling are required to become a cardiothoracic surgeon. Patience and intense focus are keys to remaining dedicated and consistent.
- To be successful as a cardiothoracic surgeon, a person must possess physical skills, leadership abilities, and emotional capacity.
- Cardiothoracic surgery is comprised of four main areas: general surgery, heart and lung transplants, surgery specific to adults, and congenital surgery. Within those areas, a surgeon can choose an area of the chest cavity to focus on.
- The earnings potential and personal fulfillment for a cardiothoracic surgeon may more than offsets the years of schooling and associated expenses.
- Advances in cardiothoracic surgery make this young and growing medical field safer than it has ever been. Four specific advances have improved survival rates for patients.
What is the focus of a cardiothoracic surgeon?
To become a cardiothoracic surgeon, you first have to be interested in the organs, bony structures and tissues that form the chest cavity. A cardiothoracic surgeon treats and provides surgical interventions for diseases occurring in these areas.
Cardiac and thoracic surgery are separate surgical specialties in some countries. But in the United States and the United Kingdom, they are usually combined. When considered separately, cardiac surgery involves surgery to the heart and large blood vessels. Thoracic surgery involves surgery to the lungs and other structures within the chest cavity.
Education needed to become a cardiothoracic surgeon
The path to become a cardiothoracic surgeon is long, but rewarding. The first step is education.
Most students endeavoring to become cardiothoracic surgeons follow a road similar to this:
- Obtain a 4-year undergraduate degree in pre-med with an emphasis on science.
- Attend and graduate from a 4-year medical school.
- Complete a 5-year general surgery residency program.
- Enter a 2- or 3-year cardiothoracic surgery residency program, or enter a 6-year integrated cardiothoracic surgery residency.
Residencies in all surgeries and surgical specialties are competitive, so doing very well in medical school is vital if you want to be selected.
Some cardiothoracic surgeons choose to do additional training in a subspecialized area like heart and lung surgeries. However, with one exception, additional training in a specific area is option. The single exception is congenital heart surgery, which mandates completion of an additional 1-year fellowship.
What are the attributes that I need to become a cardiothoracic surgeon?
Cardiothoracic surgery is a highly demanding role for which you need a unique blend of skills and personal qualities. You will also need significant leadership expertise. In addition to the characteristics possessed by all successful surgeons, a cardiothoracic surgeon also requires skills in the following areas.
- Exceptional hand-eye coordination and dexterity.
- High perception of spatial relationships among and between objects.
- Ability to work long hours without a break.
- Undivided focus in spite of potential distractions.
- The capacity to remain calm and level-headed in very stressful situations.
- The aptitude to monitor developing conditions in and out of the operating room.
- The foresight to anticipate potential issues and complications.
- The ability to thrive under pressure.
- The desire and proficiency to lead and direct a team.
- The capability to inspire confidence in others.
- The resilience to cope with unexpectedly changing circumstances.
- A supportive disposition for the patient, their family, and your team in sometimes problematic circumstances.
What types of conditions do cardiothoracic surgeons treat?
Since the late 1940s, cardiothoracic surgery has experience brisk growth and fast-moving technological changes. The specialty is considered young and evolving as science and research reveal more about the cardiothoracic area of the body.
The field of cardiothoracic surgery includes:
- Adult cardiac surgery.
- Congenital cardiac surgery.
- General thoracic surgery.
- Heart and lung transplant surgery.
Cardiac surgeons perform the following types of surgeries:
- Aortic surgery – replaces enlarged or damaged blood vessels leaving the heart.
- Coronary artery bypass surgery – bypasses narrowed coronary arteries, restoring blood flow to the heart.
- Heart valve surgery – repairs and replaces usually thin or leaking heart valves.
Surgeries completed by thoracic surgeons include:
- Pectus surgery – repairs chest wall deformities.
- Video-assisted thoracoscopic surgery (VATS) – treats some thoracic disorders without opening the chest.
- Lung surgery – inflates collapsed lungs and removes abnormal tissues from them.
Congenital cardiac surgeons treat diseases and correct physical conditions present in babies and children who have suffered with them from birth. These surgeons repair the following types of conditions:
- When the aortic or aortic and pulmonary valve is narrower than usual.
- When there is a a hole between two of the heart’s chambers.
- When the arteries are transposed.
A cardiothoracic surgeon’s earning potential
Cardiothoracic surgery is not for the faint-of-heart. Long years of training, working, studying, and practical surgical experience require intense focus. A residency as well as years practicing as a cardiothoracic surgeon are required. That’s how you become the best surgeon you can be in this delicate specialty. Given the time and financial resources needed, you may be interested in knowing what the return could be on your investment.
According to the U.S. Bureau of Labor Statistics (BLS), as of 2016, physicians practicing primary care earned a total median annual compensation of $251,578. Physicians practicing in medical specialties received a total yearly median salary of $425,509. It is important to note that BLS figures may not include the income of doctors and surgeons in private practice.
Earning potential may increase with additional certifications. To become certified in cardiothoracic surgery you must complete a specialty residency and pass exams from the American Board of Thoracic Surgery (ABTS). The ABTS administers the same tests for all heart surgeons and thoracic surgeons, regardless of their scope of practice. If you wish, after achieving general certification, you can qualify as a subspecialist in congenital heart surgery through passing an additional exam.
Besides earnings, cardiothoracic surgeons often see some immediate and life-changing results of their work. When patients are able to return to most, if not all of their activities, the work becomes emotionally rewarding and filled with purpose.
Watch this video of a cardiothoracic surgeon opening up a patient’s chest cavity:
Advances in cardiothoracic surgery
The heart has intrigued mankind throughout history, ascribing to the heart mystical and spiritual attributes. As an organ, the heart has always occupied an elevated place in the human body. To some extent it’s because the heart, like the brain, is a vital organ. In other cases it’s because we associate the heart with many emotions transcending our ability to put them into words. So the heart becomes mystical and almost unknowable in nature.
Consequently, the ability to repair the heart is important if for no other reason than the need to stay alive. If the heart stops functioning, a person will soon lose consciousness and will die within minutes without medical intervention. In the early days of surgery, heart surgery was very challenging. When conducted, there was a high death rate. Several advances have improved its surgical procedures and survival rates. A few are:
- Heart-lung machine. The heart-lung machine is a medical apparatus that can take over the functions of the heart for many hours (operated by a perfusionist) giving the heart surgeon hours of time to operate on the heart with very little or no bleeding.
- Cooling techniques. The development of mechanisms cooling down the temperature of the heart during a surgical procedure gives the cardiac surgeon more time to perform quality surgery on a heart that is motionless. At the conclusion of surgery, the heart is warmed and “restarted,” which resumes the pumping functions of the heart.
- Replacing aortic valves without surgery . Transcatheter aortic valve replacement (TAVR) offers a way to fix stiff, narrowed aortic valves without open-heart surgery. The technique delivers the new valve through a thin tube called a catheter that is threaded into an artery in the groin and gently maneuvered into the heart. People who have undergone TAVR had a higher one-year survival rate than people who had surgery to replace the valve. Currently, TAVR is approved for people considered too sick or high risk for valve replacement surgery.
- Wireless sensors for severe heart failure . A new device helps doctors keep tabs on people with acute heart failure by measuring pressure in the pulmonary artery, which transports blood from the heart to the lungs. The CardioMEMS HF System is implanted in the pulmonary artery. From there it wirelessly sends data to a doctor, who can then adjust the person’s treatment as needed—often without an office visit. The goal is to prevent hospitalization for flare-ups of heart failure symptoms.
The following is a quote from one of the pioneers in the field of cardiothoracic surgery. Nicholas T. Kouchoukos, M.D. “If you are a student or resident with intelligence, drive, and stamina, who loves challenges, hard work and positive outcomes, who is results-oriented, loves working with your hands as well as your brain, and enjoys caring for others and interacting with highly competent physicians and other health care professionals, you should strongly consider becoming a cardiothoracic surgeon…” Click here for full article.
Best wishes for your success!
 This year’s top 10 advances in cardiovascular disease, December 2014, Harvard Health Publishing, Harvard Medical School.
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