Help choosing specialty - Cardio vs Ortho? Watch

RollerBall
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Any tips? I've worked in both, enjoyed both and am really stuck. At the moment leaning more towards Orthopaedics but it may be because I'm just finishing a rotation in it. My plan at the moment is to take an FY3 year (currently F2) to gain more experience in both to help decide and then take exams/bulk portfolio up before applying for training.

I can write a lot more if people want more information if required. I originally wrote a four paragraph post about myself, why these two and my experiences but figured people won't read it.
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macpatgh-Sheldon
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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!
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COYS...TTID
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^^ not sure if you should focus too much on varicose veins/tired arms when deciding haha
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(Original post by macpatelgh)
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.
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macpatgh-Sheldon
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(Original post by Anonymous)
Tbh I'd have thought "cardio" meant cardiology.
I thought that, too, initially, but then figured that a choice between a medical specialty and a surgical one would not be too difficult to make.
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macpatgh-Sheldon
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(Original post by COYS...TTID)
^^ not sure if you should focus too much on varicose veins/tired arms when deciding haha
Just an extension of a dentist friend saying his hands were very achy every evening and a couple of surgeons with problems arising from standing - minor consideration I agree!
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RollerBall
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I mean cardiology when I say cardio. I've spent a bit of time shadowing a CT surgeon in GOSH and it's not for me.I find both are built on first principles tbh. The problem is I enjoy both medical and surgical aspects (I am only really interested in ortho vs gen surg tho, whereas i enjoy a wider range of medicine). I think my biggest worry would be letting go of general medical knowledge/breadth of utility if i went to Orthopaedics.
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RollerBall
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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.
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RollerBall
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I would consider the exams this year, if i could make a decision on which one

I'm definitely not applying for training this cycle. Outside the indecision, there are also some personal reasons as to why I have to take a year out next year as I need flexibility. I've thought a lot about the extra year of CMT but on balance it's just something I have to accept
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Asklepios
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Is ortho not mainly run-through?
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RollerBall
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(Original post by Asklepios)
Is ortho not mainly run-through?
I wish. There's a few run throughs around (mostly up north) but its still primarily st applications
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plrodham1
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(Original post by Asklepios)
Is ortho not mainly run-through?
Only in Scotland or for Academic, in England it's ST3
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fishfacesimpson
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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.
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(Original post by fishfacesimpson)
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.
How does one know if theyd enjoy operating as an f2, with so little experience?

(I'm also undecided medicine vs surgery.)
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Cheesychips1
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I am in a similar predicament! Also cardio v ortho. I agree with the above poster, it's so hard to know how much you enjoy operating because you have little exposure.

I've always been interested in surgery but it hurts my feet to stand for more than 4/5 hours at a time (I'm sure that's similar for a lot of people), so I thought maybe it was ruled out and then enjoyed interventional cardio, but I'm always drawn back to theatre when I've got spare time on placement.

I spoke to an Ortho Consultant and he was basically like, look your achey feet shouldn't hold you back, and sent me some info and advice. Is there anyone locally you could chat it through with? Presumably who knows your strengths etc.
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RollerBall
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I've had a fair bit of exposure in thia placement. In approx 20 trauma lists & a few elective - assisted in several hemis, removed some screws, done a fair bit of a DHS etc etc. I scrub or leave.

I definitely enjoy T&O theatre.
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nexttime
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It seems like fundamentally you're going to either be very specialist and have no clue about anything else (ortho) or you're going to go through CMT and have to deal with lots of comorbid patients routinely, alongside doing your specialist procedures. The angioplasty itself i guess is a lot more of a 'fine' procedure versus most of ortho.

Both are very male dominated and involve lots of out of hours, although i haven't seen ortho consultants in the hospital at night as much as i've seen cardiologists i guess? In terms of job prospects both are good.
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Becca-Sarah
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(Original post by RollerBall)
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.
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RollerBall
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(Original post by Becca-Sarah)
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.
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plrodham1
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(Original post by RollerBall)
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.
Losing the medicine is a choice as to how much effort you want to put into maintaining it. Fair enough you won't have experience to go beyond many of the basics, but you could at least retain enough to instigate simple management and sounds reasonably respectable over the phone.

Certain subspecialties lend themselves more to having 'greater' medical knowledge, trauma and oncology are the two that come to mind.
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