"The future of healthcare delivery partners leading academic medical centers with strong community hospitals. This relationship makes the innovation and expertise of academic centers available to local communities."A thoracic surgeon operates on the chest. The organs include the lungs, heart, esophagus, chest wall, blood vessels, etc. Most surgeons undergo the same general training and are allowed to operate on all the parts. There are some surgeons, however, who wish to concentrate in a particular part of the chest, like the esophagus or the heart. In fact, the ABTS (American Board of Thoracic Surgery) demands a separate certification for congenital heart surgeons. There are a number of responsibilities that these doctors have to fulfill. The thoracic surgeon job description and salary range is given in the paragraphs below.
― Dr. Vaughn Starnes, Cardiothoracic surgeon, Keck Medicine
- You have to enroll in a medical school and obtain your Doctor of Medicine (M.D.).
- After this, you have to complete your residency program. You could combine this with vascular surgery residency or complete an integrated thoracic surgery residency that comprises 6 years.
- After completing your residency, you need to obtain a certification from the ABTS in your area of expertise.
- You can find more details here about the educational requirements.
As mentioned, thoracic surgeons are called by different names depending on their specialization. A few categories are as follows:
They mainly operate on the diseases of the heart. The operations involving the blockage of arteries and other chest tissues, open heart surgery, etc., come under this category as well.
Congenital Heart Surgeon
Congenital surgery is a rather delicate branch of thoracic surgery. It requires a special certification from the ABTS, as mentioned above. It involves corrective action to treat one or more heart defects that a child is born with.
Lung Cancer Specialists
They are the ones who operate on the lungs and all its related diseases. They perform surgery to remove cancerous tumors in the lungs. They also treat other defects related to the lungs that may require surgery.
Esophageal Cancer Specialist
Any disease related to the esophagus, including the complex surgery of removing malignant tumors, is performed by these specialists. Some of the diseases include gastroesophageal reflux disease (GERD) and esophageal motility disorders.
Chest Trauma Surgeons
They operate on the chest in order to treat complex chest injuries, which may cause difficulty in breathing.
- The surgeon needs to have thorough knowledge of the respiratory and cardiac systems.
- The surgeries under this category include bypass grafting, heart transplant, etc.
- For this purpose, the patient is first given anesthesia and then endotracheal intubation is performed.
- This procedure will change as per the surgery performed; to begin with, a thoracotomy is performed.
- Thoracotomy is making an incision on the chest, that ordinarily begins from the shoulder blade, runs beneath the arm, and reaches the front of the chest. This is done so that the surgeon can have better access to the thorax.
- The surgeon needs to decide how he would want the incision - perhaps, depending on the surgery, he may want to perform a sternotomy instead.
- Once the chest is open, the surgeon should cut the muscles and retract the ribs, and carry on with the invasive procedure.
- If the surgery is a heart transplant, the dead heart is replaced with a donor heart, and the patient can be sewn on immediately.
- The surgeon may also use VATS (Video-assisted thoracic surgery), an advanced technique that will help him access the thorax better by means of a thoracoscope.
- A breathing tube is inserted in one of the incision sites, while the others are sealed.
Congenital Heart Surgery
- Sometimes, babies are born with rare heart defects. Some of these include having a narrow section in the aorta, a hole in the ventricular septum, non-closure of the ductus arteriosus, etc.
- It is the duty of the surgeon to perform these demanding and delicate procedures so that the heart defect can be eliminated.
- The surgeries vary with the defect, of course.
- In case of aorta repair, the surgeon has to cut open the chest, and make the narrow section bigger. This is done by means of a synthetic material.
- The surgeon may also use another method, which involves taking a part of the subclavian artery for expansion.
- If there is a hole in the atrial septal wall, the surgeon has to perform open heart surgery (if need be).
- In this procedure, the hole is covered using a patch or stitches.
- Other surgeries that the doctor has to perform may include closure of the ventricular septum, repairing the truncus arteriosus, etc.
Lung Cancer Surgery
- Surgery is generally performed for lung cancer when it is in the very early stage.
- It is the responsibility of the surgeon to perform accurate diagnosis and inform the patient if a surgery is necessary.
- If the cancer is detected in the later stages, the treatment involves chemotherapy and radiation.
- In case of a procedure for small cell lung cancer, the thorax is opened and the tumor is carefully removed.
- In fact, if the surgeon finds that there are cancer patches in and around (which may not have been detected earlier), he has to assess the seriousness of the condition and scrape away all the cancerous parts in the chest.
- If the procedure is a pneumonectomy, the surgeon will need to remove the whole lung. Generally, this is recommended if the malignant tumor is in the center of the lung.
- If the tumor is in one part of the lung, a lobectomy is performed.
- The surgeon must also take care of the post-surgical procedures, as to how and when the patient has to undergo chemotherapy cycles, what medicines have to be taken, etc.
Esophageal Cancer Surgery
- The surgeon will perform esophagectomy when the tumor is detected near the esophagus.
- Depending on the stage, a part or the whole of the esophagus is removed.
- If the tumor is near the gastroesophageal junction, a part of the stomach will also be removed along with a part of the esophagus.
- If the tumor is right in the middle of the esophagus, almost all parts of the organ are removed along with some surrounding tissue.
- If the surgeon is going to use a part of the intestine to bridge the gap between the stomach and the esophagus, he has to be extremely careful to see to it that the surrounding blood vessels are not damaged.
- There are plenty of risks associated with esophagectomy. For this purpose, patients normally prefer highly skilled surgeons. It is the duty of the surgeon to do the best he can with potentially minimum risk.
- Even a minimally invasive esophagectomy requires a highly skilled and experienced surgeon.
- In this procedure, the surgeon will make minute incisions and introduce a video device through one of them.
- The other incisions are used to introduce the equipment and remove the tumor.
Chest Trauma Surgery
- These surgeries are mainly done to get rid of chest injuries and infections.
- It is the surgeon's responsibility to assess the extent of injury and decide upon a procedure.
- Breathing problems and other lung-related disorders are also treated though chest surgeries.
- In such cases, the surgeon performs a regular thoracostomy and the rest of the procedure depends on the injured organ.
- Some of the injuries include chest wall trauma, rib fractures, hemothorax, hemoptysis, subcutaneous emphysema, etc.
- The salary of a thoracic surgeon is generally high, though the experience counts.
- As per the BLS, the average annual salary is reported to be more than USD 400,000.
- However, this figure is provided only after a few years of experience; initially, the salary is anywhere between 150,000 and 240,000.
- Highly experienced and qualified surgeons may earn more than USD 500,000 as well.
- A general distribution of salary according to the state is given in the table below.
|New Hampshire||USD 203,000|
|New Jersey||USD 222,000|
|New Mexico||USD 179,000|
|New York||USD 248,000|
|North Carolina||USD 196,000|
|North Dakota||USD 182,000|
|Rhode Island||USD 187,000|
|South Carolina||USD 203,000|
|South Dakota||USD 155,000|
|West Virginia||USD 194,000|
One cannot adequately emphasize the seriousness of the medical profession. Whether they are cardiothoracic surgeons, or esophageal cancer specialists, or anyone else, a job in the field of medicine demands complete dedication and perfection. A tiny error in diagnosis or treatment may cost a patient his life.