interventional cardiology vs cardiothoracic surgery vs general surgery

[Chogoz]

Hello guys,

I am in my final year of med school. I am in a dilemma , I seem to be unable to choose among cardiothoracic surgery, interventional cardiology and general surgery for a speciality.  I have done some extensive research on the specialities, however, I still fail to get some information with regards to salary and work-life balance differences between them.

1. I am someone who would enjoy cutting and suturing, but definitely I wouldn't enjoy standing for more than 3 hours everyday. I also enjoy doing something with my hands, but I also enjoy analysing and untangling complex processes and situations, e.g. interpreting complex lab results, and making sense out of them. I also enjoy sitting quietly and think deeply to arrive at a conclusion.

2. I am an ambivert, there are moments I enjoy talking and a lot of company, and there are moments I enjoy not talking much and just being alone. I enjoy to work in an environment full of people (for example a busy hospital) for a certain period of time, and then would also enjoy to work in a less stressful environment where it's quiet e.g a private practice office. So basically I would want a speciality that would allow me to work in a hospital, and in private practice. I would also like to teach at universities and do some research.

3. Generally the heart fascinates me, and I am someone who also enjoys physiology and pathophysiology so much. They have been my favorite courses of all time. However, I also enjoy doing things that are mentally stimulating, than doing a routine that may become monotonous.

4. I enjoy spending time with my family, and if I don't have family time, I easily feel lonely and frustrated.

5. I would want a speciality that would allow me to work on voluntary medical missions to help vulnerable and poor communities e.g in Africa and many other developing countries. I would also want a speciality that would allow me to do these missions in a team, or alone if working as a team proves difficult.

6. Lastly but not least, I would want a speciality that is well remunerated of course :)

Which speciality do you think best suits me? What would you recommend? Thanks in advance for your help. :)

[zizoupanda]

To do cardiology you have to do IM first so you need to be ok with doing that for 3 years. I didn't like IM but I survived it to get into my subspeciality which is also heavily procedural so it is doable.

Cardiology will likely have a better lifestyle overall and you'll have the medicine aspect if you choose that.

That said, keep in mind jobs and geography may come in play. Jobs in interventional cardiology to my knowledge aren't always easy to come by, I know of people doing THREE year fellowships to work in an academic center as interventional cardiologist in a large Canadian city. Talk to people about this in the field in your city if geography is important for you. That said, I think cardiac surgery is no better and likely worse in terms of job prospects.

[Chogoz]

What is your subspeciality?

[robclem21]

Anesthesia

- Work with your hands often

- Mentally stimulating and challenging

- More physiology than you could ever want or need

- Good renumeration and work-life balance (prob avg 400-500k/year in anesthesia vs 700-800/year in cardiac surgery/cardiology, but way better work-life balance). If you still love only the heart you can do a 1-year cardiac anesthesia fellowship.

- Opportunity for hospital and private sector work, as well as international volunteering

- Can sit (or stand) as much as you like. Any surgery field (except maybe ophtho, you'll be standing 8-10 hours a day)

- 5 year training, compared to 7+ for other specialties you've listed.

To be honest, nothing you've mentioned here suggests you would enjoy any surgical field. Sounds like you have an idea in your head that you want surgery and you're having a hard time letting go of that.

Also, in Canada, cardiac and thoracic surgery are different specialties. Cardiac surgery is a direct entry Carms, and thoracic surgery is a fellowship after general surgery. Jobs for all 3 you've listed are nearly impossible to come by right now and will be for some time.

[1D7]

On 8/4/2023 at 1:32 PM, Chogoz said:

1. I am someone who would enjoy cutting and suturing, but definitely I wouldn't enjoy standing for more than 3 hours everyday. I also enjoy doing something with my hands, but I also enjoy analysing and untangling complex processes and situations, e.g. interpreting complex lab results, and making sense out of them. I also enjoy sitting quietly and think deeply to arrive at a conclusion.

Pretty much any surgical or interventional field reaches 3+ hrs on a normal procedure/OR day. Plus in interventional cardiology you will wear lead constantly.

I think based on this alone I'm not sure why you want to pursue a surgical/proceduralist field. Sitting down and looking at labs is IM/general cardiology work.

Quote

3. Generally the heart fascinates me, and I am someone who also enjoys physiology and pathophysiology so much. They have been my favorite courses of all time. However, I also enjoy doing things that are mentally stimulating, than doing a routine that may become monotonous.

The point of being an expert is to have complex cases become routine. Unless you are a research leader or doing congenital pediatric cardiac surgery, most of your cases will be routine ones. Interventional cardiology probably has the most devices and new technologies being introduced of the specialties you mentioned though.

[Edict]

On 8/4/2023 at 1:32 PM, Chogoz said:

Hello guys,

I am in my final year of med school. I am in a dilemma , I seem to be unable to choose among cardiothoracic surgery, interventional cardiology and general surgery for a speciality.  I have done some extensive research on the specialities, however, I still fail to get some information with regards to salary and work-life balance differences between them.

1. I am someone who would enjoy cutting and suturing, but definitely I wouldn't enjoy standing for more than 3 hours everyday. I also enjoy doing something with my hands, but I also enjoy analysing and untangling complex processes and situations, e.g. interpreting complex lab results, and making sense out of them. I also enjoy sitting quietly and think deeply to arrive at a conclusion.

2. I am an ambivert, there are moments I enjoy talking and a lot of company, and there are moments I enjoy not talking much and just being alone. I enjoy to work in an environment full of people (for example a busy hospital) for a certain period of time, and then would also enjoy to work in a less stressful environment where it's quiet e.g a private practice office. So basically I would want a speciality that would allow me to work in a hospital, and in private practice. I would also like to teach at universities and do some research.

3. Generally the heart fascinates me, and I am someone who also enjoys physiology and pathophysiology so much. They have been my favorite courses of all time. However, I also enjoy doing things that are mentally stimulating, than doing a routine that may become monotonous.

4. I enjoy spending time with my family, and if I don't have family time, I easily feel lonely and frustrated.

5. I would want a speciality that would allow me to work on voluntary medical missions to help vulnerable and poor communities e.g in Africa and many other developing countries. I would also want a speciality that would allow me to do these missions in a team, or alone if working as a team proves difficult.

6. Lastly but not least, I would want a speciality that is well remunerated of course :)

Which speciality do you think best suits me? What would you recommend? Thanks in advance for your help.

1. You get used to standing actually, in the beginning its hard to stand for so long if you aren't used to it, but it gets better over time, so I would rethink this as a limitation unless you have medical reasons which make standing harder.

2. I think all the specialties you listed can provide you this.

3. Cardiology and cardiac surgery all provide this

4. Cardiology and general surgery provide this best.

5. General surgery provides this best, pediatric cardiac surgery may also provide this (but wouldn't meet your goal of having time with family)

6. Cardiology and cardiac surgery tend to be renumerated better but all the specialties are well renumerated.

I hope this helps, overall, you won't be able to have all those things you listed in a specialty, so rank those goals of yours by importance and pick the specialty you think makes sense from that. I personally think you might like cardiology, because it gives you more options and flexibility and meets most of your criteria. It is very hard to do 5 years of general surgery residency without having an absolute passion for abdominal surgery. 

[futureGP]

Sounds like anesthesia.

 

the thing with overseas mission work is that unless you’re in a surgical field where you can be there for a week, fix a lot of people and come back, it’s hard to commit for long term benefit.

so for that, surgical specialties will be better, including anesthesiology.

ICU would work too as well as EM.

It would be pretty hard to make use of Cards in missions. Most of cardiology is chronic first world problem

[Chogoz]

Thank you all for your advice. I finally decided to go for what I have always loved, cardiovascular surgery.