How to Become a Cardiothoracic Surgeon

April 11, 2024
5 min read


Reviewed by:

Jonathan Preminger

Former Admissions Committee Member, Hofstra-Northwell School of Medicine

Reviewed: 4/11/24

If you’re interested in joining an in-demand surgical specialty, read on to learn more about how to become a cardiothoracic surgeon.

For centuries, the human heart was an untouchable organ of operation. This vital, life-sustaining organ was simply too delicate, too complex to risk intervention. That changed when bold surgeons began to challenge the impossible.

Dr. Dwight Harken’s breakthrough paved the road to cardiothoracic surgery. Today, it's a dynamic field where meticulous heart procedures are routine, and research relentlessly pushes the boundaries of what’s possible. 

If you're drawn to this fast-paced, high-stakes specialty, this guide is for you. We'll explore the path to becoming a cardiothoracic surgeon, the demands of the job, its diverse subspecialties, and much more!

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What Does a Cardiothoracic Surgeon Do?

Cardiothoracic surgeons operate on the heart, lungs, esophagus, and trachea. These surgeons diagnose patients and help create effective treatment plans such as surgery.

The most common types of disease and issues that cardiothoracic surgeons treat are:

  • Coronary artery disease: when plaque buildup narrows or blocks coronary arteries
  • Atrial fibrillation: an irregular heart rhythm 
  • Aortic issues: commonly aneurysms 
  • Lung disease: often cancer
  • Emphysema: a type of lung disease affecting the alveoli 
  • Esophageal disease: often cancer
  • Heart failure: when the heart cannot pump enough blood throughout the body 
  • Problems with swallowing: has numerous causes
  • Chest injury: often caused by accidents
  • Congenital heart defects: heart problems that have been present since birth and affect its functioning
  • Hiatal hernias: when the top of the stomach bulges into the opening of the diaphragm
  • Chest wall issues: often involve the muscle and bone
  • Artery issues: such as aneurysms
  • Heart valve issues: when one or more of the valves are defective or blocked
  • Gastroesophageal reflux disease (GERD): when liquid content of the stomach refluxes into the esophagus

The most common surgeries performed by cardiothoracic surgeons to treat these diseases are:

  • Angioplasties: tubing is threaded through the coronary arteries to help widen blocked areas
  • Artificial heart valve surgery: to replace abnormal or damaged valves
  • Atherectomy: a catheter is threaded through the arteries to cut away at plaque in the arteries
  • Bypass surgery: to reroute blood around clogged arteries
  • Cardiomyoplasty: muscles are taken from a patient’s back to put around a heart to increase its pumping
  • Heart transplant: replacing a diseased heart with a healthy one
  • Lung transplant: replacing diseased lung(s) with healthy lung(s)
  • Stent placement: a wire mesh tube used to open a clogged artery
  • Lung biopsies: to diagnose abnormal cells
  • Bronchoplasty: reconstruction or repair of the bronchus
  • Lobectomy: one lobe of the lung is removed in patients with lung cancer
  • Pleurectomy: a procedure to remove the thin layers of tissue around the lung that is damaged
  • Pneumonectomy: a lung cancer surgery in which a lung is removed completely
  • Thoracotomy: to view and access chest organs for diagnosis
  • Tumor resection: to remove malignant or benign growths
  • Arterial revascularization: to restore blood flow to arteries
  • Carotid Endarterectomy: when plaque is surgically removed from arteries to prevent stroke
  • Pacemaker placement: a device implanted in the chest to correct irregular heartbeats 
  • Cricopharyngeal myotomy: to section the upper esophageal sphincter
  • Endoscopic diverticulotomy: to help stretch the esophagus for people with swallowing difficulties
  • Esophagectomy: the removal of part of all of the esophagus 

There are also various minimally invasive procedures these surgeons perform for more uncomplicated issues.

Steps to Becoming a Cardiothoracic Surgeon

The time it takes to become a cardiothoracic surgeon is 15 years. Since it’s a long process, we’ve broken it down into bite-sized steps.

Step One: Obtain an Undergraduate Degree

Start your journey to becoming a cardiothoracic surgeon by earning a four-year undergraduate degree with a specialization in science. Make sure you complete the necessary prerequisites for medical school admission. Focus on achieving high grades, and take challenging courses to demonstrate your academic ability.

Step Two: Gain Relevant Experience

Build a stellar medical school application by gaining substantial clinical and shadowing experience. Impress admissions committees with your dedication to the field.

Step Three: Prepare for and Take the MCAT

Begin studying for the MCAT in your sophomore or junior year of college. Know your target score and create a comprehensive study plan. Your MCAT performance heavily influences medical school acceptance.

Step Four: Attend Medical School

Earn your Doctor of Medicine (MD) degree. This four-year program teaches you the fundamentals of medicine and patient care. Apply your knowledge during clinical rotations, and maintain excellent grades to secure a strong surgical residency placement.

Step Five: Complete Your USMLE Exams

Pass the USMLE exams to gain independent medical practice licensure. Most students take these exams in phases throughout and after medical school. Step 1 of the USMLE can be completed after the second year of med school. Step 2 of the USMLE can be completed during the third or fourth year of med school. Step 3 of the USMLE can be completed once graduated from med school.

Step Six: Join a General Surgery Residency

Secure a spot in a general surgery residency through the competitive Match process. Spend at least five years learning surgical procedures across various specialties, including cardiothoracic.

Step Seven: Complete a Cardiothoracic Fellowship

The final step before you can officially become a cardiothoracic surgeon is to complete a cardiothoracic fellowship, lasting two to three years. This final step marks your official path to becoming a cardiothoracic surgeon!

Subspecialties Within Cardiothoracic Surgery

Cardiothoracic surgery is a broad field encompassing surgeries of the heart, lungs, and other chest organs. Surgeons often specialize in specific areas of expertise and focus. Here are the major subspecialties.

Adult Cardiac Surgery: Focuses on the heart, including coronary artery bypass grafting (CABG), valve repair/replacement, and aortic surgery.

Thoracic Surgery: Treats diseases of the lungs, esophagus, and chest wall, including lung cancer resections and esophageal surgery.

Congenital Heart Surgery: Addresses heart defects present at birth, both in children and adults.

Transplantation and Heart Failure Surgery: Focuses on heart and lung transplantation as well as mechanical support devices for advanced heart failure.

Some cardiothoracic surgeons can practice a combination of these specialties. But like any practice, it’s always best to have one area of focus.

Cardiothoracic Surgeon Salary and Career Outlook

Cardiothoracic surgeons are among the highest-paid medical specialists, performing complex surgeries on the heart, lungs, and other chest organs.

Salary: Cardiothoracic surgeons earn a median annual salary of $523,400. Compensation varies based on experience, location, and practice setting.

Career Outlook: The demand for cardiothoracic surgeons is expected to remain stable or slightly increase due to the aging population and advances in surgical options.

Is this a rewarding career?: While challenging, cardiothoracic surgery offers significant financial compensation, intellectual stimulation, and the profound satisfaction of saving lives.

FAQs: Becoming a Cardiothoracic Surgeon

If you still have burning questions, we’ll relieve you in the section below.

1. How Long Does it Take to Become a Cardiothoracic Surgeon?

It takes at least 15 years to become a cardiothoracic surgeon. This is comprised of four years of an undergrad, four years of an MD, five years of a general surgery residency, and at least two years of a cardiothoracic surgery fellowship. 

2. Is it Hard to Become a Cardiothoracic Surgeon?

Yes, it is very difficult to land a career as a cardiothoracic surgeon. Not only are top-ranking medical schools challenging to get into, but residencies and fellowships have even fewer spots available. 

3. What Skills Do I Need to Become a Cardiothoracic Surgeon?

The skills you need include dedication, attention to detail, manual dexterity, interpersonal skills, and adaptability. In addition, you’ll need technical skills such as performing surgeries.

4. How Many Hours a Week Do Cardiothoracic Surgeons Work?

Cardiothoracic surgeons work more than 60 hours a week. It’s highly encourageable to find a healthy work-life balance in this field.

5. What Is the Difference Between Cardiologists and Cardiothoracic Surgeons?

The difference between cardiologists and cardiothoracic surgeons is that cardiologists do not perform surgeries. While cardiologists can diagnose heart disease, they can only assist with non-surgical treatment plans. Cardiologists and cardiothoracic surgeons work together to create an effective treatment plan.

Final Thoughts

So now you’ve learned how to become a cardiothoracic surgeon, but what are your next steps? With how far cardiothoracic surgery has come since the creation of the Harken technique, this specialty will continue to advance and push the limits of what’s considered possible. 

It’s now time to take matters into your own hands. Do even more research about the job outlook, job satisfaction, and what it takes to succeed in this field. While it may seem like a qualified job title, it definitely comes with the downside of long, grueling work hours. But if you are certain of your success in this field, start getting your application ready!

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