the glory that comes with being a CT surgeon. Let's debunk the public perception myths

的榮耀，成為一名CT醫生。讓我們來揭開公眾對CT的認識迷思

of what it means to be a cardiothoracic surgeon, and give it to you straight. This is the reality

的意思，並直接給你說出來，成為一名心胸外科醫生。這就是現實

of cardiothoracic surgery.

心胸外科的。

Dr. Jubbal, MedSchoolInsiders.com.

朱波醫生，醫派內參網。

Welcome to our next installment in So You Want to Be. In this series, we highlight a

歡迎來到我們的下一期《所以你想成為》。在這個系列中，我們將重點介紹

specific specialty within medicine, such as cardiothoracic surgery, and help you decide

醫學內的特定專業，如心胸外科，並幫助您決定如何進行手術。

if it's a good fit for you. You can find the other specialties on our So You Want to

是否適合你。你可以在我們的 "你想 "網站上找到其他的專業。

Be playlist. You guys voted for it, so here it is. Make sure you're subscribed if you

是播放列表。你們投了票，所以它在這裡。確保你訂閱了，如果你

want to vote for future episodes.

想為未來的劇情投票。

Cardiothoracic surgery refers to surgery within the thorax, or the chest cavity. This includes

心胸外科指的是胸腔內的手術，或胸腔內的手術。這包括

surgery on structures such as the heart, aorta, lungs, mediastinum, esophagus, and diaphragm.

心臟、主動脈、肺、縱隔、食道和膈肌等結構的手術。

These are the surgeons who do procedures like coronary artery bypass grafts, or CABG for

這些是做冠狀動脈旁路移植或CABG等手術的外科醫生。

short, to treat plaque buildup in heart vessels. They perform valve replacements to replace

簡而言之，治療心臟血管中的斑塊堆積。他們進行瓣膜置換手術，以更換

poorly functioning heart valves, lung resections to remove lung cancer, and esophageal repairs

心臟瓣膜功能差，肺部切除術切除肺癌，食道修復術。

to remove esophageal cancers. They can also perform heart and lung transplants, usually

以切除食道癌。他們還可以進行心臟和肺部移植，通常是

one or the other, but in rare instances both at the same time.

一個或另一個，但在極少數情況下，兩者同時進行。

This specialty is not for the faint of heart. Most CT surgeons are workaholics, as CT surgery

這個專業不適合膽小的人。大多數CT外科醫生都是工作狂，因為CT手術

is a specialty with a more challenging lifestyle than most. Operations such as CABG or lung

是一個比大多數人的生活方式更具挑戰性的專業。諸如CABG或肺癌等手術。

resections last from 4 to 8 hours, and when things go wrong, complications can result

切除手術持續4至8小時，一旦出錯，可能會導致併發症。

in a procedure lasting up to 12 hours!

療程長達12小時!

That being said, many CT surgeons make time for their family and hobbies. After all, these

也就是說，很多CT醫生都會抽出時間陪伴家人和愛好。畢竟，這些

are very smart doctors, and they understand the importance of a balanced life for sustainability

都是非常聰明的醫生，他們明白平衡生活對可持續發展的重要性。

and longevity.

和長壽。

CT surgery also has a reputation for a malignant culture, which is a term we use to mean you

CT手術也有惡性培養的名聲，我們用這個詞來表示你

aren't treated well by your superiors or colleagues. This may have been the norm in

不受上級或同事的待遇。這可能是常態，在

the past, but luckily things are changing for the better, and many CT surgeons love

過去，但幸運的是，事情正在發生變化，許多CT外科醫生喜歡

teaching residents and medical students.

教授居民和醫學生。

There are a few ways to categorize CT surgery.

CT手術有幾種分類方法。

First, we can divide the types of surgery based on anatomy. After finishing CT surgery

首先，我們可以根據解剖學來劃分手術類型。完成CT手術後

training, surgeons can choose to specialize even further as cardiac or thoracic surgeons.

訓練，外科醫生可以選擇更進一步的專業，成為心臟或胸外科醫生。

Cardiac surgeons focus on the heart and aorta, performing operations such as CABG and valve

心臟外科醫生專注於心髒和主動脈，進行CABG和瓣膜等手術。

replacements.

替換。

Thoracic surgeons mainly operate on the lung, such as lung cancer resections, but also work

胸外科醫生主要是對肺部進行手術，如肺癌切除術，但同時也會從事以下工作

on the esophagus, diaphragm, mediastinum, ribs, and other structures within the thorax.

食道、膈肌、縱隔、肋骨和胸腔內其他結構上。

Alternatively, they can remain generalized and operate in both cardiac and thoracic domains,

另外，它們也可以保持通俗化，在心臟和胸腔領域都可以操作。

which is more common at community centers. However, if you work at a larger urban or

這在社區中心比較常見。然而，如果你在較大的城市或地區工作。

academic hospital, you'll probably be specializing in cardiac or thoracic.

學術醫院，你可能會專攻心臟或胸腔。

When you think of CT surgery, especially cardiac surgery, you may imagine an open chest, the

當你想到CT手術，尤其是心臟手術時，你可能會想象到一個開放的胸腔，你可能會想象到心臟手術。

heart stopped in the surgeon's hand, and a giant machine circulating blood to the patient.

心臟停在了外科醫生的手中，一臺巨大的機器在給病人循環血液。

And that stereotype is mostly true. The majority of cardiac operations, such as aortic valve

而這種刻板印象大多是正確的。大多數的心臟手術，如主動脈瓣手術

replacements and CABG involve performing a sternotomy, whereby a saw is used to cut the

替換和CABG需要進行胸骨切開術，即用鋸子切割胸骨。

breast bone in half to access the heart.

將乳骨對半切開，以進入心臟。

The cardiopulmonary bypass machine takes over the function of the heart and lungs while

心肺旁路機接管了心臟和肺部的功能，而

they're stopped, such that the patient's blood is drained into the machine, where it's

他們停止了，這樣病人的血液就會被排入機器，在那裡，它是。

oxygenated, and then gets pumped back to the rest of the body. This allows the surgeons

氧氣，然後被泵回身體其他部位。這使得外科醫生

to operate as needed on the stopped heart.

以根據需要對停止的心臟進行操作。

On the other hand, minimally invasive surgeries include video-assisted thoracoscopic surgeries

另一方面，微創手術包括視頻輔助胸腔鏡手術等。

or robot-assisted, like the Da Vinci robot. Most lung cancer resections are performed

或機器人輔助，如達文西機器人。大多數肺癌切除手術是在

in this manner. Four to six small incisions are made in the spaces between the ribs to

以這種方式。在肋骨之間的空隙處做4到6個小切口，以達到以下目的

insert ports for the robot arms or camera. Using long instruments and a camera, surgeons

插入機器人手臂或相機的端口。使用長器械和相機，外科醫生

are able to maneuver through the thorax to cut, remove, and suture tissue. Certain cardiac

能夠通過胸腔操作來切割、移除和縫合組織。某些心臟

surgeries, such as valve replacements, can also be performed with robot assistance.

手術，如瓣膜置換術，也可以在機器人的協助下進行。

After finishing medical school, there are three pathways to become a CT surgeon. This

醫學院畢業後，有三種途徑可以成為CT醫生。這個

is very similar to the plastic surgery training pathway that we covered in a previous So You

是非常類似於我們在之前的《所以你》中介紹的整形外科培訓途徑。

Want to Be episode.

想成為一集。

The most common and traditional, called the independent pathway, is to complete a general

最常見也是最傳統的，叫做獨立的途徑，就是完成一般的

surgery residency, lasting 5-7 years depending on the program, and then complete an additional

外科住院醫師，根據項目的不同，持續5-7年，然後再完成一個額外的。

2-year CT surgery residency afterwards. In this situation, the surgeon is board certified

2年的CT外科住院醫師後。在這種情況下，外科醫生是有資質的。

in both general surgery and CT surgery, and is spending between 7 and 9 years of additional

在普通外科和CT手術方面，並在7至9年的時間裡，花了更多的時間。

training after medical school.

醫學院畢業後的培訓。

The second option is the integrated pathway, lasting only 5 or 6 years in total. Residents

第二種選擇是綜合途徑，總共只有5年或6年。居民

rotate on general and CT surgery, but spend most of their time on CT. This is a smaller

輪流做普通外科和CT手術，但大部分時間都在做CT。這是一個較小的

and newer format, but it's growing each year. Residents in this pathway are only board

和更新的形式，但每年都在增長。這個途徑的居民只有板

certified in CT surgery, not general surgery.

CT手術認證，而不是普通外科。

The third option is the combined pathway, also known as the fast track pathway. Rather

第三種選擇是組合途徑，也就是所謂的快速通道。而是

than 5 years of general surgery residency and then applying separately to another program

超過5年的普通外科住院醫師，然後單獨申請另一個項目。

for a 2 year CT residency, you'll do 4 years of general surgery and 3 years of CT surgery

對於2年的CT住院醫師，你要做4年的普通外科手術和3年的CT手術。

at a single program. These graduates are certified in both general and CT surgery.

在一個項目中。這些畢業生都獲得了普通外科和CT外科的認證。

Again similar to plastic surgery, most medical students want to obtain an integrated pathway

同樣與整形外科類似，大多數醫學生都希望獲得一個綜合的途徑。

position. After all, it's fewer years in training. However, CT surgery integrated programs

的位置。畢竟，它的培訓年限較少。然而，CT手術綜合項目

are new and small in number. Last year, there were only 37 individual positions available,

是新設且數量較少。去年，僅有37個個人職位。

meaning that fewer than 50% of applicants successfully matched. For this reason, most

也就是說，成功配對的申請人不到50%。是以，大部分

aspiring CT surgeons choose general surgery residency, which is a less competitive path.

有抱負的CT外科醫生選擇競爭較少的普通外科住院醫師。

Don't think it'll be easy however, as it's still very challenging to match at

不過，不要以為這很容易，因為在比賽中還是很有挑戰性的。

a top tier big name program.

一流的大牌項目。

What types of medical students apply to CT surgery? Stereotypically, the gunners. After

什麼樣的醫學生報考CT外科？刻板印象中，槍手。經過

all, CT surgery is far from easy, and it comes with long hours. The bread and butter cases,

所有，CT手術遠非易事，而且時間長。的麵包和黃油的情況。

such as CABG and lung resections, can last a long while. For these reasons, it attracts

如CABG和肺切除術，可以持續很長時間。由於這些原因，它吸引了

those who aren't afraid of hard work. Particularly if you end up at an integrated CT surgery

不怕辛苦的人。特別是如果你最終在綜合CT手術的時候

residency program, you'll need to be at the top of your class with stellar board scores,

住院醫師項目，你需要在班級中名列前茅，並有出色的董事會成績。

research, letters of recommendation, and honors in your clinical rotations.

研究，推薦信，以及在臨床輪轉中獲得的榮譽。

After completing CT surgery training, you can subspecialize even further with a 1 year

在完成CT手術培訓後，您還可以通過1年的時間來進一步細分專業。

fellowship.

獎學金。

Congenital cardiac surgery is for those who love precision and working on tiny objects.

先天性心臟手術適合那些喜歡精密和在微小物體上工作的人。

Many congenital cardiac operations must be done as soon as the neonate is born, which

許多先天性心臟病手術必須在新生兒出生後立即進行，這就使得

means working on a heart the size of a golf ball.

意味著在一顆高爾夫球大小的心臟上工作。

Congenital cardiac surgeons also operate on adults with congenital heart defects. If you'd

先天性心臟外科醫生也為有先天性心臟缺陷的成年人做手術。如果您想

like to work with a wide age range of patients, this may be a good fit.

喜歡與不同年齡段的患者合作，這可能是一個很好的選擇。

Transplant surgery is for the workaholics who love a rush. Transplants can occur at

移植手術適合喜歡急功近利的工作狂。移植手術可以發生在

any moment, depending on when the donor passes, and this often translates to operations in

隨時都有可能，這取決於捐贈者何時去世，而這往往會轉化為操作中。

the middle of the night. The glorious side of transplant surgery is that you'll be

半夜的時候移植手術光榮的一面是，你將會是。

riding in helicopters and private jets to harvest the organs.

乘坐直升機和私人飛機去摘取器官。

Thoracic aortic and endovascular surgery includes extra training to master operating on the

胸主動脈手術和血管內手術包括額外的訓練，以掌握操作在

thoracic aorta, or the part of the aorta that is in the chest. You mostly treat patients

胸主動脈，或胸腔內的主動脈部分。您主要治療的病人

with aortic aneurysms, or aortas with expanded and weak walls that are about to erupt! You

患有主動脈瘤，或主動脈瘤壁膨大、薄弱，即將爆發!您

can either perform open surgeries to replace the diseased segment of the aorta, or perform

可以進行開放性手術來替換病變的主動脈段，或者進行

an endovascular operation in which you snake a wire and a stent through the patient's

血管內手術，即用一根線和一個支架穿過病人的血管。

femoral artery in the leg. Once you work it up to the thoracic aorta, you can deploy the

腿上的股動脈一旦你把它弄到胸主動脈，你就可以部署好了

stent by expanding it to address the defect in the wall.

通過擴大支架來解決壁上的缺陷。

Cardiothoracic surgery is a pretty dope specialty. If you love big, epic operations, this is

心胸外科是一個很坑爹的專業。如果你喜歡大的、史詩般的手術，這就是你的夢想。

the field for you. Where else can you feel the heart beating in your hands, stop it,

的領域為你。哪裡還能感受到你手中的心臟跳動，停止吧。

and then bring it back to life? CT surgery is also incredibly exciting with rapid innovation

然後讓它重獲新生？CT手術的快速創新也讓人感到無比興奮

and new robotic and minimally invasive surgeries being developed regularly.

和新的機器人和微創手術正在定期開發。

In terms of patients, you'll be working with the sickest of the sick. Particularly

在病人方面，你將和病入膏肓的病人一起工作。特別是

with heart failure and heart attack patients, who are at death's door, you'll be saving

與心力衰竭和心臟病發作的病人，誰是在死亡門口，你將會節省。

lives. For this reason, it's highly rewarding and CT surgeons build a strong bond with their

的生命。是以，這是非常有意義的，CT外科醫生與他們建立了緊密的聯繫。

patients. However, you should also be able to stomach when cases occasionally go bad.

病人。但是，當病例偶爾出現問題時，你也應該能夠忍受。

If you love complex work with multiple moving parts and teamwork, CT surgery has you covered.

如果你喜歡複雜的工作，有多個移動部件和團隊合作，CT手術就能滿足你。

Not only are you working with the nurses and anesthesiologists, but you'll have the perfusionist

你不僅要和護士和麻醉師一起工作，還要和灌注師一起工作。

manning the cardiopulmonary bypass machine and robot assistance for minimally invasive

操作心肺旁路機和機器人協助微創手術

surgery. Additionally, these patients require close post-op monitoring and care, so you'll

手術。此外，這些患者需要密切的術後監測和護理，所以你會

be working with several other members of the healthcare team to ensure a safe recovery.

將與醫療團隊的其他幾位成員合作，以確保安全恢復。

Lastly, the money. CT surgeons are highly compensated for their work, with an average

最後是錢。CT外科醫生的工作報酬很高，平均

annual salary of $480,000.

年薪48萬元。

While CT surgery is glamorous and exciting, it's definitely not for everyone. This is

CT手術雖然魅力十足，令人興奮，但絕對不是每個人都能做的。這就是

a highly demanding specialty with a great deal of hard work. Surgeries are long, and

是一個要求很高的專業，有很大的辛苦。手術時間長，而且

patients are sick, often not having favorable outcomes. You will have more patients die

病人生病，往往不會有好的結果。你會有更多的病人死亡

compared to other specialties.

與其他專業相比。

And you won't have a predictable schedule. In this line of work, emergency surgeries

而且你不會有一個可預測的時間表。在這一行，急診手術

in the middle of the night are not uncommon. Get ready to pull all nighters and still operate

在半夜的時候並不少見。準備好通宵達旦的工作，同時還可以操作

the next day. The usual “9 to 5”, 40 hours per week does not apply here.

第二天。通常的 "朝九晚五"、每週40小時的工作時間在這裡並不適用。

Training is long and it will take a while to become a CT surgeon, and even longer if

培訓時間長，要想成為一名CT醫生需要一段時間，甚至更久，如果

you want to specialize further. While other specialties have 3 to 5 years of training

你想進一步專研。而其他專業則要經過3到5年的培訓。

after medical school, be prepared to spend another decade for CT surgery. That's 10

醫學院畢業後，準備再花十年時間做CT手術。那是10

years of making $50 to $80k a year as a resident or fellow as well as 10 years of spending

作為住院醫師或研究員，年薪5-8萬美元，以及10年的消費時間。

intense hours in training.

緊張的訓練時間。

At the end of the day, how can you decide if CT surgery is a good fit for you? If you're

最後，如何決定CT手術是否適合自己？如果你是

an adrenaline junkie who loves big cases, a fast paced lifestyle, but isn't afraid

一個腎上腺素狂熱者，他喜歡大案子，快節奏的生活方式，但並不害怕。

of standing for hours doing longer surgeries in the middle of the night, then CT surgery

在半夜站立數小時做較長時間的手術，然後做CT手術。

may be a good fit.

可能是一個很好的選擇。

If you also crave innovation and want to be on the cutting edge of surgery, CT seems to

如果你也渴望創新，想走在手術的最前沿，CT似乎是一個不錯的選擇。

always have a new noteworthy technology every year, and is one of the leading specialties

每年都有新的值得注意的技術，是領先的專業之一。

in robotics utilization.

在機器人利用中。

And finally, CT surgery is incredibly competitive, particularly if you want to get into an integrated

最後，CT手術的競爭非常激烈，特別是如果你想進入一個綜合性的

residency or get into a strong general surgery residency to position you well for a CT fellowship.

住院醫師或進入實力雄厚的普外科住院醫師，為你的CT研究工作做好定位。

And who better to learn from and be mentored by than CT surgeons themselves. Big shout

還有誰比CT醫生自己更適合學習和接受指導呢？大聲呼喊

out to the CT surgeons at Med School Insiders that helped me in the creation of this video.

出的CT外科醫生在醫學院內幕，幫助我在創建這個視頻。

If you need help acing your MCAT, USMLE, or other exams, our tutors can maximize your

如果你需要幫助你通過MCAT、USMLE或其他考試，我們的導師可以最大限度地提高你的成績。

test day performance. If you're applying to medical school or cardiothoracic surgery

測試日表現。如果你要申請醫學院或心胸外科

residency, our CT surgeons can share the ins and outs of what it takes and how to navigate

住院醫師，我們的CT外科醫生可以分享它的來龍去脈和如何駕馭

the highly competitive process most effectively. We've become the fastest growing company

競爭激烈的過程中最有效的。我們已經成為發展最快的公司

in the industry, and it's no surprise. Our customers love us because we're committed

在行業中，這並不奇怪。我們的客戶喜歡我們，因為我們致力於

to delivering results, period. Learn more at medschoolinsiders.com.

提供結果，就這樣。瞭解更多資訊，請訪問medschoolinsiders.com。

Thank you all so much for watching! If you enjoyed this video, you may also enjoy our

非常感謝大家的觀看!如果你喜歡這個視頻，你可能也喜歡我們的

So You Want to Be episode on Neurosurgery, or our video covering the 5 most competitive

所以，你想成為神經外科的情節，或我們的視頻覆蓋5個最具競爭力的。

specialties. Much love, and I'll see you guys in that next one.

特產。很多愛，我們下一場見。