Six-Year "Integrated" Cardiac Surgery Programs and Practicing in Canada

[The_Legacy]

Hey guys,

 

New to the forum - I'm at a Canadian school and I've recently become interested in cardiac surgery. I've noticed that a few American schools offer six-year "integrated" programs that lead to ABTS certification. Would completing one of these programs allow one to come back to Canada to practice (yes, I know the job market for CTS in Canada is horrific), and obtain an FRCSC designation/RCPSC certification?

 

Thanks!

[thebouque]

Stay away from cardiac surgery. I know quite a few residents who took an 8 years integrated cardiac surgery/family medicine residency...

[Med0123]

Cardiac surgery is one of these fields where the demand of service is largely inferior to the supply and this imbalance is causing the terrible job market existing right now.

 

Currently, residents are trained in Canada and then move south of the border because of the lack of job here. As a US trained cardiac surgeon, you must have exceptional skills to find a Canadian position that would be otherwise granted to a Canadian trained cardiac surgeon.

[The_Legacy]

Hmm, I know that the job market for cardiac surgery is bad - any input on whether you think it'll improve in the next 10-20 years? I'll be done in 2016, so add 6-8 years of GME, and we're into ~2023. As a side note, how's the market for vascular surgery looking these days/future?

[NLengr]

Stay away from cardiac surgery. I know quite a few residents who took an 8 years integrated cardiac surgery/family medicine residency...

 

LOL

 

/10 Char

[oilcountry]

Cardiac surgery is a unique specialty. You can't compare how people find jobs in cardiac surgery to how they find them in other specialties. Jobs in cardiac surgery are earned, not posted on a database. If you don't have a job as a cardiac surgeon either you should've done a PhD, published more if you actually did do a PhD or worked harder as a resident to make sure that the program you did your residency at has no choice but to offer you a job. Most cardiac surgery programs don't want to give their residents jobs; they're happy to have people that round and manage patients for less than minimum wage. You have to make it so that they cannot justify not hiring you once you graduate.

[D-Rock]

Cardiac surgery is a unique specialty. You can't compare how people find jobs in cardiac surgery to how they find them in other specialties. Jobs in cardiac surgery are earned, not posted on a database. If you don't have a job as a cardiac surgeon either you should've done a PhD, published more if you actually did do a PhD or worked harder as a resident to make sure that the program you did your residency at has no choice but to offer you a job. Most cardiac surgery programs don't want to give their residents jobs; they're happy to have people that round and manage patients for less than minimum wage. You have to make it so that they cannot justify not hiring you once you graduate.

 

That is a misguided comment from someone who is a long way from finishing medical school. In the end, health care budgets dictate how much the health care region/board/superboard and the chief of surgery have to divide among divisions for new hires, resources, and so on. It's true that divisions like to hire people they trained that worked hard and are good, but if there is no money then there is no money. Too bad, so sad. Good luck finding a job somewhere, and let us know if you want us to write you great reference letters.

[Alastriss]

Cardiac surgery is a unique specialty. You can't compare how people find jobs in cardiac surgery to how they find them in other specialties. Jobs in cardiac surgery are earned, not posted on a database. If you don't have a job as a cardiac surgeon either you should've done a PhD, published more if you actually did do a PhD or worked harder as a resident to make sure that the program you did your residency at has no choice but to offer you a job. Most cardiac surgery programs don't want to give their residents jobs; they're happy to have people that round and manage patients for less than minimum wage. You have to make it so that they cannot justify not hiring you once you graduate.

 

All I have to add is: don't listen to the aforementioned rubbish.

[medicine man]

Cardiac surgery is one of these fields where the demand of service is largely inferior to the supply and this imbalance is causing the terrible job market existing right now.

 

Currently, residents are trained in Canada and then move south of the border because of the lack of job here. As a US trained cardiac surgeon, you must have exceptional skills to find a Canadian position that would be otherwise granted to a Canadian trained cardiac surgeon.

 

Not in cardiac surgery, but as I understand the US market doesn't look that great either (better than Canada though I hear). You basically have to offer something else to make a hospital hire you b/c there is not enough work to go around.

 

I've heard of Cardiac surgery residents do all sorts of thing to make themselves more competitive. Some do extended cardiac surgery fellowship like congenital/aorta, Vascular fellowship, some do a Thoracic fellowship, some do ICU, some do PhD or combination of above. Its insane, but they should probably not let Canadian grads go into Cardiac surgery for a year or two. Let the Saudis fill it up and then re-open it to CaRMS after.

[dh79]

Here's a tip: when a topic is outside somebodies specialty, take their opinion with a grain of salt. The problem is that most people outside of the specialty do not know much about it or the specific challenges in the job market.

 

If you really want to know, ask some cardiac surgery residents, surgeons, and/or program directors. You should get honest answers.

 

I am a cardiac surgery resident so I dare say I know more about this than the casual observer in a medical or other surgical program. However, I'm going to try to keep this brief.

 

As with many specialties, there have been job issues recently. However, it does appear as the market has turned around. In the last couple years most Canadian grads have gotten jobs in Canada. In the next few years many centers in Canada are expecting to hire. There are projections stating Canada needs to train 9 surgeons a year to keep up with demand. Currently we are training much fewer Canadian grads. There is the real possibility of a cardiac surgeon shortage in the next 10 years. People considering entering training right now have very good timing in my opinion.

 

There has been good research performed recently to determine the facts about cardiac surgery training in Canada. Google or pubmed cardiac surgery canada manpower and you should find some good articles. Feindel and Ouzounian (and others) have published on this. The CSCS specifically addresses the state of training and jobs each year at it's annual meeting. There is a general consensus that training programs have some responsibility in training appropriate numbers of surgeons.

 

As for getting hired at the center in which you train, that depends a lot on the specific center and what you can bring to it. As stated, most are looking to hire in the next few years; either for expansion in volumes or replacement of pending retirements. Fellowships ARE required after residency. Graduate degrees are common, and a PhD will certainly help but I don't think it's absolutely required at most centers.

 

The bottom line is that if you're interested in cardiac surgery, please go talk to somebody in the field. Med students please go to observerships or electives. It is a great field.

 

Be warned though, cardiac surgery residency is VERY challenging, and the ultimate career doesn't get any easier. For those that get through it and succeed, it is a tremendous job. I'm not guaranteed to walk into a job when I'm done, but there are reasons to be optimistic and I certainly wouldn't trade this job for any other.

 

To address the OP, I don't know for sure, but I would suspect it would be technically possible to do the 6 year american program and work in Canada. However, it would be advantageous to train in Canada.

[djmackj]

Hmm, I know that the job market for cardiac surgery is bad - any input on whether you think it'll improve in the next 10-20 years? I'll be done in 2016, so add 6-8 years of GME, and we're into ~2023. As a side note, how's the market for vascular surgery looking these days/future?

 

I'm a vascular surgery PGY-1 and my program director and I had a conversation about job outlook today. As of last year there was 1.9 job for every graduate in the country. I'm not sure how that will shape up in the next few years but I do know that many of the pioneers in the field in Canada are still working in some capacity. As you can imagine, these positions will be up for grabs. There are many regions, even in Ontario where vascular surgery coverage is anemic so I'm not surprised if jobs continue to meet demand for a while. However not all practice will look the same. Expect more rural practices to focus on open surgeries rather than advanced endovascular aortic and hybrid procedures.

[The_Legacy]

Thanks! It's so tough to find someone who's in VS. I'm assuming you're in one of the new fast-track programs started in 2012 if you're PGY-1? How are you finding it? May I ask what school you're at? How is the outlook for surgeon-scientists in VS (I couldn't find too many basic scientists)? Sorry for all the questions!