*organ transplant surgeon ??

[harold56]

Hey everyone,

I am interested in organ transplant surgery, specifically, kidney transplant.
I would like to know anyone have any ideas how long the time is? If I'm not mistaken its like:

+4 years of undergrad
+4 medical school
+5 years surgery residency
+2 fellowship (??)

total = 15 years ?

Does any one the aprox salary?

i know surgeons make ~$300-350k but how much are transplant surgeons?

what about lifestyle and work hours?

any information would be most appreciated.

-peace and blessings to all.

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[SocialistMD]

,
+4 years of undergrad
+4 medical school
+5 years surgery residency
+2 fellowship (??)

+/- 2 years of research in your residency, but yes, that is pretty much correct.

Does any one the aprox salary?

i know surgeons make ~$300-350k but how much are transplant surgeons?

Starting out, it will be no where near $300k; more like $200-225 if you are lucky. Nearly all transplant surgeons are at academic institutions, so their salaries tend to be on the lower end of the spectrum when you compare them to private practice surgeons.

what about lifestyle and work hours?

A lot of your operating is done in the middle of the night, and unless you are doing living donor transplants, your schedule is blank until an organ becomes available. Many renal transplant surgeons also perform vascular access procedures (AV fistulas and grafts) to give themselves something more routine to do. Also, it seems organs become available in bunches, so you will go 3-4 days without operating only to operate for 40-50 hours straight when you all of a sudden have four kidneys to transplant.

 

[Habeed]

So...what exactly are the upsides...

 

[Winged Scapula]

So...what exactly are the upsides...

Uhmmm...let's see.

Well there's...no, that isn't it. Ok, how about...no.

Alright...transplant is intellectually stimulating, it feels good to really help people, and the operations are cool. Or at least my friends who are transplant fellows and surgeons tell me!

 

[Habeed]

But you can really help people and save lots of lives in other specialties as well, right. And not be stuck in residency til the end of days, and actually get to sleep at home...

 

[Winged Scapula]

But you can really help people and save lots of lives in other specialties as well, right. And not be stuck in residency til the end of days, and actually get to sleep at home...

Sure, most surgery is designed to help people; we wouldn't do it otherwise. I was stretching to find positive things about Txp because I never enjoyed it. But not all surgery is "saving lives". Much of general surgery for example is relieving discomfort but many of the procedures done are not for threatened lives.

Truth be told is that all fields have downsides; in transplant there are quite a few, but if you love the work and find it intellectually stimulating then the positives outweigh the benefits.

BTW, transplant surgery is no longer than any other surgery subspecialty in terms of being "stuck in residency til the end of days". As a matter of fact, given its relative lower competitiveness, research time in the lab (which adds 2-3 years onto residency) is not required, so transplant can be one of the shorter routes to surgical subspecialty.

 

[Habeed]

Oh. On these boards I heard about "PGY-10s" and other craziness for transplants.

Umm, may I ask, which board has the info on the training track for transplant? Are most of these subspecialties reached through a general surgery fellowship?

And if the lab weenies ever manage to grow new and working human organs from stem cells, it'll be transplant surgeons who go under the hood to install the new parts, right?

 

[Winged Scapula]

Oh. On these boards I heard about "PGY-10s" and other craziness for transplants.

Many surgical subspecialists are PGY-10s. It is certainly true that you *can* be PGY-10, but that's usually for CT Surg, Peds Surg, PRS or Surg Onc (which can have longer fellowships and require time in the lab...at least CT used to). My friend who is a transplant surgeon in Seattle was a PGY-9 (7 years gen surg, 2 years txp fellowship) which is typical. Some may spend an extra year in fellowship doing research. Or since Txp is not particularly competitive, it may be possible to get into without lab time during residency.

Umm, may I ask, which board has the info on the training track for transplant? Are most of these subspecialties reached through a general surgery fellowship?

As noted above, transplant surgery is a fellowship completed after general surgery or urology. See: http://www.nrmp.org/fellow/match_name/abdom_trans_surg/about.html
and http://www.asts.org/FellowshipTraining/Accreditation.aspx

If you are interested in doing Heart Transplants, then gen surg, CT Surg then a Heart Transplant fellowship.

And if the lab weenies ever manage to grow new and working human organs from stem cells, it'll be transplant surgeons who go under the hood to install the new parts, right?

Presumably.

 

[Habeed]

Thanks. What about lung transplants?

A heart or lung transplant seems like the most dramatic surgery possible, since once you chop out the patient's own organ, if you can't make the donor parts work then they are going to turn into a cadavar right on the table.

I would imagine that probably happens on a routine basis, unfortunately...something like a heart or lung transplant is so dangerous.

Wonder if the liability is particularly high? (since mortality is so high for transplant patients anyways, one would assume juries would grant fewer malpractice awards)

 

[Winged Scapula]

Thanks. What about lung transplants?

Usually cardiopulmonary transplant fellowship or there are stand-alone lung transplant fellowships open to CT surgeons (I think Cleveland Clinic has one).

A heart or lung transplant seems like the most dramatic surgery possible, since once you chop out the patient's own organ, if you can't make the donor parts work then they are going to turn into a cadavar right on the table.

Well there are artificial devices available for short-term use.

Wonder if the liability is particularly high? (since mortality is so high for transplant patients anyways, one would assume juries would grant fewer malpractice awards)

CT and Transplant Surgeons have no more high malpractice than other surgeons.

 

[BobA]

Anyone considering medicine at all should read http://pandabearmd.com/

 

[harold56]

Thanks for the info guys,

I cant believe surgeons start out at ~$200-250K, that is so depressing.

I understand its not for the money and for the interest, but 5+ years in surgical residency only for like $50K increase in salary opposed to FM or GP.

I herd that most transplant surgeons get paid out the ass, but now i see that they barely make anything. What happened to all those lucrative salaries doctors were receiving ?? I understand its not the 80's anymore, and with malpractice, HMO's, and liability, health practitioner salaries are being more and more decreased. I know no one should enter medicine in hopes of financial success, sure there is financial stability and job security. But the lifestyle seems very depressing, working endless hours just to stay afloat. The worst is everyone is always trying to become rich off a doctor. Doctors are overworked, underpaid, and overstressed and they must perform at 100%, 100% of the time. How is that possible? It seems that doctors are superheros these days.

Dermatology and plastic surgery seems most lucrative and appealing, considering lifestyle, pay and work hours. Although many sub-specializations require longer hours, and more time in medical school, shouldn't these guys be paid more !

Well, apologizes for the lengthy post, but if one was to embark on the 12 year journey into transplant surgery, how can one acquire an attractive salary? What is the ACTUAL salaries. Is there any websites or books (other than the AAMA salary book) that breaks down the process? IF a TXP has a private practice mainly concentrating on kidneys, what is the potential income a TXP can make?

Whats starting for a TXP, and the highest? (after how many years of practice)

I hope someone can answer these questions. Thank you.

-please and blessings upon you all.

 

[Habeed]

If you're a strong candidate, meaning you did well in med school and went to a big name general surgery program, would it really take 12 years?

The posts above seem to indicate that it actually takes 7...5 for general surg, 2 for fellowship.

Or to do heart, it would take 10...3 CT fellows, 2 transplant fellowship.

Ok, that's pushing close to 12 I guess, especially if you don't manage to get the fellowship without 2-3 years of research.

 

[beaverfetus]

If you're a strong candidate, meaning you did well in med school and went to a big name general surgery program, would it really take 12 years?

The posts above seem to indicate that it actually takes 7...5 for general surg, 2 for fellowship.

Or to do heart, it would take 10...3 CT fellows, 2 transplant fellowship.

Ok, that's pushing close to 12 I guess, especially if you don't manage to get the fellowship without 2-3 years of research.

You can safely bet that a US med grad at a US categorical program, can get a transplant fellowship, even at a great place... without 2 years of research. At my program we have 4 fellows, 1 of whom is an American grad. The international surgeons, are (with exceptions) in the program because that's the job they could get.

Although transplant surgery means an academic job, so papers will need to be written at some point...

 

[Winged Scapula]

As above, TXP does not require research at most places to get a position. Friends of mine who are doing Txp and have research, did so for a variety of reasons (ie, not sure what they wanted to do, wanted time away from clinical medicine) and as American grads had essentially their pick of fellowships. There are a fair number of FMGs in the field (true for any less attractive field).

To the OP: sorry about the bad news regarding pay. Remember that the most complex transplants are going to be done in tertiary care centers where pay tends to be lower than in private practice. Generally, the best sources for academic pay is a book published by the AAMC which lists average faculty salaries around the country and the MGMA data (which is expensive so you'd have to hunt around and see if anyone has it). Medicine has NEVER been about paying people for time spent in training - procedural specialties pay more, but the effort to get there is not factored in.

IMHO we ALL should make more...when midlevels are approaching, if not exceeding physician salaries (without the stress and malpractice), some thing has to change (but that's a topic for many threads on SDN).

 

[villa99]

I just wanted to know how does it work for liver transplants...do you have to do hepatobiliary surgery and then transplant or just transplant or just hepatobiliary?? thanks

 

[beaverfetus]

the guys at our place have diverse practices in addition to doing transplants, some of the liver guys do hepato biliary surgery, some do lots of kidney's in addition to liver. I think the unifying theme is that they all did multi organ transplant fellowships, and then had some leway to develop the rest of their practices.

None of the attending have additional fellowships that I know of.

 

[SocialistMD]

I just wanted to know how does it work for liver transplants...do you have to do hepatobiliary surgery and then transplant or just transplant or just hepatobiliary?? thanks

If you want to be a transplant surgeon, you do a transplant fellowship. It is the only way to gain ASTS certification. As stated before, once graduating from one of these fellowships, you can either do strictly transplant or you can do some vascular access or some benign/malignant HPB work, depending on the referral patterns at your institution. Of the transplant surgeons we have on staff here, two also do vascular access, two do only transplant (one does all of the pediatric transplants) and three also do hepatobiliary.

 

[bigpharmD]

Pharmd that works with a transplant program here. I would say the salary is quoted (200,000) is pretty correct. The big downsides are that they work A LOT (depending on the size of the group), txs typically happen at odd hours. One of our attending surgeons worked 12 days in a row and only went home for 10 hours. I think for these guys the upside is huge. You get to take someone from death to a normal life in a matter of hours. Also, many of our surgeons have an interest in pharmacology/medications. Most of our tx surgeons work part time. I think the stress gets to them.

 

[bigpharmD]

Anyone considering medicine at all should read http://pandabearmd.com/

why?

 

[JaggerPlate]

removed reference to deleted post

Are you whoring out your organs on SDN??? Awesome. I'm going to go bid on your kidney on the site after my check comes in from helping multiple Nigerian princesses.

 

[genie123]

As far as the training and work hours, most of you are correct. High volume centers are the most competitive programs because they have the hospital/admin infrastructure to support the volume. A lot goes into making a successful transplant program, not just surgical expertise. Also, higher volume programs allows you to gain more experience which makes you able to help the most complex cases.

A fair number of TRP surgeons have an MD + PhD in clinical research or immunology.At a larger Transplant center, the Abdominal TRP surgeons start out at roughly 325k (all-in with benefits). After that 3 year intro period, you become faculty and have a 530k guarantee, plus annual bonuses which can be around 200k. You will need to be ready to operate anytime 24/7/365. A very intense, but highly rewarding career, especially in the pediatric population. Currently, there is a very small talent pool for this specialty because it requires dedication and the infrastructure to support large volumes. This is why large centers usually exist in Academic Health Centers in larger metropolitan areas who usually have a Level-1 trauma center.

 

[Winged Scapula]

sigh

Well at least someone's posting here.

I was about to bring my blanket and pillow to the Allo forum, what with all the time I'm (and you) spending there.