How to Become a Cardiothoracic Surgeon

August 23, 2023


Reviewed by:

Jonathan Preminger

Former Admissions Committee Member, Hofstra-Northwell School of Medicine

Reviewed: 03/20/23

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

According to history, the human heart was often considered to be a no-go zone when it came to surgery. This organ that’s responsible for sustaining life was considered far too risky to operate on.

That was until daring surgeons took it upon themselves to begin experimenting. One such surgeon, Dr. Dwight Harken, began experimenting on animals to figure out how to safely remove shrapnel from soldiers’ hearts. After several unsuccessful attempts, he finally mastered his technique and had a 100% success rate.

Since Harken’s technique was invented, the field of cardiothoracic surgery has greatly evolved and continues to advance. Today, there are countless procedures done on the heart everyday and growing research to extend this list. 

If you’d like to be part of this fast-growing specialty, this guide will go over how to become a cardiothoracic surgeon, what the job entails, different cardiothoracic subspecialties, and more!

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What Does a Cardiothoracic Surgeon Do?

Cardiothoracic surgeons operate on all of the organs inside your chest, including your heart, lungs, esophagus, and trachea. These surgeons diagnose patients and help create effective treatment plans for them, including surgeries.

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

Now that you know the myriad of complex procedures these professionals perform, you might be asking, “how long does it take to become a cardiothoracic surgeon?”

These surgeons require extensive training to perform these intricate procedures. This training involves multiple degrees and certifications which take at least 15 years to complete. These 15 years are broken down as follows:

Step One: Obtain an Undergraduate Degree

The very first step to become a cardiothoracic surgeon is completing an undergraduate degree from an accredited university. While you may choose any major you’re interested in, you’ll have to complete certain prerequisites to be eligible to apply to medical school.

Regardless of the major you pursue, ensure you maintain high grades to increase your chances of getting into your dream medical school. You should also take challenging and diverse courses to prove your academic talent. 

Step Two: Gain Valuable Experience

Getting into medical school is challenging. To give yourself the best shot of acceptance, you’ll want to create a stellar application. Substantial clinical and shadowing experience is one way to strengthen your application and impress the admissions committee.

Step Three: Write the MCAT

As you near the end of your undergraduate degree, you should begin preparing to write the MCAT. The summers of your sophomore or junior year are typically the best time periods to study for and write the exam. 

Depending on the schools you’d like to apply to, you should have an idea of your target MCAT score. Create a comprehensive study plan with reliable resources to help you reach this score.

How you perform on the MCAT will play a large role in the admissions committee’s decision, so it’s essential you put in the work to achieve a competitive score.

Step Four: Attend Medical School

After successfully completing your first degree, the next degree you’ll have to obtain is a Doctor of Medicine (MD). This degree will also take four years to complete, but will be much more extensive.

You’ll spend these years learning the fundamentals of medicine and patient care, putting this knowledge to use during your clinical rotations.

As overwhelming as medical school will seem, it’s essential you keep your grades up to match with a strong surgical residency post graduation!

Step Five: Complete Your USMLE Exams

During and after medical school you’ll have to complete your USMLE exams to receive the licensing to practice medicine independently.

The majority of students complete the first step of these exams after their second year of medical school, the second step during their third or fourth year, and the final step after they’ve graduated.

These exams are essential to proceed to the final steps of your journey to becoming a cardiothoracic surgeon, so it’s crucial you spend an adequate amount of time preparing for them!

Step Six: Join a General Surgery Residency

Match day is one of the most nerve-wracking and memorable days of a medical students’ life. Maintaining strong grades and connections throughout the previous steps of your journey can help assure you receive good news and are matched with your top residency.

This part of the journey will take at least five years to complete. During these five years, you will learn how to perform surgical procedures in several types of specialities, including cardiothoracics. 

Step Seven: Complete a Cardiothoracic Fellowship

The final step before you can officially become a cardiothoracic surgeon is to complete a cardiothoracic fellowship. This fellowship will provide you with specialized training in cardiothoracics. Depending on the program you join, this step will take two to three years to complete.

Subspecialities Within Cardiothoracic Surgery

While these surgeons are trained to perform all cardiothoracic surgeries, many of them choose to specialize in one of the following areas:

Cardiac Surgery

These surgeons focus on the heart and the surrounding vessels. Some of them choose to specialize in pediatric cardiac surgery.  

Congenital Heart Surgery

Congenital heart defects are those that people are born with. While the majority of these are found during or closely after birth, some go undetected until adulthood. As such, these surgeons typically work on both children and adults.

Thoracic Surgery

Thoracic surgery is largely dominated by operations on the lungs, chest wall, diaphragm, and esophagus. The most common types of disorders seen by thoracic surgeons are malignant disease requiring resection or the removal of part or all of a chest organ.

Transplant Surgery

Transplants are some of the most complicated surgeries to perform, which is why these procedures cover a subspeciality of their own. Transplant surgeons are responsible for replacing all organs, including the heart.

Cardiothoracic Surgeon Salary and Career Outlook

The final factor to discuss when exploring how to become a cardiothoracic surgeon is their salary and career outlook.

Considering the years of training involved in becoming a cardiothoracic surgeon, and the often life-saving procedures they perform, it’s no surprise that these professionals are well-paid. The average cardiothoracic surgeon salary is around $400,000 a year

This salary can go up depending on your experience and location. Since new procedures and technologies are always emerging in this specialty, surgeons willing to keep up-to-date with these procedures can also earn more because they can offer a wider range of options to their patients and employers.

There is currently a shortage of cardiothoracic surgeons that is projected to dip to critical levels if more medical students don’t join this speciality. 

In fact, if there isn’t a significant increase in these professionals, current cardiothoracic surgeons will have to increase their caseload by an impossible 121% to keep up with the needs of the nation!

Hospitals have and will continue to have the highest demand for cardiothoracic surgeons, but these professionals often also work in private practices.

FAQs: Becoming a Cardiothoracic Surgeon

For any remaining questions about how to become a cardiothoracic surgeon, read on to find your answers.

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

It will take at least 15 years to join this profession: four years to complete an undergrad, four years to complete an MD, five years to complete a general surgery residency, and at least two years to complete a cardiothoracic surgery fellowship. 

2. Is it Hard to Become a Cardiothoracic Surgeon?

Yes, you’ll be met with fierce competition throughout your journey to becoming a cardiothoracic surgeon. Not only are top-ranking medical schools challenging to get into, but residencies and fellowships have even fewer spots available. 

Throughout your studies you’ll have to maintain high grades to give yourself the best chances of gaining acceptance into these difficult programs. 

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

While you’ll need a lot of technical skills to become a cardiothoracic surgeon, these will take time, training, and practice to develop. Aside from the learnable skills you’ll need to perform surgeries, you should already possess the following skills:

  • Dedication: you’ll need to commit 100% of your effort to at least 15 years of extensive training
  • Attention to detail: you’ll be handling delicate yet highly intricate organs that will require a sharp eye as even the slightest error can be fatal
  • Manual dexterity: you’ll need to have precision to properly handle surgical instruments while operating
  • Interpersonal skills: you’ll collaborate with a large team of healthcare providers everyday and will have to communicate with often frightened patients and families
  • Adaptability: you’ll have to know how to quickly adapt your surgical plans as new or emergent issues arise 

Along with these skills, it’s essential you have a passion for this medical specialty! Aside from the 15 years it’ll take to learn about cardiothoracics, you’ll be expected to continue learning about emerging procedures to provide the best care to your patients.

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

While the exact hours a cardiothoracic surgeon depends on their practice and work setting, it’s not uncommon for these surgeons to work more than 60 hours a week!

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

Cardiologists do not perform surgeries. While they understand and are able to diagnose heart disease, they can only assist with non-surgical treatment plans. While some cardiologists perform intravenous catheter procedures, they do not have the specialized training to perform more complex procedures.

On the other hand, cardiothoracic surgeons perform various operations, both simple and complex. Cardiologists and cardiothoracic surgeons typically work together to create the most effective treatment plan for their patients.

Final Thoughts

With how far cardiothoracic surgery has come since the creation of the Harken technique, one can only assume this speciality will continue to advance and push the limits of what’s considered possible. 

After going over the lengthy process required to join this profession, you should have a better idea if you’re up for the task and have what it takes to join this evolving speciality!

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