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Silvestre J, Cevasco M. Comparing Match Outcomes in a Surgical Subspecialty: Independent Versus Integrated Training Pathways. JOURNAL OF SURGICAL EDUCATION 2023; 80:468-475. [PMID: 36464614 DOI: 10.1016/j.jsurg.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE In recent years, the Thoracic Surgery Match (TSM) has become increasingly competitive. The purpose of this study was to compare recent trends in application and match rates in the TSM by training pathway. DESIGN This was a retrospective cohort study of all applicants to Integrated and Independent pathways for Thoracic Surgery training (2008-2021). Chi square tests were used to elucidate temporal trends and make comparisons by training pathway. SETTING Accreditation Council for Graduate Medical Education (ACGME)-accredited Thoracic Surgery training programs in the United States. PARTICIPANTS 1500 Independent and 1242 Integrated pathway applicants for Thoracic Surgery training. RESULTS From 2008 to 2021, the annual match rate decreased from 91% to 71% in the Independent pathway (p < 0.001). This was driven by a decrease in the number of training positions (130-101, 22% decrease) and increase in number of applicants (96-140, 46% increase). In the Integrated pathway, the annual match rate increased from 33% to 35% (p < 0.001) as did the number of training positions (3 to 46, 1430% increase) and applicants (9-129, 1333% increase). During each year, match rates in the Independent pathway exceeded those in the Integrated pathway (p < 0.001). U.S. Allopathic graduates had higher match rates than non-U.S. Allopathic graduates for both Integrated and Independent training pathways. The percentage of applicants in the Independent pathway matching at one of their top 3 choices decreased from 73% to 40% (p < 0.001). The percentage of Independent thoracic surgery training positions that went unmatched decreased from 28% to 2% (p < 0.001). This percentage was stable at an average of 1% in the Integrated pathway (p > 0.05). CONCLUSIONS The TSM has become increasingly competitive for Independent pathway applicants and remains ultracompetitive for Integrated pathway applicants. More research is needed to understand disparities in match rates by Thoracic Surgery training pathway.
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Brescia AA, Louis C, Luc JGY, Coyan GN, Han JJ, Blitzer D, Wilder FG, Bergquist CS, Bloom JP, Reddy RM, Sandhu G, Mehaffey JH. The utilization of educational resources published by the Thoracic Surgery Residents Association. JTCVS OPEN 2022; 11:241-264. [PMID: 36172408 PMCID: PMC9510814 DOI: 10.1016/j.xjon.2022.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 04/03/2022] [Accepted: 04/18/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The Thoracic Surgery Residents Association (TSRA) is a trainee-led cardiothoracic surgery organization in North America that has published a multitude of educational resources. However, the utilization of these resources remains unknown. METHODS Surveys were constructed, pilot-tested, and emailed to 527 current cardiothoracic trainees (12 questions) and 780 former trainees who graduated between 2012 and 2019 (16 questions). The surveys assessed the utilization of TSRA educational resources in preparing for clinical practice as well as in-training and American Board of Thoracic Surgery (ABTS) certification examinations. RESULTS A total of 143 (27%) current trainees and 180 (23%) recent graduates responded. A higher proportion of recent graduates compared with current trainees identified as male (84% vs 66%; P = .001) and graduated from 2- or 3-year traditional training programs (81% vs 41%; P < .001), compared with integrated 6-year (8% vs 49%; P < .001) or 4 + 3 (11% vs 10%; P = .82) pathways. Current trainees most commonly used TSRA resources to prepare for the in-training exam (75%) and operations (73%). Recent graduates most commonly used them to prepare for Oral and/or Written Board Exams (92%) and the in-training exam (89%). Among recent graduates who passed the ABTS Oral Board Exam on the first attempt, 82% (97/118) used TSRA resources to prepare, versus only 48% (25/52) of recent graduates who passed after multiple attempts, failed, have not taken the exam, or preferred not to answer (P < .001). CONCLUSIONS Current cardiothoracic trainees and recent graduates have utilized TSRA educational resources extensively, including to prepare for in-training and ABTS Board examinations.
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Affiliation(s)
| | - Clauden Louis
- Department of Cardiothoracic Surgery, University of Rochester, Rochester, NY
| | - Jessica G Y Luc
- Division of Cardiovascular Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Jason J Han
- Division of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pa
| | - David Blitzer
- Department of Surgery, Columbia University, New York, NY
| | - Fatima G Wilder
- Department of Surgery, Johns Hopkins University, Baltimore, Md
| | | | - Jordan P Bloom
- Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Mass
| | | | - Gurjit Sandhu
- Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - J Hunter Mehaffey
- Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Va
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Vaysburg DM, Wells D, Lynch C, Kassam AF, Cortez AR, Potts JR, Starnes SL, Quillin RC, Van Haren RM. Impact of Integrated Thoracic Residency on General Surgery Residents' Thoracic Operative Volume. Ann Thorac Surg 2021; 113:302-307. [PMID: 33600789 DOI: 10.1016/j.athoracsur.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Integrated thoracic surgery (I-6) programs have become popular over traditional general surgery (GS) pathways since their inception in 2007. However the effect of I-6 programs on GS resident training remains unknown. The purpose of this study was to evaluate the effect of I-6 programs on the thoracic operative experience of co-located GS residents. METHODS Thoracic surgery cases recorded by residents in GS programs co-located with I-6 programs until 2019 were analyzed. Cases were reviewed 5 years before (TSR-5) through 5 years after (TSR-5) the matriculation of the first thoracic resident in the co-located I-6 program. To contextualize the overall trends in the field Accreditation Council for Graduate Medical Education GS resident case logs from 1990 to 2018 were analyzed and total thoracic surgery cases recorded. Statistical analysis was performed with linear regression. RESULTS Residents in 19 GS programs with co-located I-6 programs showed an increase in total thoracic cases from 3710 to 4451 (Δ/year of +85.05 cases a year; P = .03) balanced by an increase in GS residents from 107 to 126 (Δ/year of +1.45; P = .01) with no significant overall change in the median thoracic operative case volume (31.00 at both thoracic residency before and after 5 years). Nationally from 1990 to 2018 there was no change in the total thoracic operative experience for GS graduates. CONCLUSIONS The introduction of I-6 programs did not negatively impact thoracic operative experience for residents in co-located GS programs. Adequate training of both I-6 and GS residents at the same institution is feasible.
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Affiliation(s)
- Dennis M Vaysburg
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Dennis Wells
- Division of Thoracic Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Caroline Lynch
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Al-Faraaz Kassam
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Alexander R Cortez
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - John R Potts
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Sandra L Starnes
- Division of Thoracic Surgery, University of Cincinnati, Cincinnati, Ohio
| | - R Cutler Quillin
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Robert M Van Haren
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
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Lou X, Brescia AA, Louis C, Han J, Blitzer D, Mehaffey JH. Development and Evolution of the Thoracic Surgery Residents Association. Ann Thorac Surg 2021; 111:723-728. [DOI: 10.1016/j.athoracsur.2020.08.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/22/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
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Liou DZ. Commentary: Two decades of innovation, leadership, and overcoming challenges, but more lies ahead. J Thorac Cardiovasc Surg 2020; 162:928-929. [PMID: 33069423 DOI: 10.1016/j.jtcvs.2020.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Douglas Z Liou
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
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Brescia AA, Lou X, Louis C, Blitzer D, Coyan GN, Han JJ, Watson JJ, Mehaffey JH. The Thoracic Surgery Residents Association: Past contributions, current efforts, and future directions. J Thorac Cardiovasc Surg 2020; 162:917-927.e5. [PMID: 33051070 PMCID: PMC7456949 DOI: 10.1016/j.jtcvs.2020.08.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/09/2020] [Accepted: 08/23/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The Thoracic Surgery Residents Association (TSRA) is a resident-led organization established in 1997 under the guidance of the Thoracic Surgery Directors Association to represent the interests and educational needs of cardiothoracic surgery residents. We aim to describe the past contributions, current efforts, and future directions of the TSRA within a conceptual framework of the TSRA mission. METHODS Primary review of educational resources was performed to report goals and content of past contributions. TSRA Executive Committee input was used to describe current resources and activities, as well as the future goals of the TSRA. Podcast analytics were performed to report national and global usage. RESULTS Since 2011, the TSRA has published 3 review textbooks, 5 reference guides, 3 test-preparation textbooks, 1 supplementary publication, and 1 multiple-choice question bank and mobile application, all written and developed by cardiothoracic surgery trainees. In total 108 podcasts have been recorded by mentored trainees, with more than 175,000 unique listens. Most recently, the TSRA has begun facilitating trainee submissions to Young Surgeon's Notes, fostered a trainee mentorship program, developed the monthly TSRA Newsletter, and established a wide-reaching presence on Facebook, Twitter, and Instagram to help disseminate educational resources and opportunities for trainees. CONCLUSIONS The TSRA continues to be the leading cardiothoracic surgery resident organization in North America, providing educational resources and networking opportunities for all trainees. Future directions include development of an integrated disease-based resource and continued collaboration within and beyond our specialty to enhance the educational opportunities and career development of cardiothoracic trainees.
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Affiliation(s)
| | - Xiaoying Lou
- Division of Cardiothoracic Surgery, Emory University, Atlanta, Ga
| | - Clauden Louis
- Department of Cardiothoracic Surgery, University of Rochester, Rochester, NY
| | - David Blitzer
- Department of Surgery, Columbia University, New York, NY
| | - Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Jason J Han
- Division of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Justin J Watson
- Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, Ore
| | - J Hunter Mehaffey
- Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Va
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Geraci TC, Ng T. Commentary: Finding a job in cardiothoracic surgery: Is it who you know rather than what you know? J Thorac Cardiovasc Surg 2019; 158:642-643. [PMID: 31101344 DOI: 10.1016/j.jtcvs.2019.03.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Travis C Geraci
- Department of Cardiothoracic Surgery, New York University-Langone Health, New York, NY
| | - Thomas Ng
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
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Zhu Y, Goldstone AB, Woo YJ. Integrated Thoracic Surgery Residency: Current Status and Future Evolution. Semin Thorac Cardiovasc Surg 2019; 31:345-349. [DOI: 10.1053/j.semtcvs.2019.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 04/02/2019] [Indexed: 11/11/2022]
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Chen H, Reddy RM, Palmer SW, Coleman DM, Hoch JR, DiMusto PD, Rectenwald JE. Attrition rates in integrated vascular and cardiothoracic surgery residency and fellowship programs. J Vasc Surg 2018; 69:236-241. [PMID: 30455051 DOI: 10.1016/j.jvs.2018.07.074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 07/21/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Attrition in surgical programs remains a significant problem resulting in trainee dissatisfaction and wasted time and educational dollars. Attrition rates in general surgery training programs approximate 5% per year (30% cumulative). Attrition rates in cardiovascular surgery training for the traditional vascular surgery fellowship (VSF), the vascular surgery residency (VSR), and the corresponding programs in cardiothoracic surgery have yet to be described, although they are assumed to be similar to those associated with general surgery training. METHODS A retrospective review of the Association of American Medical Colleges Annual Physician Specialty Data Book was performed. Data from consecutive academic years 2007-2008 to 2013-2014 were analyzed. The number of total residents, the number who did not complete their training, and those who successfully completed the program were recorded. Attrition rates were then calculated for VSF, VSR, general surgery residency (GSR), cardiothoracic surgery fellowship (CTF), and cardiothoracic surgery integrated residency (CTR). RESULTS Annually, between 2007-2008 and 2013-2014, there were zero to two vascular surgery residents who failed to complete the program (0%-5.9%). In the last 4 years of the study, whereas the absolute number of residents who failed to complete the program remained constant at 1 or 2 per year, the attrition rate decreased to 1 of 171 trainees (0.6%) in 2013-2014 as the total number of programs (and numbers of vascular surgery residents) significantly increased. During the same 7-year period, the number of vascular surgery fellows who did not complete their training ranged from one to six annually (0.4%-2.5%). Compared with the VSF, the VSR data show a relatively low and constant rate of attrition. In contrast, the number of general surgery residents who did not complete their program during the study period varied from 255 to 388 residents annually (3.3%-5.2%). During its first 3 years of inception, the CTR program had an attrition rate of 0%, and it was not until 2012-2013 that trainees failed to complete the program, resulting in an annual attrition rate of 1.2% to 3.2% from that point on. The annual attrition rate of CTF training programs ranged from 7 to 15 fellows (2.9%-6.8%) during the study period. CONCLUSIONS The inception of VSR and CTR programs dramatically changed the paradigms for training in these highly specialized surgical fields. Comparisons of attrition rates between these two programs and the traditional VSF and CTR as well as GSR suggests lesser rates of attrition in the integrated programs. These data may prove reassuring to VSR and CTR program directors, whose significantly smaller programs are more vulnerable to the loss of even a single trainee than general surgery training programs are. In addition, the VSF program has stable and lower attrition rates compared with the CTF and GSR programs.
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Affiliation(s)
| | - Rishi M Reddy
- Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - Sarah W Palmer
- Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - Dawn M Coleman
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - John R Hoch
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin, Madison, Wisc
| | - Paul D DiMusto
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin, Madison, Wisc
| | - John E Rectenwald
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin, Madison, Wisc.
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Lajos P, Negrete A, Ravin R, Marin M, Faries P. A survey of 0 + 5 vascular surgery residency candidates: Perceptions of an applicant pool. Vascular 2016; 24:610-620. [DOI: 10.1177/1708538116629590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Applications to integrated (0 + 5) vascular surgery residencies have increased, while total applications have stayed relatively constant. This survey sought to document the perceptions of 0 + 5 vascular surgery applicants. Methods Academic faculty conducted interviews for 0 + 5 residency match at an academic medical center in preparation for the National Resident Matching Program (NRMP) Main Residency Match. Applicant pool (n = 20) perceptions were determined with surveys. Participation was anonymous and voluntary. Results Nineteen interviewees (26.3% female: 73.7% male), age (26.8 ± 2.6 years) responded (95% response rate). Of 19 respondents, 68% became interested in vascular surgery in their third year with 53% becoming aware of 0 + 5 programs in their third year. All respondents identified a vascular surgery attending at their institution as significant mentors. Forty-seven percent identified their mentor during their third year of medical school. All respondents felt that 0 + 5 training would prepare them adequately for the workforce and board certification exams. Almost all (89%) had plans to seek jobs immediately upon completion of residency. Conclusion Applicants remained positive about their planned training and career paths. Attending vascular surgeons were identified as the strongest mentors, yet most students decided only in their third and fourth years to pursue 0 + 5 residencies. Educational debt remains a concern, and there may be consideration for a concerted effort to recruit potential candidates sooner.
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Affiliation(s)
- Paul Lajos
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Vascular Surgery, Mount Sinai Medical Center, New York, USA
| | - Alejandro Negrete
- Division of Vascular Surgery, Mount Sinai Medical Center, New York, USA
| | - Reid Ravin
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Vascular Surgery, Mount Sinai Medical Center, New York, USA
| | - Michael Marin
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Vascular Surgery, Mount Sinai Medical Center, New York, USA
| | - Peter Faries
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Vascular Surgery, Mount Sinai Medical Center, New York, USA
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Tchantchaleishvili V, LaPar DJ, Odell DD, Stein W, Aftab M, Berfield KS, Eilers AL, Groth SS, Lazar JF, Robich MP, Shah AA, Smith DA, Stephens EH, Stock CT, DeNino WF, Nguyen TC. Predictors of Career Choice Among Cardiothoracic Surgery Trainees. Ann Thorac Surg 2015; 100:1849-54; discussion 1853. [DOI: 10.1016/j.athoracsur.2015.04.073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/01/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
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Resident Perceptions of 2-Year Versus 3-Year Cardiothoracic Training Programs. Ann Thorac Surg 2015; 99:2070-5; discussion 2075-6. [DOI: 10.1016/j.athoracsur.2015.01.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 12/26/2014] [Accepted: 01/06/2015] [Indexed: 11/18/2022]
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Lebastchi AH, Yuh DD. Nationwide survey of US integrated 6-year cardiothoracic surgical residents. J Thorac Cardiovasc Surg 2014; 148:401-7. [DOI: 10.1016/j.jtcvs.2014.03.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/10/2014] [Accepted: 03/21/2014] [Indexed: 11/30/2022]
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Kansier N, Varghese TK, Verrier ED, Drake FT, Gow KW. Accreditation Council for Graduate Medical Education case log: general surgery resident thoracic surgery experience. Ann Thorac Surg 2014; 98:459-64; discussion 464-5. [PMID: 24968766 DOI: 10.1016/j.athoracsur.2014.04.122] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/24/2014] [Accepted: 04/28/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND General surgery resident training has changed dramatically over the past 2 decades, with likely impact on specialty exposure. We sought to assess trends in general surgery resident exposure to thoracic surgery using the Accreditation Council for Graduate Medical Education (ACGME) case logs over time. METHODS The ACGME case logs for graduating general surgery residents were reviewed from academic year (AY) 1989-1990 to 2011-2012 for defined thoracic surgery cases. Data were divided into 5 eras of training for comparison: I, AY89 to 93; II, AY93 to 98; III, AY98 to 03; IV, AY03 to 08; V, AY08 to 12. We analyzed quantity and types of cases per time period. Student t tests compared averages among the time periods with significance at a p values less than 0.05. RESULTS A total of 21,803,843 general surgery cases were reviewed over the 23-year period. Residents averaged 33.6 thoracic cases each in period I and 39.7 in period V. Thoracic cases accounted for nearly 4% of total cases performed annually (period I 3.7% [134,550 of 3,598,574]; period V 4.1% [167,957 of 4,077,939]). For the 3 most frequently performed procedures there was a statistically significant increase in thoracoscopic approach from period II to period V. CONCLUSIONS General surgery trainees today have the same volume of thoracic surgery exposure as their counterparts over the last 2 decades. This maintenance in caseload has occurred in spite of work-hour restrictions. However, general surgery graduates have a different thoracic surgery skill set at the end of their training, due to the predominance of minimally invasive techniques. Thoracic surgery educators should take into account these differences when training future cardiothoracic surgeons.
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Affiliation(s)
- Nicole Kansier
- Department of Surgery, University of Washington, Seattle, Washington.
| | - Thomas K Varghese
- Department of Surgery, University of Washington, Seattle, Washington; Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington
| | - Edward D Verrier
- Department of Surgery, University of Washington, Seattle, Washington; Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington
| | - F Thurston Drake
- Department of Surgery, University of Washington, Seattle, Washington
| | - Kenneth W Gow
- Department of Surgery, University of Washington, Seattle, Washington; Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, Seattle, Washington
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Griffith BP. The eggs may be teaching the chickens. Ann Thorac Surg 2013; 96:1520-1524. [PMID: 24088480 DOI: 10.1016/j.athoracsur.2013.05.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 02/04/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Bartley P Griffith
- Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
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Boffa DJ, Gangadharan S, Kent M, Kerendi F, Onaitis M, Verrier E, Roselli E. Self-perceived video-assisted thoracic surgery lobectomy proficiency by recent graduates of North American thoracic residencies. Interact Cardiovasc Thorac Surg 2012; 14:797-800. [PMID: 22381653 DOI: 10.1093/icvts/ivr098] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Minimally invasive surgical techniques offer several advantages over traditional open procedures, yet the pathway to minimally invasive proficiency can be difficult to navigate. As a part of an effort of the Joint Council of Thoracic Surgical Education to increase access to this skill set in the general thoracic community, recent graduates of thoracic residencies were surveyed to determine the self-reported achievement of video-assisted thoracic surgery (VATS) lobectomy proficiency and the merits of various educational opportunities. The objective of this study was to estimate the comfort level of recent graduates with the minimally invasive approach, as this demographic not only reflects the current status of training, but represents the future of the specialty. Surgeons graduating North American thoracic residencies between 2006 and 2008 identifying themselves as practitioners of general thoracic surgery were surveyed. A total of 271 surgeons completed training between 2006 and 2008 and indicated general thoracic to be a part of their practice (84 dedicated thoracic and 187 mixed). One hundred and forty-six surgeons completed the survey (54%) including 74 of 84 (88%) dedicated thoracic surgeons. Overall, 58% of recent graduates who perform general thoracic procedures consider themselves proficient in VATS lobectomies (86% of dedicated thoracic surgeons and 28% of surgeons with a mixed practice, P < 0.0001). Of surgeons considering themselves to be proficient at VATS lobectomies, 66% felt thoracic residency was critical or very important to achieving proficiency. Fellowships after completing board residency, animal labs, and follow-up VATS courses put on by experts were much less consistently beneficial. The vast majority of the 25 dedicated general thoracic surgeons who graduate each year consider themselves proficient in VATS lobectomies, largely due to training in their thoracic residencies. On the other hand, the minority of surgeons performing general thoracic procedures as a part of a mixed practice consider themselves proficient in VATS lobectomies. Further study is warranted to enhance the VATS lobectomy experience of mixed practice surgeons particularly during their thoracic residencies.
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Affiliation(s)
- Daniel J Boffa
- Department of Thoracic Surgery, Yale University School of Medicine, Smilow Cancer Hospital, New Haven, CT, USA.
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Sarkaria IS, Carr SR, MacIver RH, Whitson BA, Joyce DL, Stulak J, Mery CM, Guitron J, Singh RR, Mettler B, Turek JW. The 2010 Thoracic Surgery Residents Association Workforce Survey Report: A View From the Trenches⁎⁎The authors comprise the Thoracic Surgery Residents Association Executive Committee. Ann Thorac Surg 2011; 92:2062-70; discussion 2070-1. [DOI: 10.1016/j.athoracsur.2011.05.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 05/05/2011] [Accepted: 05/09/2011] [Indexed: 10/15/2022]
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Chikwe J, Brewer Z, Goldstone AB, Adams DH. Integrated Thoracic Residency Program Applicants: The Best and the Brightest? Ann Thorac Surg 2011; 92:1586-91. [DOI: 10.1016/j.athoracsur.2011.05.107] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 05/23/2011] [Accepted: 05/27/2011] [Indexed: 10/15/2022]
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