Help choosing specialty - Cardio vs Ortho?

Hi,

I would consider your preferences/interests/type of thinking/logic, ability to stand for hours (!), etc

My own personal experience is that cardiology/cardiothoracic surgery (I suppose you mean the latter when you say "cardio" is an extremely logical subject in that most symptoms/signs/ECG findings, etc. can be predicted from first principles/pathophysiology e.g. the leads in which you see ST changes in STEMI depend on the distribution of the coronary artery occluded or the precise reason for the finding of a fixed wide split of the second heart sound in ASD (equal delay of aortic and pulmonary components during inspiration due to effective "common atrium", etc. etc. etc.

I suppose my exposure to orthopaedic surgery is limited, so my view might be biased.

In general, cardiothoracic procedures are longer lasting (valve replacements?) compared to orthopaedics, so might involve more standing and consequent risk of varicose veins, etc.

On the other hand, orthopaedics involves more "DIY" type procedures (e.g. sawing through bones", so might be more exhausting on hands/arms.

Think also about supply/demand - it is more difficult to reach consultant level in cardio; it may become easier in ortho after some years with the increasing demand for e.g. TKRs and THRs with the increasing obesity problems.

Good luck!

Tbh I'd have thought "cardio" meant cardiology.

^^ not sure if you should focus too much on varicose veins/tired arms when deciding haha

Is ortho not mainly run-through?

Is ortho not mainly run-through?

This isn't a choice you hear about very often. It should boil down to fundamentally whether you want to spend the majority of your work operating or not? What did you enjoy about both jobs? Bear in mind what you see in fy1 is often not reflective of a consultant job.

Not all cardiologist do PCI. Even those that do have the scope to do other things, which can include a lot of diagnostic work which surgical specialties simply won't have. Cardiology is one of the most varied medical specialties around, and also offer the chance to do acute medicine if desired.

Yeah, the topics are different (I enjoy both for different reasons) but I found the worklife of consultants not too different. I have an interest in biomechanics and anatomy fostered through powerlifting and intercalating in Sports & Exercise med, but have always had an interest in the nitty gritty and complex decision making associated with cardiology. Its the only medical or surgical speciality I could see myself really enjoying for my entire career.

I'm not too concerned with doing CST or CMT (my cardiology on calls also covered gen med, and I worked in gen surg as an FY1 and my ortho on calls covered gen surg). I'm quite a driven chap and very goal orientated once I've settled on a target.

Edit: Whichever i settle on I intend to sit part 1 of the relevant exams in my year out.

Sounds like you've already made your decision, really. There's no point basing career choices on what Core training will be like, or whether SpR training is 4/7 years, when the bulk of your career is going to be as a consultant. If you can't see yourself operating age 50, but you can see yourself still doing PCI or whatever it is cardiologists are playing with these days, go for cardio.

Ah, sorry I wasn't clear. I meant ortho is the only surgical and cardio is the only medical. The second sentence could be applied to cardio or ortho (That is awfully written).

Tbh, I am leaning towards Ortho but I'm not sure how I feel about becoming that specialised and leaving a lot of medicine behind.

Somewhat on topic, I'm considering the Future Ortho Surgeons conference on saturday in London and wondered if you knew anything about it? It looks like it might be quite helpful re career decision but not sure if its worth the £100. I appreciate you may have never heard of it.