Congenital exposure at I6 programs

[cutandsew]

Can anyone who has rotated/interviewed/etc. at some of the different integrated thoracic programs comment on the level of congenital cardiac exposure at these programs? I know some programs are known for getting residents involved in these cases whereas others are known for not letting residents get involved. There is some information in previous threads but these are 5+ years old. From those I've gathered:

Involved:
USC
Emory
Michigan

Not Involved:
Penn

Would love to hear some updates on this!

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[ThoracicGuy]

Can anyone who has rotated/interviewed/etc. at some of the different integrated thoracic programs comment on the level of congenital cardiac exposure at these programs? I know some programs are known for getting residents involved in these cases whereas others are known for not letting residents get involved. There is some information in previous threads but these are 5+ years old. From those I've gathered:

Involved:
USC
Emory
Michigan

Not Involved:
Penn

Would love to hear some updates on this!

I'm not sure about any of these, but with Congenital having their own boards and fellowships, the exposure you get during training is less and less.

 

[swoopyswoop]

I certainly misread this thread title.

 

[LebronManning]

Besides the point, but how much of congenital cardiac surgery occur outside of academics? Does any pediatric congenital occur outside of academics?

 

[Norwood-Sano]

I would like to hear more about this as well, since this is my end goal as of now...as much of a starry eyed pre-med as this sounds.

The congenital guys I have seen are all older so they clearly went the traditional pathway to get there, at least we know the traditional pathway is tried and true in terms of producing successful results.

Also since this hasn't been answered yet, I figured I'd add in another question: How competitive is it to get into Congenital Cardiac Surgery? I hear completely different theories from "you need a pulse" to "the technicality of the skill needed is second to none and unteachable" to "it's such a long path that it's undesirable".

 

[metzthatcut]

Besides the point, but how much of congenital cardiac surgery occur outside of academics? Does any pediatric congenital occur outside of academics?

Depends what you mean by "academic"? Very little if any occurs outside of major pediatrics referral centers because a lot of resources are necessary to have a peds cardiac program. Some big referral centers don't necessarily have an attached medical school, but still have major NICU, PICU, peds intensivists, peds cardiologists etc necessarily to support a congenital heart surgery program

I would like to hear more about this as well, since this is my end goal as of now...as much of a starry eyed pre-med as this sounds.

The congenital guys I have seen are all older so they clearly went the traditional pathway to get there, at least we know the traditional pathway is tried and true in terms of producing successful results.

Also since this hasn't been answered yet, I figured I'd add in another question: How competitive is it to get into Congenital Cardiac Surgery? I hear completely different theories from "you need a pulse" to "the technicality of the skill needed is second to none and unteachable" to "it's such a long path that it's undesirable".

The short answer is that it's pretty competitive.

People who say anyone with a pulse can get in are a little bit out of touch. It's not competitive in the sense that you need >250 on step 1 or honors, etc. etc. to get into the field, it's a little more Consider this... look at the match outcomes for the thoracic surgery match for the last few years. I'm not super familiar with the congenital match, but there always seem to be more applicants than spots (and this is AFTER you've done 4 years of medical school, 5-7 years of residency and another 2-3 years of thoracic residency). To me, any field that it takes at least 11 years of high performance just to be qualified to apply to is competitive on principle alone. And then take into account that its a small field and there are a limited number of jobs out there. Finally, consider that once you finish training and finally have a job, if your outcomes are not very good, you won't have that job for very long. It is true that the training is long and that filters out a lot of people who choose to go into it, but that doesn't mean it is not competitive.

And yes, the technical skill needed in peds cardiac surgery really matters. Again, if you are not very good at performing the cases, you will not have a job for long. (This actually applies to all of CT/thoracic surgery)

 

[Norwood-Sano]

Depends what you mean by "academic"? Very little if any occurs outside of major pediatrics referral centers because a lot of resources are necessary to have a peds cardiac program. Some big referral centers don't necessarily have an attached medical school, but still have major NICU, PICU, peds intensivists, peds cardiologists etc necessarily to support a congenital heart surgery program



The short answer is that it's pretty competitive.

People who say anyone with a pulse can get in are a little bit out of touch. It's not competitive in the sense that you need >250 on step 1 or honors, etc. etc. to get into the field, it's a little more Consider this... look at the match outcomes for the thoracic surgery match for the last few years. I'm not super familiar with the congenital match, but there always seem to be more applicants than spots (and this is AFTER you've done 4 years of medical school, 5-7 years of residency and another 2-3 years of thoracic residency). To me, any field that it takes at least 11 years of high performance just to be qualified to apply to is competitive on principle alone. And then take into account that its a small field and there are a limited number of jobs out there. Finally, consider that once you finish training and finally have a job, if your outcomes are not very good, you won't have that job for very long. It is true that the training is long and that filters out a lot of people who choose to go into it, but that doesn't mean it is not competitive.

And yes, the technical skill needed in peds cardiac surgery really matters. Again, if you are not very good at performing the cases, you will not have a job for long. (This actually applies to all of CT/thoracic surgery)

I appreciate your honest response to my question and everything you said makes perfect sense. I had no intention in believing that “you need a pulse” to make into congenital and from the sounds of it, the limiting factor is skill more than anything. I’m just a starry eyed med student who has had an interest in it since undergrad when I had the incredible opportunity to see a few Norwoods, switches and Tet repairs.

 

[DokterMom]

I appreciate your honest response to my question and everything you said makes perfect sense. I had no intention in believing that “you need a pulse” to make into congenital and from the sounds of it, the limiting factor is skill more than anything. I’m just a starry eyed med student who has had an interest in it since undergrad when I had the incredible opportunity to see a few Norwoods, switches and Tet repairs.

If you're still lusting after congenital cardio, you'll probably want to be "Future MD" instead of "Future DO". Not saying that you couldn't get there as a DO, but your odds would be diminished.

 

[Norwood-Sano]

If you're still lusting after congenital cardio, you'll probably want to be "Future MD" instead of "Future DO". Not saying that you couldn't get there as a DO, but your odds would be diminished.

Believe me, I know. Not much I can do at this point though except my work ass and be aware of the bias that will exist!

 

[BigRedBeta]

Besides the point, but how much of congenital cardiac surgery occur outside of academics? Does any pediatric congenital occur outside of academics?

Pretty rare, and as previously mentioned even some sizable centers you think would have cardiac surgery programs don't. On the flip side, there are some places with tenuous academic affiliations that still have programs. By that, I mean they still have have GME offices and residency programs in some fields, but aren't necessarily attached to a medical school. Advocate Lutheran in Chicago is a good example - has a peds residency and even a PICU fellowship (which requires a congenital cardiac surgical program), but no medical school.

 

[btbam]

If you're still lusting after congenital cardio, you'll probably want to be "Future MD" instead of "Future DO". Not saying that you couldn't get there as a DO, but your odds would be diminished.

Our current fellow at Emory/Egleston is a DO.

To answer your question, the I6 do 3 months of congenital cardiac. You won’t really “do” much though. On a lot of cases, even the fellows are basically acting as a first assist. I’m not sure how they ever learn to do the more complicated stuff (Norwood, Truncus, switch etc..) honestly.

 

[Norwood-Sano]

Our current fellow at Emory/Egleston is a DO.

To answer your question, the I6 do 3 months of congenital cardiac. You won’t really “do” much though. On a lot of cases, even the fellows are basically acting as a first assist. I’m not sure how they ever learn to do the more complicated stuff (Norwood, Truncus, switch etc..) honestly.

1.) Inspiring to hear that!

2.) Seeing several congenital cases myself I noticed the fellow wasn't doing a whole lot either. No wonder they spend several more years as a "junior attending" post fellowship.

 

[Mr Cookie Pants]

Our current fellow at Emory/Egleston is a DO.

To answer your question, the I6 do 3 months of congenital cardiac. You won’t really “do” much though. On a lot of cases, even the fellows are basically acting as a first assist. I’m not sure how they ever learn to do the more complicated stuff (Norwood, Truncus, switch etc..) honestly.

late bump but at Indiana theres tons of congenital exposure...too much probably. I'm doing 6 months during a 3 year traditional fellowship, and the I-6 last 3 years are the same as the traditionals. If you're interested in congenital with our I-6 you can get 12 months. And Riley is a freshly minted 3 star program (busy, complex and quality). As a regular fellow (no superfellows - ACGME or not), I generally do the redo by myself and the attending comes in to cannulate. All ASD's are ours, VSD/AV canals are attendings, we usually do 1/2-2/3 of a Glenn, PA side of a norwood etc.