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How to Become a Cardiothoracic Surgeon in the USA

by Jennifer Alyson

Training for a career in cardiothoracic surgery is not for the faint of heart. It can take 15 years to finish the schooling and residencies you need to perform surgeries on the heart, lungs, esophagus and blood vessels in the chest. But if you're willing to put in the time, a career in cardiothoracic surgery offers plenty of job security. The Society of Cardiothoracic Surgeons says more than half of the nation's heart-and-chest specialists are set to retire by 2023, which will drive demand for new specialists. Demand will also be driven by an aging population that will need more medical services.

Undergraduate School

The first step is a bachelor’s degree. You can major in any field in undergraduate school, as long as you take one year each of biology, general chemistry, inorganic chemistry, physics and calculus. During your junior year, plan to take the Medical College Admissions Test (MCAT), a multiple-choice exam that covers physical science, biology and verbal reasoning. As of 2013, it cost $270 to register for the MCAT, with an additional $85 fee for candidates who take the exam at an international test site outside the United States.

Medical School

After undergraduate school, you need a medical degree, which typically takes four years to earn. You’ll spend the first two years in the classroom, studying basic sciences and clinical medicine. Courses cover biochemistry, the nervous system, immunology, and cardiovascular, pulmonary and endocrine systems. In the third and fourth years, you’ll complete rotations providing patient care in hospitals under the supervision of experienced doctors. Every med student has to serve rotations in family medicine, internal medicine, neurology, pediatrics and surgery. During your final year, you should begin applying for residencies to begin your surgical training.

Training

Residencies in general surgery and cardiothoracic surgery follow med school. General surgery residencies last five years and include rotations in pediatric surgery, orthopedic surgery, urology, gastrointestinal surgery and oncology surgery. You can also expect rotations in cardiothoracic surgery in the first through third years. In your fourth year of general surgery residency, you can apply for a two- to three-year residency in cardiothoracic surgery. Residents learn to perform heart-valve surgery, complex thoracic surgery, clinical trials and lung and esophageal surgery. You can also get additional training through fellowships in advanced techniques in heart failure and transplantation, children’s heart surgery or lung disorders.

Licensing

Like all medical doctors, cardiothoracic surgeons in the United States need a license to practice in their respective states. Requirements vary. Some states, including Arizona, California, Florida and Pennsylvania, mandate one year of postgraduate residency training for U.S. medical school graduates. Nevada requires the most post-graduate training, at three years. Most states have higher minimum training standards for graduates of international medical schools -- often an additional one to two years of post-graduate experience.

Board Certification

Certification through the American Board of Thoracic Surgery isn’t mandatory, but patients and employers often prefer certified doctors because medical boards have specific training and testing requirements. After you finish your residencies, you’ll be eligible to apply for board certification. In addition to finishing surgical residencies, the American Board of Thoracic Surgery requires an unrestricted state medical license, an ethical professional standing and moral status in the community. You’ll also have to pass a two-part test with 250 multiple-choice questions and an oral exam with 12 protocols given by six examiners.

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