Vascular surgeon shortage?

[You shall know the Truth]

many of the community hospitals I have been looking at for surgery jobs almost ubiqoustly have vascular openings. Is there anything to read into here in terms of shortages or is it because they are community programs that have little interest? Is vascular surgery going to mimic the urology trend to some degree in the next decade?

Thank you for your time.

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[LucidSplash]

many of the community hospitals I have been looking at for surgery jobs almost ubiqoustly have vascular openings. Is there anything to read into here in therms of shortages or is it because they are community programs that have little interest? Is vascular surgery going to mimic the urology trend to some degree in the next decade?

Thank you for your time.

There are 6 jobs available for every graduate. There is a shortage especially as older surgeons retire.

 

[AsianPersuasion]

I sure hope there's one still in 7 years when I'm done

 

[You shall know the Truth]

There are 6 jobs available for every graduate. There is a shortage especially as older surgeons retire.

Hmmm, this is interesting. Is compensation following the shortage. I have not seen or read anything to that affect. Thank you for your insight.

 

[LucidSplash]

Sure. If you want to go to North Dakota you can make a million. But then you'd be in North Dakota.

Vascular is in general well compensated already though. Desirable jobs don't have to increase compensation because they are desirable.

 

[Jolie South]

Sure. If you want to go to North Dakota you can make a million. But then you'd be in North Dakota.

Vascular is in general well compensated already though. Desirable jobs don't have to increase compensation because they are desirable.

I have gotten some not terrible job ads starting at 600k with potential up to 1 mill. Not in North Dakota!

 

[LucidSplash]

I have gotten some not terrible job ads starting at 600k with potential up to 1 mill. Not in North Dakota!

Caveat emptor. If it's not an undesirable location, something else must be undesirable for offers that far above market average.

 

[mimelim]

Hmmm, this is interesting. Is compensation following the shortage. I have not seen or read anything to that affect. Thank you for your insight.

Lets just start with this:

There is a massive shortage and it is only getting worse. Vascular surgery is the worst in terms of need and over the next ~30 years figures to get worse faster than any other specialty. It is a hot topic everywhere:

Physician Shortage Spikes Demand in Several Specialties | NEJM CareerCenter
The national shortage of vascular surgeons | Society for Vascular Surgery
Like Many Specialties, Vascular Surgery is Facing a Physician Shortage

I highly recommend you watch this. It is the presidential address at the SVS from 2 years ago. It is long (over an hour), but if you are interested in this topic, you really should spend the time:

I have gotten some not terrible job ads starting at 600k with potential up to 1 mill. Not in North Dakota!

I have as well and frankly, salaries are lagging behind need. A lot of hospitals are recognizing their growing need, but are not willing to pay more than others to get someone in the building. I had 3 hospitals in a single town trying to recruit a vascular surgeon. When I ran the numbers with them, the first year projected impact of a surgeon at any of them was about $2 million. Given the lack of surgeons in the area, it was unclear how quickly someone would be able to get off the ground and would likely highly depend on the individual. But, the hospitals were more than willing to dump tons of cash into a vascular lab, outpatient centers, hybrid rooms, etc. to get someone to move in. If one of those 3 hospitals doesn't pick up a surgeon and the others do, it will really harm them on many different fronts. They may just not realize it yet.

Caveat emptor. If it's not an undesirable location, something else must be undesirable for offers that far above market average.

I disagree. I looked around extensively. To be blunt, it seems like a good number of people don't know the market. Hospitals, hospital systems and new surgeons (and some other clueless existing surgeons) have no idea what the margins are or the need. They have a vague idea that "there are a lot of patients", but don't really realize the opportunities out there. It seems like to me that the bigger private vascular groups are the only ones really capitalizing on this right now.

The one caveat that I'll add is that what I'm talking about requires a fair bit of ability outside of the medicine. It isn't just having good clinic skills/smiling face and reasonable operating talent. It is taking ownership of one's practice which many are reluctant to do. Big cities are saturated in their cores and it feels like every city has a different set of practice patterns, but unless you are truly tied to one specific location, there are a ton of extremely well paying jobs with relatively big upsides. The tricky part is going to be the work/life balance because it is so easy to be busy. How you take that on with only 1-2 people is a huge challenge.

 

[hurtem&healem]

I was very interested in vascular surgery for a while, but here's the thing...

 

[Jolie South]

Caveat emptor. If it's not an undesirable location, something else must be undesirable for offers that far above market average.

It’s all moot for me at the moment anyways as my future is somewhat set. Imma just count on a nice lifestyle for a while and having a kid. Then maybe I will say eff this and do solely veins and dialysis.

 

[You shall know the Truth]

Sure. If you want to go to North Dakota you can make a million. But then you'd be in North Dakota.

Vascular is in general well compensated already though. Desirable jobs don't have to increase compensation because they are desirable.

I appreciate this. Rural is where I would lik

Lets just start with this:

There is a massive shortage and it is only getting worse. Vascular surgery is the worst in terms of need and over the next ~30 years figures to get worse faster than any other specialty. It is a hot topic everywhere:

Physician Shortage Spikes Demand in Several Specialties | NEJM CareerCenter
The national shortage of vascular surgeons | Society for Vascular Surgery
Like Many Specialties, Vascular Surgery is Facing a Physician Shortage

I highly recommend you watch this. It is the presidential address at the SVS from 2 years ago. It is long (over an hour), but if you are interested in this topic, you really should spend the time:




I have as well and frankly, salaries are lagging behind need. A lot of hospitals are recognizing their growing need, but are not willing to pay more than others to get someone in the building. I had 3 hospitals in a single town trying to recruit a vascular surgeon. When I ran the numbers with them, the first year projected impact of a surgeon at any of them was about $2 million. Given the lack of surgeons in the area, it was unclear how quickly someone would be able to get off the ground and would likely highly depend on the individual. But, the hospitals were more than willing to dump tons of cash into a vascular lab, outpatient centers, hybrid rooms, etc. to get someone to move in. If one of those 3 hospitals doesn't pick up a surgeon and the others do, it will really harm them on many different fronts. They may just not realize it yet.



I disagree. I looked around extensively. To be blunt, it seems like a good number of people don't know the market. Hospitals, hospital systems and new surgeons (and some other clueless existing surgeons) have no idea what the margins are or the need. They have a vague idea that "there are a lot of patients", but don't really realize the opportunities out there. It seems like to me that the bigger private vascular groups are the only ones really capitalizing on this right now.

The one caveat that I'll add is that what I'm talking about requires a fair bit of ability outside of the medicine. It isn't just having good clinic skills/smiling face and reasonable operating talent. It is taking ownership of one's practice which many are reluctant to do. Big cities are saturated in their cores and it feels like every city has a different set of practice patterns, but unless you are truly tied to one specific location, there are a ton of extremely well paying jobs with relatively big upsides. The tricky part is going to be the work/life balance because it is so easy to be busy. How you take that on with only 1-2 people is a huge challenge.

thank you for this. I want to do rural surgery with a lot of over seas work. Juxtapositing General v. Vascular is my main point of contention. Which would meet the greatest need and at this point vascular looks to be it, but I don’t know the over seas implications of vascular. I appreciate your help. Any conjecture on 0+5 and 5+2?

 

[mimelim]

I appreciate this. Rural is where I would lik

thank you for this. I want to do rural surgery with a lot of over seas work. Juxtapositing General v. Vascular is my main point of contention. Which would meet the greatest need and at this point vascular looks to be it, but I don’t know the over seas implications of vascular. I appreciate your help. Any conjecture on 0+5 and 5+2?

I had a hard time following your questions, so clarify if I miss the mark with my response.

You are going to be busy as a vascular surgeon. You will not need to do general surgery in order to keep very busy unless you are in a saturated market (large city centers) and at that point, you won't be doing general surgery anyways because there will be dedicated surgeons for the other pathologies. If you wanted to do GS and VS in the community, there are jobs out there that would allow you to take call for both, although there are exceptionally few individuals that want that in their practice. Overseas implications, depends on what you are looking to do. Mission trips every couple of years vs. having an established international practice etc. There is no lack of work to do internationally, but again it all comes down to what you want to do with your life. You are going to be busy, adding in "a lot of over seas work" will range from difficult to overwhelming.

Big grain of salt since I am an 0+5, but... 0+5 vs 5+2 it is not close. 0+5. 5 years of vascular surgery instead of 2 years. You will not have the same open abdominal comfort and one can argue about how important that is to the modern vascular surgeon, but you will also finish 2 years earlier which obviously has it's pluses.

 

[You shall know the Truth]

I had a hard time following your questions, so clarify if I miss the mark with my response.

You are going to be busy as a vascular surgeon. You will not need to do general surgery in order to keep very busy unless you are in a saturated market (large city centers) and at that point, you won't be doing general surgery anyways because there will be dedicated surgeons for the other pathologies. If you wanted to do GS and VS in the community, there are jobs out there that would allow you to take call for both, although there are exceptionally few individuals that want that in their practice. Overseas implications, depends on what you are looking to do. Mission trips every couple of years vs. having an established international practice etc. There is no lack of work to do internationally, but again it all comes down to what you want to do with your life. You are going to be busy, adding in "a lot of over seas work" will range from difficult to overwhelming.

Big grain of salt since I am an 0+5, but... 0+5 vs 5+2 it is not close. 0+5. 5 years of vascular surgery instead of 2 years. You will not have the same open abdominal comfort and one can argue about how important that is to the modern vascular surgeon, but you will also finish 2 years earlier which obviously has it's pluses.

I want to apologize, I missed punctuation that would have made that more coherent. I wanted to compare vascular and GS in terms of need in the community. It appears that the need for a vascular surgeon is of higher priority and thus should be pursued in residency. Next I wanted to know the need for vascular surgeons internationally, like in mission trips. Finally, it was the 0+5 v. 5+2 route for residency.

You addressed them all so thank you. Could you address the open abdominal aspect of your last point? I thought medicine was going away from open and going toward non-invasive (forgive me of my ignorance). Also, in an 0+5 program there is a lot more vascular, would a graduate miss out on some of the GS training that would be beneficial in rural/overseas settings? Thank you again.

 

[HighwayVagabond]

Could you address the open abdominal aspect of your last point? I thought medicine was going away from open and going toward non-invasive (forgive me of my ignorance). Also, in an 0+5 program there is a lot more vascular, would a graduate miss out on some of the GS training that would be beneficial in rural/overseas settings? Thank you again.

Regarding the open abdominal work...you made mimelin's point exactly. The volume of open abdominal aortas is decreasing due to the increase in endovascular options for treatment. Those who have gone through general surgery training will have a much higher level of comfort working in the abdomen in general than an integrated vascular resident. There will always be patients whose pathology is not amenable to an endovascular approach, and often this will be in an emergent or urgent setting, so when you are faced with working in the abdomen you really want to be comfortable with it. (Obviously, I am from the 5+2 perspective. That's not to say integrated aren't also comfortable, because in some programs they are).

Regarding the rural/overseas setting...I know a handful of vascular surgeons who work in underserved settings part-time. None of them do much vascular work in those settings at all (with the exception of amputations and flaps/skin grafts). They do a ton of general surgery, OB, ortho, and plastic surgery/burn work.

 

[You shall know the Truth]

Regarding the open abdominal work...you made mimelin's point exactly. The volume of open abdominal aortas is decreasing due to the increase in endovascular options for treatment. Those who have gone through general surgery training will have a much higher level of comfort working in the abdomen in general than an integrated vascular resident. There will always be patients whose pathology is not amenable to an endovascular approach, and often this will be in an emergent or urgent setting, so when you are faced with working in the abdomen you really want to be comfortable with it. (Obviously, I am from the 5+2 perspective. That's not to say integrated aren't also comfortable, because in some programs they are).

Regarding the rural/overseas setting...I know a handful of vascular surgeons who work in underserved settings part-time. None of them do much vascular work in those settings at all (with the exception of amputations and flaps/skin grafts). They do a ton of general surgery, OB, ortho, and plastic surgery/burn work.

Thank you for this.

 

[HighPriest]

Most of the vascular surgeons I've known were of average height or taller.

 

[Jolie South]

Most of the vascular surgeons I've known were of average height or taller.

Truth. I am much over average height for a woman.

 

[TypeADissection]

Imma just count on a nice lifestyle for a while and having a kid. Then maybe I will say eff this and do solely veins and dialysis.

I mean, not everyone can live the dream Dr South. Someone’s got to. Might as well be you.

PS - Now is a good time to mention that I am more tired now through the beginning months of fellowship than I have ever been at any point in my general slavery training...ever. Do I regret this? Hayllz nah. Wouldn’t change a single thing.

 

[Gurby]

PS - Now is a good time to mention that I am more tired now through the beginning months of fellowship than I have ever been at any point in my general slavery training...ever. Do I regret this? Hayllz nah. Wouldn’t change a single thing.

Is vascular everything you hoped and dreamed it would be so far? High point and low point of the last 2 months?

 

[TypeADissection]

Is vascular everything you hoped and dreamed it would be so far? High point and low point of the last 2 months?

@Gurby. Sup friend. In short, it really has been. The service is busy and we do a lot of cases per week. At times I feel like a kid in a candy store when I look at the OR schedule and see all the opportunities to learn and get reps. It's also been an incredibly humbling experience. You get to your chief year and you're the big man on campus. You're doing cases fairly autonomously and feel confident and comfortable in your decision making and operative abilities. I get to fellowship and even though I thought I was ready (and in many ways I was), I also realized that it's just a different league. But I'm very fortunate in that I have an awesome senior fellow who basically is another attending and is just a smart, fun, all-around easy guy to get along with. Learning to read vascular lab has been a steep learning curve but it incrementally makes more sense each week I read studies and go through the video lectures and textbook. The faculty has been great and are eager to teach and have been patient with me as I learn the culture and get up to speed. So all in all, the answer is yes. It is everything I had hoped and dreamed and am very confident I'll leave this place in 2 years well prepared for whatever I decide to do. Cheers.

PS - Highlights: Lots of open surgery here so I've already done open thoraco, a handful of mesenteric bypasses, TCAR has been fun to learn. Lowlights: I'd rather not bad mouth other services so...

 

[Gurby]

@Gurby. Sup friend. In short, it really has been. The service is busy and we do a lot of cases per week. At times I feel like a kid in a candy store when I look at the OR schedule and see all the opportunities to learn and get reps. It's also been an incredibly humbling experience. You get to your chief year and you're the big man on campus. You're doing cases fairly autonomously and feel confident and comfortable in your decision making and operative abilities. I get to fellowship and even though I thought I was ready (and in many ways I was), I also realized that it's just a different league. But I'm very fortunate in that I have an awesome senior fellow who basically is another attending and is just a smart, fun, all-around easy guy to get along with. Learning to read vascular lab has been a steep learning curve but it incrementally makes more sense each week I read studies and go through the video lectures and textbook. The faculty has been great and are eager to teach and have been patient with me as I learn the culture and get up to speed. So all in all, the answer is yes. It is everything I had hoped and dreamed and am very confident I'll leave this place in 2 years well prepared for whatever I decide to do. Cheers.

PS - Highlights: Lots of open surgery here so I've already done open thoraco, a handful of mesenteric bypasses, TCAR has been fun to learn. Lowlights: I'd rather not bad mouth other services so...

Thanks so much for this reply. I'm still waffling and agonizing about maybe pursuing vascular or general surgery so really value your perspective. I look forward to following your progress over the next 2 years via SDN.

I laughed at the "kid in a candy store" - I was shadowing recently in vascular clinic and, after booking an open AAA and enrolling the patient in a study, the surgeon said he always felt clinic days were like Christmas

 

[AsianPersuasion]

@Gurby. Sup friend. In short, it really has been. The service is busy and we do a lot of cases per week. At times I feel like a kid in a candy store when I look at the OR schedule and see all the opportunities to learn and get reps. It's also been an incredibly humbling experience. You get to your chief year and you're the big man on campus. You're doing cases fairly autonomously and feel confident and comfortable in your decision making and operative abilities. I get to fellowship and even though I thought I was ready (and in many ways I was), I also realized that it's just a different league. But I'm very fortunate in that I have an awesome senior fellow who basically is another attending and is just a smart, fun, all-around easy guy to get along with. Learning to read vascular lab has been a steep learning curve but it incrementally makes more sense each week I read studies and go through the video lectures and textbook. The faculty has been great and are eager to teach and have been patient with me as I learn the culture and get up to speed. So all in all, the answer is yes. It is everything I had hoped and dreamed and am very confident I'll leave this place in 2 years well prepared for whatever I decide to do. Cheers.

PS - Highlights: Lots of open surgery here so I've already done open thoraco, a handful of mesenteric bypasses, TCAR has been fun to learn. Lowlights: I'd rather not bad mouth other services so...

So jealous! Hope I'm there someday!

The other day I did a carotid ultrasound and I keep slanting the beam like an idiot cause I'm so focused on the image without realizing what I'm doing and then the attending pimped me about ulceration, heterogenous plague which I haven't read a lot on so I got all the questions wrong. It was rough... but VS is so much fun

 

[KtotheVascular]

many of the community hospitals I have been looking at for surgery jobs almost ubiqoustly have vascular openings. Is there anything to read into here in terms of shortages or is it because they are community programs that have little interest? Is vascular surgery going to mimic the urology trend to some degree in the next decade?

Thank you for your time.

 

[KtotheVascular]

Hi all!!
well I can tell you at least SUNNY SOUTHWEST FLORIDA is currently looking for a vascular surgeon My practice is looking to expand in our busy snowbird area and we need you!!! Great opportunity to move where you never have to shovel snow AGAIN I know i sound like a sales person selling vacations.. I actually run the angio suite and I'm Registered Cardiovascular Invasive Specialist there.. I am trying to help out my favorite doc and find someone amazing and NOT just "ok" if you want more information let me know.. We really need someone more established and ready to go. He has a busy practice and needs thats person to be ready Come down to SUN and FUN.. Also about 3.5 hours from Disney