Is masters/PhD basically required in residency for cardiac surgery?

[bruh]

I have a couple of questions regarding cardiac surgery residency.
 

It seems that research is a part of most cardiac surgery residencies, but I can’t tell if this is because it’s expected by the program or the interest of the resident themselves. Is it pretty much required to complete a masters or PhD in residency?
 

My 2nd question is: how long is a CS residency with a masters? PhD? 

I’m looking into the specialty, but it is already the longest residency at 6 years and with the implied expectation of doing either a masters or PhD, that sounds like a 7-9 year residency, possibly longer with fellowships. I’d really appreciate some insight. 

[rmorelan]

16 minutes ago, bruh said:

I have a couple of questions regarding cardiac surgery residency.
 

It seems that research is a part of most cardiac surgery residencies, but I can’t tell if this is because it’s expected by the program or the interest of the resident themselves. Is it pretty much required to complete a masters or PhD in residency?
 

My 2nd question is: how long is a CS residency with a masters? PhD? 

I’m looking into the specialty, but it is already the longest residency at 6 years and with the implied expectation of doing either a masters or PhD, that sounds like a 7-9 year residency, possibly longer with fellowships. I’d really appreciate some insight. 

couple of thoughts/points

One they have a year usually in the fellowship for doing something like research - so if you have the time then you probably want to spin that to get a grad degree. 

Two the job market at least relatively recently was not very good so having advanced degrees probably would help with that eventual job search. 

Three cardiac surgeons are as a rule about the most productive dedicated people I know - so they are always reaching for more anyway. 

and yes it can be quite long - but for them that is just the job. You would never go into a demanding high stress field with poor job prospects unless you are extremely committed to it. Well unless you are an idiot.......

[offmychestplease]

-

[bruh]

9 hours ago, rmorelan said:

couple of thoughts/points

One they have a year usually in the fellowship for doing something like research - so if you have the time then you probably want to spin that to get a grad degree. 

Two the job market at least relatively recently was not very good so having advanced degrees probably would help with that eventual job search. 

Three cardiac surgeons are as a rule about the most productive dedicated people I know - so they are always reaching for more anyway. 

and yes it can be quite long - but for them that is just the job. You would never go into a demanding high stress field with poor job prospects unless you are extremely committed to it. Well unless you are an idiot.......

Thank you. So, is that master’s embedded in the 6 year residency, or would it be 6 + 1? The reason I’m asking is because I see most programs indicate one year is dedicated to “academic enrichment” so I don’t know if that means it’s meant to give you a grad degree or not.

Your third point is the one that stands out the most to me actually. All of the cardiac surgeons I know completed 8-10 year residencies with masters or PhD and fellowships. I have a hard time seeing myself being satisfied in that predicament.  I would literally be 40 by that time LOL. I find cardiac surgery incredibly fascinating but I also feel like I just want to get the residency done so I can do surgery instead of years of research. If I could do it in 6-7 years I would be more inclined, but I fear that it’s not the right “fit” for me if I have that mentality. I don’t know if that makes sense.

9 hours ago, offmychestplease said:

There are no jobs in Canada at all for it (literally the worst or second worst field in all of medicine). The residency is 6 years but you will need to pick up a masters/PhD along the way with more than one fellowship to have a chance at a job = 9-10+ years as a resident. You will work insane hours as well. If all those things sound good, and you are ok to not have in job in the end after 13-14 grueling years (med + residency + fellowship) from today, go for it.

I guess one thing I want to mention is I am open, and in fact considering working in the US either way. I have always been very open to relocating and embrace it actually. This is why I feel like maybe it would be possible to do CS residency in 6-7 years and get a job after? It sounds very wishful, I know. But if that’s a possibility, I might be okay with it. Also, it’s not like other surgical residencies are forgiving. Ortho residents do multiple fellowships and end up with 6-8 years - same with NSx, plastics, and GenSx. 

 

Too early to tell right now, but one thing I am sure about is I am going into surgery. I just don’t want 10+ years of residency. 

[offmychestplease]

-

[rmorelan]

4 hours ago, bruh said:

Thank you. So, is that master’s embedded in the 6 year residency, or would it be 6 + 1? The reason I’m asking is because I see most programs indicate one year is dedicated to “academic enrichment” so I don’t know if that means it’s meant to give you a grad degree or not.

Your third point is the one that stands out the most to me actually. All of the cardiac surgeons I know completed 8-10 year residencies with masters or PhD and fellowships. I have a hard time seeing myself being satisfied in that predicament.  I would literally be 40 by that time LOL. I find cardiac surgery incredibly fascinating but I also feel like I just want to get the residency done so I can do surgery instead of years of research. If I could do it in 6-7 years I would be more inclined, but I fear that it’s not the right “fit” for me if I have that mentality. I don’t know if that makes sense.

I guess one thing I want to mention is I am open, and in fact considering working in the US either way. I have always been very open to relocating and embrace it actually. This is why I feel like maybe it would be possible to do CS residency in 6-7 years and get a job after? It sounds very wishful, I know. But if that’s a possibility, I might be okay with it. Also, it’s not like other surgical residencies are forgiving. Ortho residents do multiple fellowships and end up with 6-8 years - same with NSx, plastics, and GenSx. 

 

Too early to tell right now, but one thing I am sure about is I am going into surgery. I just don’t want 10+ years of residency. 

Ha I will say again for cardiac people - in particular because it is so long you really kind of stop thinking as 10 years of residency etc to get to a finishing point. It really does become more of a journey than a destination. I mean you are going to be at 40 at some point regardless - do want to be 40 and type of doctor XYZ or 40 and a cardiac surgeon. They say this for somethings in medicine but for cardiac surgery in particular it is true - it isn't a job, or probably really even a career - it is more of a lifestyle ha. 

There are only 12 spots in cardiac a year in Canada as well - just to give an idea again of how exclusive the club is. 

[offmychestplease]

-

[IMislove]

46 minutes ago, offmychestplease said:

Yes, but this past year only 17 students picked Cardiac as their first choice across Canada...that means that there is literally on average only 1 medical student in each medical school who is really down for the crazy hard 10 year residency process, that says a lot as well in another respect about the field besides it's "exclusivity".

If it helps, there are like 3 people gunning for it in my class alone, could be more but they seem to come and go in what they want. 

[rmorelan]

50 minutes ago, offmychestplease said:

Yes, but this past year only 17 students picked Cardiac as their first choice across Canada...that means that there is literally on average only 1 medical student in each medical school who is really down for the crazy hard 10 year residency process, that says a lot as well in another respect about the field besides it's "exclusivity".

sure - so you also have to compete pretty hard just to get one of the spots. Then spend the rest of your initial career competing again with the same extremely hard core type of people for any eventual job. It is an uphill process every step of the way - so you better really love the field. 

[rmorelan]

Ha, to be clear I should have not just said the same type of people - I mean literally the exactly same people. At every step of the way you will seem to be competing with the same small group of extremely hard working intelligent people - for residency spots, fellowship spots, awards at research conferences...... 

[ACHQ]

I know two former classmates/friends of mine who are in the midst of their CVSx residency. One of them is definitely doing a PhD (they already had a masters and knew that going into the field they needed a PhD), the other is doing another fellowship in CCM/ICU (so as to be marketable to the CVICU groups), and I believe they had a masters/PhD before starting medical school. I would say most doing a CVSx residency in Canada realize that they "need" some sort of extra training (graduate degree and/or fellowship) and is not limited to just a 6 year residency. I think you have prepare of a 8-10 year residency.

We have to start being realistic with medical students so that when they go into fields they don't have this mismatch between what they thought a field was and the actual reality of the field. This mismatch between expectation and reality is what leads to bitterness, regret and burnout.

Its good you are open and flexible to going to the U.S. because it makes it a bit better trying to find a job. If you "know" you want *any* surgical career (but by your signature it seems you just started medical school this year, so you have time to truly decide if you are willing to make major sacrifices for a career in surgery), then I would definitely do the USMLEs (step 1 and 2CK, while in medical school, Step 2CS with MCCQE2/LMCC2, and step 3 thereafter). I would also look into if you do a CVSx residency in Canada whether you need any extra training and whether the U.S. has a reciprocity agreement when it comes to training in CVSx (from my limited understanding I thought CVSx in the US was a combo of Cardio-thoracics...), and potentially look into U.S. residency programs as well. I think ultimately it would probably be longer than 6 years of residency and/or extra training/degrees....

[blah1234]

On 9/1/2020 at 11:45 AM, ACHQ said:

I know two former classmates/friends of mine who are in the midst of their CVSx residency. One of them is definitely doing a PhD (they already had a masters and knew that going into the field they needed a PhD), the other is doing another fellowship in CCM/ICU (so as to be marketable to the CVICU groups), and I believe they had a masters/PhD before starting medical school. I would say most doing a CVSx residency in Canada realize that they "need" some sort of extra training (graduate degree and/or fellowship) and is not limited to just a 6 year residency. I think you have prepare of a 8-10 year residency.

We have to start being realistic with medical students so that when they go into fields they don't have this mismatch between what they thought a field was and the actual reality of the field. This mismatch between expectation and reality is what leads to bitterness, regret and burnout.

Its good you are open and flexible to going to the U.S. because it makes it a bit better trying to find a job. If you "know" you want *any* surgical career (but by your signature it seems you just started medical school this year, so you have time to truly decide if you are willing to make major sacrifices for a career in surgery), then I would definitely do the USMLEs (step 1 and 2CK, while in medical school, Step 2CS with MCCQE2/LMCC2, and step 3 thereafter). I would also look into if you do a CVSx residency in Canada whether you need any extra training and whether the U.S. has a reciprocity agreement when it comes to training in CVSx (from my limited understanding I thought CVSx in the US was a combo of Cardio-thoracics...), and potentially look into U.S. residency programs as well. I think ultimately it would probably be longer than 6 years of residency and/or extra training/degrees....

It really is the mismatch between expectations and reality that creates bitterness down the line. I think as a profession we do a really bad job of conveying the reality to students. It's hard because things can change so much in 5 years. Also, students are primarily exposed to academic physicians who may not be fully up to date with the latest job dynamics. The only source of true information I find are people who are about to finish training and are embarking on their own job search.

The US/CAN training mismatch is also an important consideration. Last I remember there are some curriculum difference in fields such as neurosurgery that make it so training isn't fully transferable. However, I am not a surgeon and this is purely second-hand information I've heard from friends in those fields over dinner.

[zoxy]

I know this is late but I wanted to chime in. Canadian CVSx residency does NOT make you board eligible in the US, as cardiac surgery and thoracic surgery are considered to be one specialty there(officially called thoracic sugery). However, you DO have the option of doing a 2-3 year cardiothoracic fellowship after a Canadian cardiac surgery residency, that would make you eligible for the American Board of Thoracic Surgery. It should be noted that if you do the fellowship on a J1 visa, you would have to leave the US for 2 years. Getting the program to sponsor the more desirable H1B visa that does not come with J1's restrictions is non trivial.

Also keep in mind that the US cardiac job market, while miles better than Canada, is poor compared to other surgical specialties like Vascular or Ortho. In fact, from early 2000's to mid 2010's, many of the ACGME cardiothoracic fellowships went unfilled. This was actually the main impetus for the establishment of the integrated cardiothoracic (I6) programs in 2008. Since then, they've reduced the number of cardiothoracic fellowship spots and improvement in the job market has made the fellowship somewhat competitive.

Just a piece of advice, you don't want to end up doing a CVSx residency+PhD+Family Medicine residency. And before you ask, yes, I know someone who ended up there.

 

[rmorelan]

4 minutes ago, zoxy said:

I know this is late but I wanted to chime in. Canadian CVSx residency does NOT make you board eligible in the US, as cardiac surgery and thoracic surgery are considered to be one specialty there(officially called thoracic sugery). However, you DO have the option of doing a 2-3 year cardiothoracic fellowship after a Canadian cardiac surgery residency, that would make you eligible for the American Board of Thoracic Surgery. It should be noted that if you do the fellowship on a J1 visa, you would have to leave the US for 2 years. Getting the program to sponsor the more desirable H1B visa that does not come with J1's restrictions is non trivial.

Also keep in mind that the US cardiac job market, while miles better than Canada, is poor compared to other surgical specialties like Vascular or Ortho. In fact, from early 2000's to mid 2010's, many of the ACGME cardiothoracic fellowships went unfilled. This was actually the main impetus for the establishment of the integrated cardiothoracic (I6) programs in 2008. Since then, they've reduced the number of cardiothoracic fellowship spots and improvements in the job market has made the fellowship somewhat competitive.

Just a piece of advice, you don't want to end up doing a CVSx residency+PhD+Family Medicine residency. And before you ask, yes, I know someone who ended up there.

 

oh wow that truly does suck - and a complete waste of a lot of people time/effort and will power. 

There are ways around the J1 exclusion - namely the O visa - but that certainly isn't a sure thing. It is also clearly against the spirit of the J1 visa in the first place. 

Edited April 3, 2021 by rmorelan

[zoxy]

16 minutes ago, rmorelan said:

oh wow that truly does suck - and a complete waste of a lot of people time/effort and will power. 

There are ways around the J1 exclusion - namely the O visa - but that certainly isn't a sure thing. It is also clearly against the spirit of the J1 visa in the first place. 

I feel like that if you're eligible for an O visa, you'd probably be able to get a green card through the NIW EB-1 or EB-2 schemes. I know non-Canadian MDs who did research in the US as post-docs who got their greencard using the NIW EB-2 program. They then went on to do residency in the US. I'm actually interested in a surgical sub specialty with abysmal job prospects in Canada myself.  However, unlike CVSx, it's board certifiable in the US. I've wondered how difficult it is to get a job on an H1B when you're board eligible/certified. I've yet to ask anyone since I don't want them to think that I want to jump ship.

Edited April 3, 2021 by zoxy
spelling

[MasterDoc]

2 hours ago, zoxy said:

Just a piece of advice, you don't want to end up doing a CVSx residency+PhD+Family Medicine residency. And before you ask, yes, I know someone who ended up there.

OH gosh! Just reading that made my heart sink. This might just be the saddest statement I have heard on this site.

[zoxy]

On 8/30/2020 at 8:07 AM, bruh said:

Thank you. So, is that master’s embedded in the 6 year residency, or would it be 6 + 1? The reason I’m asking is because I see most programs indicate one year is dedicated to “academic enrichment” so I don’t know if that means it’s meant to give you a grad degree or not.

Your third point is the one that stands out the most to me actually. All of the cardiac surgeons I know completed 8-10 year residencies with masters or PhD and fellowships. I have a hard time seeing myself being satisfied in that predicament.  I would literally be 40 by that time LOL. I find cardiac surgery incredibly fascinating but I also feel like I just want to get the residency done so I can do surgery instead of years of research. If I could do it in 6-7 years I would be more inclined, but I fear that it’s not the right “fit” for me if I have that mentality. I don’t know if that makes sense.

I guess one thing I want to mention is I am open, and in fact considering working in the US either way. I have always been very open to relocating and embrace it actually. This is why I feel like maybe it would be possible to do CS residency in 6-7 years and get a job after? It sounds very wishful, I know. But if that’s a possibility, I might be okay with it. Also, it’s not like other surgical residencies are forgiving. Ortho residents do multiple fellowships and end up with 6-8 years - same with NSx, plastics, and GenSx. 

 

Too early to tell right now, but one thing I am sure about is I am going into surgery. I just don’t want 10+ years of residency. 

The 6 year residency is broken down into 5 years of actual clinical training (2 years foundations+3 years at the senior level) plus an enrichment year that can be clinical or research. Most people add an extra year of research for two years of research in total and get a masters degrees for seven years of total training time. You then probably need a year or two of fellowship(Aortic, Minimally Invasive, Congenital, Transplant and Mechanical Circulatory Support) if you want an academic job anywhere in Canada. And before you ask, even in Saskatoon and Winnipeg the recent hires all have graduate degrees and fellowships.

In all the doom and gloom you do have exit options. With a CVSx residency you can do a two year fellowship in General Thoracic or Vascular and get Royal College certified in them. I know of two surgeons who've taken the thoracic route while another who's taken the vascular one. Another option after a CVSx is to do a two year critical care fellowship which makes you board certifiable for Critical Care.

I've spent a lot of time thinking about CVSx myself and still haven't reached a conclusion. On one hand, it seems insane that anyone would knowingly put themselves through this. Median age of entry in English language med schools is around 24. The prospect of being unemployed and over a hundred thousand dollars in debt after the Residency+PhD/Masters+Fellowship route at 38 is not appealing. On the other hand, I feel that trying to predict the job market 10-15 years from now is a fool's errand. So many variables could impact this. The long term results from the TAVR vs SAVR trials in low risk patients for aortic valves, the long term Mitraclip trials for Mitral reapir, the future of LVAD use, future retirement trends of practising surgeons, provincial government health priorities, and general fiscal situation will all impact the job market. At this point, I feel like if CVSx is the only thing you can see yourself being happy with then go for it. Just remember that you only have one life to live and to make the decision with open eyes. How many other things in life would you be willing to give up to be a CVSx surgeon?

[rmorelan]

3 minutes ago, zoxy said:

I feel like that if you're eligible for an O visa, you'd probably be able to get a green card through the NIW EB-1 or EB-2 schemes. I know non-Canadian MDs who did research in the US as post-docs who got their greencard using the NIW EB-2 program. They then went on to do residency in the US. I'm actually interested in a surgical sub specialty with abysmal job prospects in Canada myself.  However, unlike CVSx, it's board certifiable in the US. I've wondered how difficult it is to get a job on an H1B when you're board eligible/certified. I've yet to ask anyone since I don't want them to think that I want to jump ship.

probably - this is more if you find yourself with a J1 and then suddenly need to escape, or didn't start the process early enough etc. 

H1B is useful as you can work outside of the training program or moonlight internally - some programs basically require that (speaking just broadly here) so J1s annoy them (and because of fellowship rules they cannot just ask you do it anyway). things like covering call shifts etc (or rather having them dumped on you). Sometimes those are baked into some programs. 

I suspect how easy it is probably job specific - in my field people in the US got emerg rad jobs all the time under H1B, and transitioned from there. It does have a reasonable length of time it is active for at least. I know a number of surgeons that have escaped to the US ha going that route. 

 

[zoxy]

15 hours ago, rmorelan said:

probably - this is more if you find yourself with a J1 and then suddenly need to escape, or didn't start the process early enough etc. 

H1B is useful as you can work outside of the training program or moonlight internally - some programs basically require that (speaking just broadly here) so J1s annoy them (and because of fellowship rules they cannot just ask you do it anyway). things like covering call shifts etc (or rather having them dumped on you). Sometimes those are baked into some programs. 

I suspect how easy it is probably job specific - in my field people in the US got emerg rad jobs all the time under H1B, and transitioned from there. It does have a reasonable length of time it is active for at least. I know a number of surgeons that have escaped to the US ha going that route. 

 

Oh wow, I did not realize that the O visa could get around the J1 restriction. I thought the only way to escape the two year rule was to work for the VA or a state designated under-served area. This O visa would actually make the J1 only fellowships feasible.

[Edict]

On 4/2/2021 at 8:48 PM, zoxy said:

I know this is late but I wanted to chime in. Canadian CVSx residency does NOT make you board eligible in the US, as cardiac surgery and thoracic surgery are considered to be one specialty there(officially called thoracic sugery). However, you DO have the option of doing a 2-3 year cardiothoracic fellowship after a Canadian cardiac surgery residency, that would make you eligible for the American Board of Thoracic Surgery. It should be noted that if you do the fellowship on a J1 visa, you would have to leave the US for 2 years. Getting the program to sponsor the more desirable H1B visa that does not come with J1's restrictions is non trivial.

Also keep in mind that the US cardiac job market, while miles better than Canada, is poor compared to other surgical specialties like Vascular or Ortho. In fact, from early 2000's to mid 2010's, many of the ACGME cardiothoracic fellowships went unfilled. This was actually the main impetus for the establishment of the integrated cardiothoracic (I6) programs in 2008. Since then, they've reduced the number of cardiothoracic fellowship spots and improvement in the job market has made the fellowship somewhat competitive.

Just a piece of advice, you don't want to end up doing a CVSx residency+PhD+Family Medicine residency. And before you ask, yes, I know someone who ended up there.

 

Very well informed, one point to add is you don't need to do a cardiothoracic fellowship to get a job in the US. You don't actually need to be board certified or eligible to work in the US, the FRCSC is enough.

[Edict]

On 4/3/2021 at 1:26 AM, zoxy said:

The 6 year residency is broken down into 5 years of actual clinical training (2 years foundations+3 years at the senior level) plus an enrichment year that can be clinical or research. Most people add an extra year of research for two years of research in total and get a masters degrees for seven years of total training time. You then probably need a year or two of fellowship(Aortic, Minimally Invasive, Congenital, Transplant and Mechanical Circulatory Support) if you want an academic job anywhere in Canada. And before you ask, even in Saskatoon and Winnipeg the recent hires all have graduate degrees and fellowships.

In all the doom and gloom you do have exit options. With a CVSx residency you can do a two year fellowship in General Thoracic or Vascular and get Royal College certified in them. I know of two surgeons who've taken the thoracic route while another who's taken the vascular one. Vascular in particular has a relatively good job market relative to other surgical specialties but a horrible patient population and bad hours, even for surgery. Another option after a CVSx is to do a two year critical care fellowship which makes you board certifiable for Critical Care.

I've spent a lot of time thinking about CVSx myself and still haven't reached a conclusion. On one hand, it seems insane that anyone would knowingly put themselves through this. Median age of entry in English language med schools is around 24. The prospect of being unemployed and over a hundred thousand dollars in debt after the Residency+PhD/Masters+Fellowship route at 38 is not appealing. On the other hand, I feel that trying to predict the job market 10-15 years from now is a fool's errand. So many variables could impact this. The long term results from the TAVR vs SAVR trials in low risk patients for aortic valves, the long term Mitraclip trials for Mitral replacement, the future of LVAD use, future retirement trends of practising surgeons, provincial government health priorities, and general fiscal situation will all impact the job market. At this point, I feel like if CVSx is the only thing you can see yourself being happy with then go for it. Just remember that you only have one life to live and to make the decision with open eyes. How many other things in life would you be willing to give up to be a CVSx surgeon?

I don't think job market will ever be good in cardiac, the residency program in surgery is somewhat Halstedian, attrition is built in. It should be something you do only if its the only thing that will make you happy.

 

[zoxy]

On 4/5/2021 at 12:21 PM, Edict said:

Very well informed, one point to add is you don't need to do a cardiothoracic fellowship to get a job in the US. You don't actually need to be board certified or eligible to work in the US, the FRCSC is enough.

That's 100 percent true. I can think of over ten Canadian cardiac surgeons without American Board boards who are practising in the US. Folks at Ohio State, Cleveland University Hospitals, Vanderbilt, UCSD, UC Davis, The Brigham, Mt. Sinai, UPenn, University of Kansas at Kansas City, Stanford affiliated community hospitals, UTexas Southwestern, and Boston Children's. Those are very good places. Also another two surgeons who were at Northwestern and Baylor but then came back to Canada when positions opened up here.

However, all of those folks are at big academic institutions that negotiate bulk liability insurance rates . It's not possible to get community jobs without American Boards, the liability cost would be too much for a community hospital. I've also anecdotally heard that insurance companies are increasingly stricter in enforcing board certification to lower their own liability. American surgeons know that Canadian training is just as good, but you can't trust a jury whipped up by ambulance chasing lawyers to know that. I wouldn't be surprised if this led to a greater reluctance on the part of American academic centres to employ Canadians in the furture.

I've been toying with the thought of doing GenSurg in Canada first, and then a two year ACGME cardio-thoracic fellowship in the US. It's actually only one year longer than a six year training program in Canada. I know a surgeon who did GenSurg in Toronto and then did an ACGME fellowship in the US and stayed there. Even if I can't get someone to sponsor me for an H1B for the ACGME fellowship and go there on a J1, I wouldn't mind doing two years of extra fellowship here in Canada after that. I feel like two years of minimally invasive or transplant fellowship and double board certification would make someone very employable. Not too unreasonable at nine years as well.

[Edict]

On 4/5/2021 at 3:21 PM, zoxy said:

That's 100 percent true. I can think of over ten Canadian cardiac surgeons without American Board boards who are practising in the US. Folks at Ohio State, Cleveland University Hospitals, Vanderbilt, UCSD, UC Davis, The Brigham, Mt. Sinai, UPenn, University of Kansas at Kansas City, Stanford affiliated community hospitals, UTexas Southwestern, and Boston Children's. Those are very good places. Also another two surgeons who were at Northwestern and Baylor but then came back to Canada when positions opened up here.

However, all of those folks are at big academic institutions that negotiate bulk liability insurance rates . It's not possible to get community jobs without American Boards, the liability cost would be too much for a community hospital. I've also anecdotally heard that insurance companies are increasingly stricter in enforcing board certification to lower their own liability. American surgeons know that Canadian training is just as good, but you can't trust a jury whipped up by ambulance chasing lawyers to know that. I wouldn't be surprised if this led to a greater reluctance on the part of American academic centres to employ Canadians in the furture.

I've been toying with the thought of doing GenSurg in Canada first, and then a two year ACGME cardio-thoracic fellowship in the US. It's actually only one year longer than a six year training program in Canada. I know a surgeon who did GenSurg in Toronto and then did an ACGME fellowship in the US and stayed there. Even if I can't get someone to sponsor me for an H1B for the ACGME fellowship and go there on a J1, I wouldn't mind doing two years of extra fellowship here in Canada after that. I feel like two years of minimally invasive or transplant fellowship and double board certification would make someone very employable. Not too unreasonable at nine years as well.

I do know of many canadian cardiac surgeons practicing in the community though, they aren't as high profile but they aren't board eligible. 

[zoxy]

17 minutes ago, Edict said:

I do know of many canadian cardiac surgeons practicing in the community though, they aren't as high profile but they aren't board eligible. 

Well, guess my information was wrong. I wonder how easy it is.

[Edict]

On 4/5/2021 at 3:21 PM, zoxy said:

That's 100 percent true. I can think of over ten Canadian cardiac surgeons without American Board boards who are practising in the US. Folks at Ohio State, Cleveland University Hospitals, Vanderbilt, UCSD, UC Davis, The Brigham, Mt. Sinai, UPenn, University of Kansas at Kansas City, Stanford affiliated community hospitals, UTexas Southwestern, and Boston Children's. Those are very good places. Also another two surgeons who were at Northwestern and Baylor but then came back to Canada when positions opened up here.

However, all of those folks are at big academic institutions that negotiate bulk liability insurance rates . It's not possible to get community jobs without American Boards, the liability cost would be too much for a community hospital. I've also anecdotally heard that insurance companies are increasingly stricter in enforcing board certification to lower their own liability. American surgeons know that Canadian training is just as good, but you can't trust a jury whipped up by ambulance chasing lawyers to know that. I wouldn't be surprised if this led to a greater reluctance on the part of American academic centres to employ Canadians in the furture.

I've been toying with the thought of doing GenSurg in Canada first, and then a two year ACGME cardio-thoracic fellowship in the US. It's actually only one year longer than a six year training program in Canada. I know a surgeon who did GenSurg in Toronto and then did an ACGME fellowship in the US and stayed there. Even if I can't get someone to sponsor me for an H1B for the ACGME fellowship and go there on a J1, I wouldn't mind doing two years of extra fellowship here in Canada after that. I feel like two years of minimally invasive or transplant fellowship and double board certification would make someone very employable. Not too unreasonable at nine years as well.

If you complete a canadian cardiac surgery residency you can complete a 2 year CT fellowship in the states and be BC/BE in the US. Only reason to do it imo is if you changed your mind and wanted to do general thoracic. The same path in Canada would require a 3 year fellowship with 1 yr of general surgery included.