#27, S2 Choosing a CT Surgery Path

Well, so let's set the stage.

You know, when I'm one of the faculty mentors for the UCLA Thoracic Surgery Interest Group, and the question that always comes up every single meeting, you know, the medical students want to know, how do I become a a thoracic surgeon.

And there are always a lot of questions about the different training pathways.

Just to give a good background for everyone who's listening, there are three general tracks.

There is a traditional pathway, which is general surgery, five years, plus an additional two or three years of fellowship training in cardiothoracic surgery.

There is also what is known as the FAST-TRACK 4 plus 3 program, which is a joint general thoracic and or sorry, general surgery and thoracic surgery training program.

And then there's the I6 integrated pathway.

So to start off with, Dr. Puri, can you talk about which options are options for a medical student considering a career in thoracic surgery, as opposed to a resident who is starting to think about a career in thoracic surgery?

Well, for a medical student who's interested in thoracic or cardiothoracic surgery, they have two pathways available to them, which is the integrated pathway where if they are committed to a career in cardiothoracic surgery, they could apply to the I-6 program, which is a six-year clinical training program with some of them having some dedicated academic enrichment slash research time built into the program, or to go to a 4-3 program, where they could decide to become a cardiothoracic surgeon partway through the program or apply to the program with the express knowledge that they want to go into the 403 program and match that program with the knowledge that they would be preferentially treated and have a spot available to them.

so those are the two pathways essentially available for medical students while someone who is already in residency uh the the general uh sort of paradigm is to apply to traditional programs so to apply to five plus two or five plus three program however There are isolated instances where spots become available in other programs where there are four plus three spots that become available or sometimes due to attrition.

Similarly, in I-6 programs, there can be some attrition.

So spots can become available which are not widely advertised, but they do become available from time to time and you watch out for those and you can apply to those spots if and when they become available, even when you're partway through your general surgical residency.

So for the medical students, there is the I-6 option, the 4 plus 3 option, and then applying to general surgery to do a traditional pathway.

And then for the residents, there is a 4 plus 3 possibly, and also the traditional pathway.

For the medical students who are considering the I-6 program, I think a lot of people are under the impression that that is only for cardiac people who are going into cardiac surgery.

I think probably the majority of I-6 applicants are interested in specifically cardiac surgery.

Are there options for an I-6 program for someone who's interested in general thoracic surgery?

Yes, at last count, when I looked at it, there were about 35 programs offering 45-ish or so spots for I-6 trainees, while the majority are still geared towards training cardiac surgeons, a number of them offer the traditional thoracic pathway training through the six-year program.

So I think they're there.

You'll have to look at individual programs' websites.

And there's also, at times, programs that maintain some flexibility that who they match from year to year.

They may take a cardiac person for one year and then take a thoracic person the following year.

Right.