The Timeline: 13 to 16 Years After High School

Becoming a cardiothoracic surgeon takes 13 to 16 years after you finish high school. This breaks down into four years of undergraduate study, four years of medical school, five to seven years of general surgery residency, and two to three years of cardiothoracic surgery fellowship. The exact length depends on whether you pursue additional research time, whether your residency program is five or six years, and whether you complete a one-year research fellowship before your clinical fellowship.

The timeline is fixed at the medical school and residency stages—you cannot compress these years. Medical school is always four years. General surgery residency is always at least five years, and most programs run six. Cardiothoracic fellowship is typically two to three years. Some surgeons add a research year between residency and fellowship, which extends the total by one year.

Key Takeaways

  • Medical school is four years, general surgery residency is five to six years, and cardiothoracic fellowship is two to three years, totaling 13 to 16 years after high school.
  • You must complete medical school and become a licensed physician before you can enter a general surgery residency program.
  • You cannot enter cardiothoracic fellowship directly—you must first finish a general surgery residency and pass the American Board of Surgery examination.
  • Many cardiothoracic surgeons add a research year between residency and fellowship, which adds one year to the total timeline.
  • Residency and fellowship positions are competitive; your performance in medical school and residency determines which programs will accept you.

Undergraduate Degree and Medical School Prerequisites

Your first four years begin with an undergraduate degree. You do not need a specific major, but you must complete the medical school prerequisites: biology, chemistry, organic chemistry, biochemistry, physics, and mathematics. Most students major in biology or chemistry to satisfy these requirements while earning their degree. Some students take prerequisites as electives if their major is different.

During your undergraduate years, you should also prepare for the Medical College Admission Test (MCAT), which you typically take in your junior or senior year. Medical schools use MCAT scores, your undergraduate GPA, clinical experience, and research experience to decide whether to admit you. Getting into medical school is competitive; most admitted students have a GPA above 3.5 and an MCAT score in the upper percentiles.

Many future surgeons work as medical scribes, emergency department technicians, or volunteer in hospitals during undergraduate years. This experience shows medical schools that you understand what surgery involves and have spent time in a clinical setting.

Medical School: Four Years

Medical school is four years long at all accredited schools in the United States. The first two years focus on classroom learning and laboratory work—anatomy, physiology, pharmacology, pathology, and other foundational sciences. The second two years are mostly clinical rotations, where you work alongside doctors in different specialties including surgery, internal medicine, pediatrics, and psychiatry.

During your third and fourth years, you begin to focus on surgery. You complete rotations in general surgery, and many students seek additional rotations in cardiothoracic surgery, vascular surgery, or cardiac surgery to show their interest and build relationships with surgeons who may later write letters of recommendation for your residency process.

In your fourth year, you explore to general surgery residency programs. This happens in the fall of your final year of medical school. You interview at programs across the country between October and February, and you learn which program accepted you in March. You graduate from medical school in May or June and begin your residency in July.

General Surgery Residency: Five to Seven Years

After medical school, you enter a general surgery residency, which is the mandatory foundation for cardiothoracic surgery. General surgery residency lasts five to six years at most programs, though some programs structure it as six or seven years if they include a built-in research year. During these years, you learn to perform operations, manage surgical patients before and after surgery, handle emergencies, and develop the judgment that surgery requires.

Your first year as a resident (called PGY-1, for postgraduate year 1) is the most supervised. You work under attending surgeons and senior residents, gradually taking on more responsibility. By your final years, you are leading operations and teaching junior residents. You are on call frequently—sometimes every third or fourth night—and you work long hours, often 60 to 80 hours per week.

During residency, you must pass the American Board of Surgery examination (usually in your final year) to become board-certified in general surgery. You also begin to show your interest in cardiothoracic surgery by seeking extra rotations in cardiac surgery, publishing research, and building relationships with cardiothoracic surgeons at your institution or at other hospitals.

Cardiothoracic Surgery Fellowship: Two to Three Years

After you finish general surgery residency and pass your board examination, you explore to cardiothoracic surgery fellowship programs. These are highly competitive—there are far fewer fellowship positions than there are general surgeons who want them. You typically explore in your final year of residency and interview in the fall and winter before your residency ends.

Cardiothoracic fellowship lasts two to three years. During this time, you focus entirely on heart, lung, and esophageal surgery. You perform coronary artery bypass grafts, valve replacements, lung resections, and other complex operations under the supervision of experienced cardiothoracic surgeons. You also complete research and publish papers in surgical journals. By the end of your fellowship, you are ready to practice independently.

In your final year of fellowship, you take the American Board of Thoracic Surgery examination to become board-certified in cardiothoracic surgery. After you pass this examination and complete your fellowship, you are a fully trained cardiothoracic surgeon and can take a job at a hospital or surgical center.

Optional Research Years and How They Extend the Timeline

Many cardiothoracic surgeons add research time to their training. Some programs offer a research year between general surgery residency and cardiothoracic fellowship. During this year, you work in a laboratory or clinical research setting, design and conduct research studies, and publish your findings. This year adds one year to your total timeline, bringing the total to 14 to 17 years.

Research years are optional but common among surgeons who want to pursue academic medicine, lead a surgical program, or develop new surgical techniques. If you take a research year, you typically do so after you finish residency and before you start fellowship. Some surgeons also do research during their fellowship years without extending their timeline, by conducting studies alongside their clinical work.

Why the Timeline Cannot Be Shortened

The length of cardiothoracic surgery training is set by accreditation bodies and cannot be compressed. Medical school is always four years because of the amount of material students must learn and the clinical experience they must gain. General surgery residency is always at least five years because surgeons must develop the judgment and technical skill that only comes with years of supervised practice and increasing responsibility.

Cardiothoracic fellowship is two to three years because you must learn a large number of complex operations, develop the ability to handle complications, and gain experience with different patient populations and disease types. Shortening any of these phases would mean less training, which would put patients at risk. Accrediting bodies and surgical boards maintain these minimum lengths to protect patient safety.

Frequently Asked Questions

Can I skip general surgery residency and go straight to cardiothoracic fellowship?

No. All cardiothoracic fellowship programs require that you complete a general surgery residency first and pass the American Board of Surgery examination. General surgery is the foundation for cardiothoracic surgery, and fellowship programs will not consider you without it.

What if I don't get into a cardiothoracic fellowship on my first try?

If you don't match into a cardiothoracic fellowship, you can practice as a general surgeon, explore again the following year, or pursue a different surgical specialty. Some surgeons take a year or two as a general surgeon to gain more experience and strengthen their process for the next cycle.

Do I have to do research to become a cardiothoracic surgeon?

Research is not required, but it is common and strengthens your process to fellowship programs. Many surgeons conduct research during residency without adding extra years. A dedicated research year is optional and is more common among surgeons interested in academic careers.

How competitive is it to get into cardiothoracic fellowship?

Cardiothoracic fellowship is very competitive. There are roughly 200 to 250 fellowship positions available each year in the United States, and many more general surgeons want them. You need strong performance in residency, good board examination scores, letters of recommendation from senior surgeons, and often research publications to be competitive.

Can I become a cardiothoracic surgeon part-time or while working another job?

No. Medical school, residency, and fellowship are full-time commitments. Residency and fellowship require you to be on call and available for emergencies, and you work 60 to 80 hours per week. You cannot pursue this training while maintaining another career.