Continuing with my previous post (BEST SPECIALTIES AFTER MS/ DNB GENERAL SURGERY ? (PROS AND CONS) - PART 1), here is the part 2 review of various pathways for specializing after completing MS General Surgery. In this post I will be reviewing following:
Contents
MCh/ DNB Plastic Surgery
- Includes wide number of both Cosmetic and Reconstructive Procedures
- Plastic surgery is not just liposuction and nose jobs, it is much much more than that. Plastic surgery as a branch has a wide spectrum of procedures which includes: Skin, Hand Surgery, cranio-maxillo-facial reconstructions, Tendon Reconstruction, peripheral nerve surgery, burns management, genitourinary reconstructions, oculoplastic surgery, bed sore management, diabetic foot management and the list goes on
- Decent demand in large private setups, high demand in large government and semi government setups
- Usually good load of cases only in big cities
- Procedure time is usually long
- Patients may have unrealistic expectations from plastic surgeons as popularized on television and in movies
- Easy to get the seat
MCh/ DNB CTVS
- Usually not preferred by most these days but it does not mean that there is less scope.
- It is still a required specialty in tertiary care hospitals with many procedure both cardiac and thoracic in the armamentarium of Cardiothoracic and vascular surgery. Some examples are Coronary artery bypass grafting (CABG), Heart valve repair or replacement, Ventricular assist devices, carotid endarterectomy, Heart transplant, Surgery in great vessels (aortic coarctation repair, Blalock-Taussig shunt creation, closure of patent ductus arteriosus), congenital heart disease surgeries, Lung volume reduction surgery, Lung cancer surgery, pleurectomy, lung transplant surgery etc.
- Very demanding in terms of challenges of access during the surgery and the need of long term intensive care support required
- One needs to be very passionate for being a heart surgeon
- Usually the work hours are more as the teams are small and number of hours one needs to put are more
- Very easy to get the seat
MCh/ FNB Minimal Invasive Surgery
- It is more like extension of your general surgical training
- For those who already have a good hands on in laparoscopic procedures, it might not be very useful
- Limited seats
- Good exposure to Bariatric surgery which we usually do not get in general surgery training
- Good only if taken in high volume laparoscopic surgery centers (only a few centers like GEM, Coimbatore | Sir Ganga Ram, Delhi| Meenakshi Mission, Madurai | Galaxy, Pune)
- All across India minimal access surgery is being practised largely by general surgeons only
- FNB and Mch MAS at AIIMS are only two courses in India which are recognised by medical council for Minimal Access surgery
- Adoption of Robotic Minimal Access surgery is still in its nascent stages in India, you will require additional training separately
So to conclude, I would say that all specialties have some good things and some bad things. There are some which are in high demand in the job market for freshers, but in the long term, more or less, all specialties offer good scope for talented and deserving surgeons.
The key to success is always dependent on the amount of interest you take and the amount of hard work you put into nurturing your surgical skills. It also depends on the right choice of institute to work in and an optimal match between the demand of the specialty that you choose and number of doctors already offering those services in your city.
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