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Since I started this blog almost 3 years ago, one of the commonest questions I get asked from budding doctors is how to become a Neurosurgeon and Cardiothoracic surgeon. I have answered these questions many times in this blog but it keep being asked again and again. I am really not sure why most budding doctors only have these 2 specialties in their mind. Do they really know what these 2 specialties is all about or are they being carried away with what is portrayed in the TV programs? Many feel that these 2 specialties are the top most medical specialty, which comes with glamour, popularity and money.  Before I talk about the above topic, let me elaborate a little about what these jobs are all about.

In my entire batch of 180 graduates, only 1 became a Cardiothoracic surgeon and none became a neurosurgeon. Why?  It is always better to decide on what speciality you want to do after you start to work. I had many colleagues and friends who wanted to become this and that but ended up doing something else, many even resigned from medical field. Things will change along the way. Only when you get yourself into the working life, you will realize what medicine is all about. Also don’t forget married life and earning money for a living. You can’t be depending on your parent’s money anymore unless you come from a very rich family.

Not everyone can become a Cardiothoracic surgeon. That’s the reason why you don’t see many, out there. It is a very high-risk job and one of the most challenging surgical fields. You need good hands and master various techniques. Furthermore, with advancing techniques applied by cardiologist with various new stents, the need for cardiothoracic surgeons is declining. The entire state of Johor has only 1 Cardiothoracic surgeon in private sector because that’s all you need. There are about 3 in the state government hospital.  Most private hospital will only need about 1-2 Cardiothoracic surgeons. I also know a few “so-called” Cardiothoracic surgeons who can’t do any proper surgeries.  That’s the reason they remain in government service or in private medical colleges, doing teaching. They do not have the skills to become one but decided to do it anyway!! Probably, the glamour of being called a Cardiothoracic Surgeon is good enough for them. I also know of some cardiothoracic surgeons who have high morbidity and mortality, some even close to 50% mortality rate.

Somewhere in this blog, there was once a comment that claims that his/her relative who is a Cardiothoracic surgeon in a private hospital is earning close to RM 200K/month.  It seems many of these budding doctors are only looking at the money rather than the quality of life, skills and the risk involved. The earning capacity can be high but in order for you to earn that amount of money, you need to do at least 1 cardiac bypass surgery every other day. This means that you will be in the hospital for 24hrs/day and 7 days a week. You practically got no life and you will hardly see your children if you do have any. The stress level is extremely high. The same amount of time in any business will yield you the same amount of money.  The day you stop operating (e.g: met with accident or illness), your income is zero and no guarantee that you can come back and do surgeries like before!  Imagine if you fracture your forearm etc.

Now, let me tell you the pathway to become a Cardiothoracic Surgeon after graduating as a doctor:

1)   2 years Housemanship

2)   2-3 years of Medical Officer (assuming you get your Master’s on first try)

3)   4 years of Master’s in Surgery

4)   6 month’s gazettement process

5)   1-2 years of waiting period

6)   4 years Cardiothoracic subspeciality training

7)   at least another 5 years of experience, assuming you have done about 500 CABG surgeries and competent enough to go out to private sector and perform surgeries without any help from superiors.

This basically means that you will need about 15-20 years of government service and training before being able to be competent enough to perform surgeries on your own. When I first told this to a budding doctor, who has not even gone into medical school, she got a shock of her life. She admitted that she never realized that it was that long. Many are still clueless of the pathway, assuming that they can become a Cardiothoracic surgeon immediately after graduating. Again, don’t forget your married life, children etc.

By now, I am sure you know why there are not many of them out there. It is a difficult field, which need a considerable amount of skills and training. Not everyone can become a Cardiothoracic surgeon ………………. unlike our doctors that are being produced by our grandiose medical schools……………….

Next, pathway to Neurosurgery…………………