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I am looking for advice on choosing between two specialties. I've completed my M3 year and am doing PhD research at the moment. I'm interested in doing a specialty that does both endovascular and open work, so vascular surgery seemed the natural choice. However, my collaborators, who are vascular neurosurgeons, have recently been suggesting I do neurosurgery (presumably with vascular fellowship(s)) instead. I hadn't considered neurosurgery before, so I wanted ask if anyone can provide some insights as to what to consider in differentiating between these specialties, so I can be prepared to ask the right questions for myself when I rotate on each service. My personal pros and cons of each specialty are as follows:
Vascular Surgery
Pros
Cons
Neurosurgery
Pros
Cons
Thank you to everyone who reads this far and considers advising! I greatly appreciate your time and insights.
Vascular Surgery
Pros
- 5 years integrated residency, no fellowship to do open or endovascular work
- Balance of "easier" and more difficult types of surgeries leading to more options for lighter work nearing retirement.
- Some focus on carotid and stroke prevention through CEA and TCAR (although I've heard this is decreasing?)
- Operate all around the body
Cons
- Bread and butter lower extremity disease is less interesting than stroke/cerebrovascular.
- Patient population can be difficult.
- Neurosurgery seems to be taking control over cerebrovascular
Neurosurgery
Pros
- Cerebrovascular is becoming more dominated by neurosurgeons rather than IR/vascular.
- CNS tumors are interesting, not much directly oncology in vascular.
- My PhD research is directly relevant, and the specialty seems to value MD/PhD students more
Cons
- Have to do 7 years residency before doing 1-2 years fellowship.
- Not that interested in open neurosurgery (especially spine), compared to open vascular (aortic, bypass, CEA).
- All open neurosurgeries seem difficult with long procedure times and attending life seems more difficult overall.
Thank you to everyone who reads this far and considers advising! I greatly appreciate your time and insights.
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