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Giuliano K, Ceppa DP, Antonoff M, Donington JS, Kane L, Lawton JS, Sen DG. Women in Thoracic Surgery 2020 Update-Subspecialty and Work-Life Balance Analysis. Ann Thorac Surg 2022; 114:1933-1942. [PMID: 35339440 DOI: 10.1016/j.athoracsur.2022.02.076] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND While women comprise nearly half of medical school graduates, they remain underrepresented in cardiothoracic (CT) surgery. To better understand ongoing barriers, we aimed to delineate issues relevant to the CT subspecialities, emphasizing personal life. METHODS An anonymous Research Electronic Data Capture (REDCap; hosted at Indiana University School of Medicine) survey link was emailed to female diplomats of the American Board of Thoracic Surgeons (ABTS). The survey included questions on demographics, professional accolades, practice details, and personal life. Survey responses were compared across subspecialities using χ2 testing. RESULTS Of 354 female ABTS diplomats, we contacted 309, and 176 (57%) completed the survey. By subspecialty, 42% practice thoracic, 26% adult cardiac, and 10% congenital cardiac; 19% report a mixed practice. The subspecialties differed in length of training (congenital-the longest), practice location (mixed practice-less urban), and academic rank (thoracic-most full professors at 17%), but were largely similar in their personal lives. Among all respondents, 65% are in a committed relationship, but 40% felt that being a CT surgeon negatively impacted their ability to find a partner. Sixty percent have children, but 31% of those with children reported using assisted reproductive technology, surrogacy, or adoption. The number with leadership roles (eg, division chief, committee chair of national organization) did not differ among subspecialities, but was low, ranging from 0 to <30%. CONCLUSIONS Women remain underrepresented in CT surgery, particularly in the academic rank of full professor and in leadership positions. We advocate for scholarship and mentorship opportunities to encourage women to enter the field, increased female leadership, and policies to enable families.
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Affiliation(s)
- Katherine Giuliano
- Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland.
| | - DuyKhanh P Ceppa
- Division of Cardiothoracic Surgery, Indiana University, Indianapolis, Indiana
| | - Mara Antonoff
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Lauren Kane
- Department of Cardiothoracic Surgery, Children's Hospital, New Orleans, Louisiana
| | - Jennifer S Lawton
- Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland
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2
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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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3
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Abri QA, von Ballmoos MCW. Cardiovascular Surgery Procedural Training and Evaluation: Current Status and Future Directions. Methodist Debakey Cardiovasc J 2022; 18:30-38. [PMID: 35734157 PMCID: PMC9165672 DOI: 10.14797/mdcvj.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/18/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Qasim Al Abri
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, US
- Weill Cornell Medicine, New York, US
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4
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Analysis of Applicants' Perspectives of Cardiothoracic Surgery Fellowship Program Websites. Ann Thorac Surg 2022; 114:2372-2378. [PMID: 35339447 DOI: 10.1016/j.athoracsur.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/23/2022] [Accepted: 03/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiothoracic (CT) surgery fellowship websites help applicants determine where they apply and/or accept an interview. However, relevant information from programs is not communicated in a standardized way. METHODS We used Fellow and Residency Electronic Interactive Database Access (FREIDA) Online to identify residency programs with traditional CT fellowships. Program-specific variables included presence or absence of tracks, track duration, and annual cardiac and thoracic cases. Resident-specific variables included number of resident(s) a program accepts and case numbers per fellow. Current CT residents completed an online survey in which they rated how important they deemed the presence of these variables in program websites. RESULTS According to FREIDA Online, 74 traditional CT surgery fellowship websites were analyzed. Among the websites listed on FREIDA, only 16 (22%) linked directly to the CT fellowship page. Surveys were sent to all trainees enrolled in the 74 programs, and 24 responded. There were marked deficiencies in the availability of information on program websites that was highly valued by trainees. Only 31% of websites reported annual program volume, and 14% reported resident case numbers, while this data was highly valued by >60% of respondents. Similarly, 11% of program websites described their education curriculum, while 81% of respondents highly valued this information. One-quarter of respondents were dissatisfied with the overall information provided by program websites. CONCLUSIONS CT fellowship program websites lack crucial content that is deemed highly valued by applicants. This study suggests the possible need for a single comprehensive data repository or a standardized method for communicating information through program websites.
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White A, O'Brien D, Singh G, Zheng B, Moon MC, Turner SR. Characterizing the Level of Autonomy in Canadian Cardiac Surgery Residents. Ann Thorac Surg 2022; 114:1538-1541. [PMID: 35339449 DOI: 10.1016/j.athoracsur.2022.02.067] [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: 07/01/2021] [Revised: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Abigail White
- Department of Surgery, University of Alberta, Edmonton, Alberta; Mazankowski Alberta Heart Institute, Alberta Health Services.
| | - Devin O'Brien
- Department of Surgery, University of Alberta, Edmonton, Alberta; Mazankowski Alberta Heart Institute, Alberta Health Services
| | - Gurmeet Singh
- Department of Surgery, University of Alberta, Edmonton, Alberta; Mazankowski Alberta Heart Institute, Alberta Health Services; Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta
| | - Bin Zheng
- Department of Surgery, University of Alberta, Edmonton, Alberta
| | - Michael C Moon
- Department of Surgery, University of Alberta, Edmonton, Alberta; Mazankowski Alberta Heart Institute, Alberta Health Services
| | - Simon R Turner
- Department of Surgery, University of Alberta, Edmonton, Alberta
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Overview of Cardiothoracic Surgeon Compensation: Practice Setting, Productivity, and Payment Structures. Ann Thorac Surg 2022; 114:2383-2390. [PMID: 35337788 DOI: 10.1016/j.athoracsur.2022.02.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/29/2021] [Accepted: 02/01/2022] [Indexed: 11/20/2022]
Abstract
The Centers for Medicare and Medicaid Services recently proposed a substantial cut to reimbursement for surgical services, punctuating a steady decline in reimbursement for clinical services provided by cardiothoracic surgeons during the last several decades. Meanwhile, the costs of practicing cardiothoracic surgery continue to increase. In an effort to defect against diminishing control over patient care and further negative changes affecting reimbursement, cardiothoracic surgeons must be able to convincingly demonstrate their value to patients and the health care system. However, the overall contribution of a cardiothoracic surgeon can be difficult to measure objectively and varies widely according to a host of factors, including practice setting, experience, subspecialization, and the local market. To address these challenges, The Society of Thoracic Surgeons Workforce on Practice Management has commissioned a Writing Task Force to raise awareness, to concentrate knowledge, and to organize information related to compensation as a comprehensive resource for cardiothoracic surgeons. The purpose of this initial report is to provide an overview of the major factors having an impact on compensation for cardiothoracic surgeons.
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Cerqueira RJ, Heuts S, Gollmann-Tepeköylü C, Syrjälä SO, Keijzers M, Zientara A, Jarral OA, Jacob KA, Haunschild J, Ariyaratnam P, Durko AP, Muller P, Myers PO, Sadaba JR, Lehtinen ML. Challenges and satisfaction in Cardiothoracic Surgery Residency Programmes: insights from a Europe-wide survey. Interact Cardiovasc Thorac Surg 2021; 32:167-173. [PMID: 33236099 DOI: 10.1093/icvts/ivaa248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/03/2020] [Accepted: 09/27/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The increasing complexity of surgical patients and working time constraints represent challenges for training. In this study, the European Association for Cardio-Thoracic Surgery Residents' Committee aimed to evaluate satisfaction with current training programmes across Europe. METHODS We conducted an online survey between October 2018 and April 2019, completed by a total of 219 participants from 24 countries. RESULTS The average respondent was in the fourth or fifth year of training, mostly on a cardiac surgery pathway. Most trainees follow a 5-6-year programme, with a compulsory final certification exam, but no regular skills evaluation. Only a minority are expected to take the examination by the European Board of Cardiothoracic Surgery. Participants work on average 61.0 ± 13.1 h per week, including 27.1 ± 20.2 on-call. In total, only 19.7% confirmed the implementation of the European Working Time Directive, with 42.0% being unaware that European regulations existed. Having designated time for research was reported by 13.0%, despite 47.0% having a postgraduate degree. On average, respondents rated their satisfaction 7.9 out of 10, although 56.2% of participants were not satisfied with their training opportunities. We found an association between trainee satisfaction and regular skills evaluation, first operator experience and protected research time. CONCLUSIONS On average, residents are satisfied with their training, despite significant disparities in the quality and structure of cardiothoracic surgery training across Europe. Areas for potential improvement include increasing structured feedback, research time integration and better working hours compliance. The development of European guidelines on training standards may support this.
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Affiliation(s)
- Rui J Cerqueira
- Cardiovascular Research and Development Unit, University of Porto and Department of Cardiothoracic Surgery, University Hospital Center of São João, Porto, Portugal
| | - Samuel Heuts
- Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Simo O Syrjälä
- Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - Marlies Keijzers
- Department of Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Alicja Zientara
- Department of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
| | - Omar A Jarral
- Department of Cardiothoracic Surgery, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Kirolos A Jacob
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | | | | | - Andras P Durko
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Patrick Muller
- Comprehensive Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Patrick O Myers
- Department of Cardiac Surgery, CHUV-Lausanne University Hospital, Lausanne, Switzerland
| | | | - Miia L Lehtinen
- Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
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Brandão CMDA, Dallan LRP, Dinato FJ, Monteiro R, Fiorelli AI, Jatene FB. Evaluation method of training simulation on biological models for cardiovascular surgery residents. J Card Surg 2021; 36:2247-2252. [PMID: 33797794 DOI: 10.1111/jocs.15524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The goal of this study was to describe and evaluate our simulation training program on biological models for the cardiovascular surgery residency program at our institution. MATERIAL AND METHODS Since 2016, with the purpose to develop better practical performance and evaluate the improvement of resident's surgical skills, a simulation training program was implemented, composed of some elemental procedures in cardiovascular surgery. It was established with one wet lab session weekly lasting 2 h, coached by two expert cardiovascular surgeons. Bovine and porcine hearts were used as biological models. At the end of the hands-on program, an objective assessment consisting of two practical modules was applied and performance was rated by way of a 5-point scale. In addition, to provide a subjective assessment, each resident filled out a questionnaire consisting of three items reviewing the overall quality of the workshops on a 10-point scale. RESULTS The objective evaluation applied at the end of the training program consisted of valve replacement and coronary artery bypass grafting (CABG) modules. The mean performance rating scores for the valve replacement module ranged from 4.2 to 4.79, and CABG, from 4.33 to 4.87. Regarding subjective assessment, all items evaluated, such as expert's didactics, simulation performance, and biological simulator fidelity, received high grades (above 9 on a 10-point scale). CONCLUSIONS Simulator training on biological models for cardiac surgery medical residents is a simple and effective learning method of surgical skills.
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Affiliation(s)
- Carlos M de A Brandão
- Cardiovascular Surgery Department, Heart Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Luis R P Dallan
- Cardiovascular Surgery Department, Heart Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Fabrício J Dinato
- Cardiovascular Surgery Department, Heart Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Rosangela Monteiro
- Cardiovascular Surgery Department, Heart Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Alfredo I Fiorelli
- Cardiovascular Surgery Department, Heart Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Fabio B Jatene
- Cardiovascular Surgery Department, Heart Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil
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Rajaram R, Abreu JA, Mehran R, Nguyen TC, Antonoff MB, Vaporciyan A. Using Quality Improvement Principles to Redesign a Cardiothoracic Surgery Fellowship Program Website. Ann Thorac Surg 2021; 111:1079-1085. [DOI: 10.1016/j.athoracsur.2020.05.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/14/2020] [Accepted: 05/26/2020] [Indexed: 10/23/2022]
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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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Lu Y, Juo YY, Martin MJ, Dan AG, Banerjee A, Jones DB, Dakin GF, Jain-Spangler K, Chen Y. Analysis of Early Job Market Experiences and Perceptions Among Bariatric Surgery Fellowship Graduates and Bariatric Surgery Program Directors. Obes Surg 2021; 31:1561-1571. [PMID: 33405180 PMCID: PMC7786144 DOI: 10.1007/s11695-020-05150-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/24/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Over the past decade, an increasing number of bariatric surgeons are trained in fellowships annually despite only a modest increase in nationwide bariatric surgery volume. The study surveys the bariatric surgery job market trend in order to inform better career-choice decisions for trainees interested in this field. MATERIALS AND METHODS A national retrospective cohort survey over an 11-year period was conducted. Bariatric surgery fellowship graduates from 2008 to 2019 and program directors (PDs) were surveyed electronically. Univariate analysis was performed comparing responses between earlier (2008-2016) and recent graduates (2017-2019). RESULTS We identified a total of 996 graduates and 143 PDs. Response rates were 9% and 20% respectively (n = 88, 29). Sixty-eight percent of graduates felt there are not enough bariatric jobs for new graduates. Seventy-nine percent of PDs felt that it is more difficult to find a bariatric job for their fellows now than 5-10 years ago. Forty-eight percent of PDs felt that we are training too many bariatric fellows. Seventy-seven percent of all graduates want the majority of their practice to be comprised bariatric cases; however, only 42% of them reported achieving this. In the univariate analysis, recent graduates were less likely to be currently employed as a bariatric surgeon (64% vs. 86%, p = 0.02) and were less satisfied with their current case volume (42% vs. 66%, p = 0.01). CONCLUSIONS The temporal increase in bariatric fellowship graduates over the past decade has resulted in a significant decline in the likelihood of employment in a full-time bariatric surgical practice and a decline in surgeons' bariatric case volumes.
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Affiliation(s)
- Yang Lu
- Department of Surgery, David Geffen School of Medicine, University of California, 10833 Le Conte Ave. 72-227 CHS, Los Angeles, CA, 90095, USA
| | - Yen-Yi Juo
- Department of Surgery, Duke University School of Medicine, 407 Crutchfield St, Durham, NC, 27704, USA
| | - Matthew J Martin
- Department of Surgery, Scripps Mercy Hospital, 4077 5th Avenue, San Diego, CA, 92103, USA
| | - Adrian G Dan
- Department of Surgery, Northeastern Ohio Medical University, Summa Health System, 95 Arch St #240, Akron, OH, 44304, USA
| | - Ambar Banerjee
- Department of Surgery, Indiana University School of Medicine, 11725 N Illinois St, Suite 350, Carmel, IN, 46032, USA
| | - Daniel B Jones
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Gregory F Dakin
- Department of Surgery, Weill Cornell Medical College, Cornell University, 525 E 68th St, New York, NY, 10065, USA
| | - Kunoor Jain-Spangler
- Department of Surgery, Duke University, 407 Crutchfield St, Durham, NC, 27704, USA
| | - Yijun Chen
- Department of Surgery, David Geffen School of Medicine, University of California, 10833 Le Conte Ave. 72-227 CHS, Los Angeles, CA, 90095, USA.
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Stephens EH, Dearani JA. Commentary: From “barber-surgeons” to virtual examinations—evolution of certification in cardiothoracic surgery. JTCVS OPEN 2020; 3:136-137. [PMID: 36003881 PMCID: PMC9390165 DOI: 10.1016/j.xjon.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 07/27/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth H. Stephens
- Address for reprints: Elizabeth H. Stephens, MD, PhD, Department of Cardiovascular Surgery, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905.
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13
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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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Fiedler AG, Emerson D, Gillaspie EA, Hermsen JL, Levack MM, McCarthy DP, Sihag S, Worrell SG, Antonoff MB. Multi-institutional collaborative mock oral (mICMO) examination for cardiothoracic surgery trainees: Results from the pilot experience. ACTA ACUST UNITED AC 2020; 3:128-135. [PMID: 34173545 PMCID: PMC7381400 DOI: 10.1016/j.xjon.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 11/24/2022]
Abstract
Objective The American Board of Thoracic Surgery–certifying examination is challenging for applicants. Single institutions have reported good results with a mock oral examination (MOE) for trainees. General surgery literature has demonstrated success with in-person multi-institutional MOE examinations. Due to small numbers of cardiothoracic training programs and significant geographic variability, we hypothesized that a multi-institutional, collaborative remotely administered MOE (mICMO) pairing faculty with trainees from different institutions would provide an important educational experience. Methods mICMOs were conducted via the Zoom virtual platform across 6 institutions. Descriptive results via post-experience survey were analyzed and reported. Results In total, 100% of trainees found mICMO useful. The majority would recommend to a peer, and 100% of faculty examiners found mICMO useful and would participate in another examination. Conclusions Faculty and trainees found the experience to be effective with respect to creating a high-stakes environment, educationally beneficial, and productive. These results support the continued use of mICMO and encourage expansion and collaboration with additional institutions across the country.
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Affiliation(s)
- Amy G Fiedler
- Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Dominic Emerson
- Department of Cardiac Surgery, Cedars Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif
| | | | - Joshua L Hermsen
- Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | | | - Daniel P McCarthy
- Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Smita Sihag
- Department of Surgery, Memorial Sloan Kettering, Thoracic Service, New York, NY
| | - Stephanie G Worrell
- Division of Thoracic Surgery, Case Western Reserve University, Cleveland, Ohio
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, UT MD Anderson Cancer Center, Houston, Tex
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15
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Super Fellowships Among Cardiothoracic Trainees: Prevalence and Motivations. Ann Thorac Surg 2020; 111:1724-1729. [PMID: 32682757 DOI: 10.1016/j.athoracsur.2020.05.097] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/08/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND After completing traditional fellowship or integrated residency in cardiothoracic surgery, many trainees spend time in nonaccredited "super fellowships." The prevalence and motivations for pursuing super fellowships are unknown. METHODS A survey was distributed to all 776 cardiothoracic surgery graduates who completed training between 2008 and 2019. The number of graduates was used as the denominator to calculate response rate. Comparisons between responses were made using Fisher's exact test. RESULTS Over an 8-week period, 261 surveys were completed with a response rate of 34%. The majority were traditional graduates (75%), for example, not integrated residents, and of those, 64% did a 2-year program. The majority (60%) did not pursue super fellowships. Among those who did complete a super fellowship, areas of training included congenital, transplantation, aortic pathology, valvular disease, and other. Among the 90 who completed super fellowships, reasons included "congenital" (34%), "felt training inadequate" (28%), "required for position" (24%), "personal" (6%), and "other" (8%). Among the 25 who selected "training inadequate," 32% focused in general thoracic-related areas. There was no relationship between length of traditional training (2 vs 3 years) and completing additional training (P = .17), but there was a significant association between completing a traditional track versus integrated residency and pursuing a super fellowship (P = .02). CONCLUSIONS Additional training in cardiothoracic surgery is common. The reasons for further instruction are varied but relate to readiness and need for specialized skills. Program directors should consider employers' needs to ensure trainees graduate with the necessary skills for future practice.
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Gallo G, Sturiale A, De Simone V, Mayol J. Epistemic Networks on Twitter: A New Way To Learn. J INVEST SURG 2019; 34:536-544. [PMID: 31475634 DOI: 10.1080/08941939.2019.1656787] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Gaetano Gallo
- Department of General Surgery, Universita Degli Studi Magna Graecia di Catanzaro Scuola di Medicina e Chirurgia, Catanzaro, Italy
| | - Alessandro Sturiale
- Proctological and Perineal Surgical Unit, Cisanello University Hospital, Pisa, Italy
| | - Veronica De Simone
- Proctology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - Julio Mayol
- Department of Surgery, Hospital Clinico San Carlos de Madrid, Instituto de Investugación Sanitaria San Carlos, Universidad Complutense de Madrid, Madrid, Spain
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Debunking the July Effect in Cardiac Surgery: A National Analysis of More Than 470,000 Procedures. Ann Thorac Surg 2019; 108:929-934. [DOI: 10.1016/j.athoracsur.2019.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/03/2019] [Accepted: 06/17/2019] [Indexed: 12/24/2022]
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18
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Disparity between recent graduates’ and experienced surgeons' assessment of time to operative independence. J Thorac Cardiovasc Surg 2019; 157:1925-1932. [DOI: 10.1016/j.jtcvs.2018.08.124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/25/2018] [Accepted: 08/27/2018] [Indexed: 11/15/2022]
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Luo F, Luo X, Li B, Tang Y, Sun H. An exploration of the surgical skill training curriculum for cardiac surgery residents. J Card Surg 2019; 34:440-446. [DOI: 10.1111/jocs.14055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 04/02/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Fuliang Luo
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Xiaokang Luo
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Bo Li
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Yue Tang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Hansong Sun
- Center of Cardiac Surgery for AdultsState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
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Capdeville M. Gender Disparities in Cardiovascular Fellowship Training Among 3 Specialties From 2007 to 2017. J Cardiothorac Vasc Anesth 2019; 33:604-620. [DOI: 10.1053/j.jvca.2018.10.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Indexed: 11/11/2022]
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21
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Graduate Subspecialty and Perceptions of Cardiothoracic Surgery Training: A 60-Year Retrospective Study. Ann Thorac Surg 2019; 107:285-293. [DOI: 10.1016/j.athoracsur.2018.07.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/19/2022]
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DeBoard ZM, Paisley M, Thomas DD. Self-Appraised Readiness of Senior and Graduating General Surgery Residents to Perform Thoracic Surgery. JOURNAL OF SURGICAL EDUCATION 2018; 75:877-883. [PMID: 29273336 DOI: 10.1016/j.jsurg.2017.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/22/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE General surgeons perform up to 50% of noncardiac thoracic surgery (TS). Although data show consistent TS case volume during general surgery (GS) residency it is unknown whether this operative trend will persist given potentially limited subspecialty exposure. We sought to determine if certain aspects of residency programs and resident characteristics were associated with trainees' perceived comfort in performing certain basic TS procedures. DESIGN An anonymous survey was distributed to GS residents regarding program characteristics, presence of a TS residency, and intent to pursue thoracic surgical training, and estimated case volumes of individual procedures. Comfort levels for performing video-assisted thoracoscopic surgical (VATS) procedures, open lobectomy, elective thoracotomy, and sternotomy were attained through a 5-point Likert-type scale. SETTING This survey was administered at 50 training programs with responses recorded via an online form. PARTICIPANTS Fourth- and fifth-year GS residents in the United States. RESULTS Of 272 respondents 58% were fourth-year residents, 62% of residents trained at university-affiliated programs, and 64% reported a TS residency program at their institution and 16% stated intent to pursue TS. Fifth-year residents performed significantly more cases than fourth-year residents despite no difference in median comfort levels. Residents intending to pursue TS performed significantly more cases and were more comfortable performing a thoracotomy, sternotomy, VATS wedge resection/biopsy, and VATS decortication/pleurodesis (p = 0.044, <0.001, 0.045, 0.025). No characteristics were associated with comfort performing a lobectomy via thoracoscopic or open (thoracotomy) approaches. CONCLUSION Most senior or graduating GS residents state they are comfortable performing certain thoracic procedures with those pursuing additional thoracic surgical training more comfortable overall. No characteristics were associated with comfort performing a lobectomy. These findings may advise residency curriculum design to ensure continued thoracic surgical exposure and recommend against non-fellowship trained surgeons performing a pulmonary lobectomy.
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Affiliation(s)
- Zachary M DeBoard
- Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah.
| | - Michael Paisley
- Department of Surgery, Santa Barbara Cottage Hospital, Santa Barbara, California
| | - Donald D Thomas
- Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, Oregon
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Foote DC, Meza JM, Sood V, Reddy RM. Assessment of Female Medical Students' Interest in Careers in Cardiothoracic Surgery. JOURNAL OF SURGICAL EDUCATION 2017; 74:811-819. [PMID: 28363674 DOI: 10.1016/j.jsurg.2017.02.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/11/2017] [Accepted: 02/25/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Although over half of medical students are females, women comprise only 21% of cardiothoracic (CT) surgery residency applicants and 5% of the CT workforce. We sought to gain insight into female medical students' perceptions of CT surgery and identify targets to increase interest. DESIGN A 33-question survey queried career selection factors, perceptions of CT surgery, and ways to increase interest in the field. Responses were stratified by sex and preclinical versus clinical years. SETTING Women at 13 US medical schools were compared to men at a Midwest medical school. PARTICIPANTS Surveys were distributed to approximately 4400 women and were completed by 372 (8.5%) women. Comparison surveys were distributed to approximately 170 preclinical men and were completed by 98 (57.6%) men. RESULTS Preclinical woman had broad interests, whereas clinical women were more interested in primary care (p = 0.0124). Intellectual interest and lifestyle were important in specialty selection for men and women (91% versus 90%; 78% versus 86%). Although preclinical men valued perceived prestige and salary significantly more than preclinical women (39% versus 20%, p = 0.0014; 64% versus 48%, p = 0.0173), preclinical women valued caring for specific ethnicities and addressing health disparities significantly more than preclinical men (26% versus 15%, p = 0.0173; 53% versus 33%, p = 0.0019). Making family plans was cited by 83% of women as difficult if they choose to become a CT surgeon. Women thought that attaining their career interests and life goals (76%) or access to female CT surgery mentors (63%) would make the field more appealing. Over 70% of preclinical women were interested in shadowing a CT surgeon. Of these women, 12% attempted to shadow. CONCLUSIONS Although baseline interest in CT surgery is low among women, there are many targets for increasing interest especially during preclinical years. Residency programs have the opportunity to entice women to the field by addressing their priorities of lifestyle, family planning, and addressing health disparities.
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Affiliation(s)
- Darci C Foote
- University of Michigan Medical School, Ann Arbor, Michigan
| | - James M Meza
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vikram Sood
- Department of Cardiac Surgery, University of Michigan Health System, Cardiovascular Center, Ann Arbor, Michigan
| | - Rishindra M Reddy
- Section of Thoracic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
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Meyerson SL, Sternbach JM, Zwischenberger JB, Bender EM. Resident Autonomy in the Operating Room: Expectations Versus Reality. Ann Thorac Surg 2017; 104:1062-1068. [DOI: 10.1016/j.athoracsur.2017.05.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 05/05/2017] [Accepted: 05/11/2017] [Indexed: 11/30/2022]
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Variability in Integrated Cardiothoracic Training Program Curriculum. Ann Thorac Surg 2017; 103:1984-1991. [DOI: 10.1016/j.athoracsur.2017.01.079] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/05/2017] [Accepted: 01/17/2017] [Indexed: 11/21/2022]
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Yoo SJ, Spray T, Austin EH, Yun TJ, van Arsdell GS. Hands-on surgical training of congenital heart surgery using 3-dimensional print models. J Thorac Cardiovasc Surg 2017; 153:1530-1540. [PMID: 28268011 DOI: 10.1016/j.jtcvs.2016.12.054] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/07/2016] [Accepted: 12/29/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Patient-based congenital heart surgery (CHS) training is opportunity-based and difficult. Three-dimensional (3D) print models of the heart were used for hands-on surgical training (HOST) at the 2015 AATS and subsequently in 2 local institutions. We aim to introduce the process of 3D printing for surgical simulation and to present the attendee's responses. METHODS Using CT or MR angiograms, the models of congenital heart disease were created and printed with flexible rubberlike material. Altogether, 81 established surgeons or trainees performed simulated surgical procedures with the expert surgeons' guidance and supervision. At the completion of the session, 50 of 81 attendees participated in the questionnaire assessment of the program. RESULTS All responders found the course helpful in improving their surgical skills. All would consider including HOST sessions in the training programs. All found that the models showed the necessary pathologic findings. Most found that the consistency and elasticity of the model material were different from those of the human myocardium. However, the responders thought that the quality of the models was acceptable (88%) or manageable (12%) for surgical practice. The major weaknesses listed were related to the print material and poor representation of the cardiac valves. CONCLUSIONS HOST using 3D print heart models is achievable and allows surgical practice on pathological hearts without patients' risk. HOST is a highly applicable surgical simulation format for CHS. Incorporation of HOST in training programs could change the traditional opportunity-based education to the requirement-based standardized education.
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Affiliation(s)
- Shi-Joon Yoo
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
| | - Thomas Spray
- Division of Cardiothoracic Surgery, Department of Surgery, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Erle H Austin
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Norton Children's Hospital, Louisville, Ky
| | - Tae-Jin Yun
- Division of Pediatric Cardiac Surgery, Asan Medical Center, Seoul, South Korea
| | - Glen S van Arsdell
- Division of Cardiovascular Surgery, Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Stephens EH, Shah AA, Robich MP, Walters DM, DeNino WF, Aftab M, Tchantchaleishvili V, Eilers AL, Rice RD, Goldstone AB, Shelstad RC, Malas T, Cevasco M, Gillaspie EA, LaPar DJ. The Future of the Academic Cardiothoracic Surgeon: Results of the TSRA/TSDA In-Training Examination Survey. Ann Thorac Surg 2016; 102:643-50. [DOI: 10.1016/j.athoracsur.2016.01.106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/18/2016] [Accepted: 01/28/2016] [Indexed: 10/21/2022]
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Chu D, Vaporciyan AA, Iannettoni MD, Ikonomidis JS, Odell DD, Shemin RJ, Starnes SL, Stein W, Badhwar V. Are There Gaps in Current Thoracic Surgery Residency Training Programs? Ann Thorac Surg 2016; 101:2350-5. [DOI: 10.1016/j.athoracsur.2016.01.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/19/2015] [Accepted: 01/08/2016] [Indexed: 01/28/2023]
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Characterizing the Operative Experience of Cardiac Surgical Trainees: What Are Residents Really Doing in the Operating Room? Ann Thorac Surg 2016; 101:2341-9. [DOI: 10.1016/j.athoracsur.2015.12.069] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/18/2015] [Accepted: 12/23/2015] [Indexed: 11/23/2022]
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Odell DD. The view from the other side of the table: Beginning a practice in academic thoracic surgery. J Thorac Cardiovasc Surg 2016; 151:924-5. [PMID: 26874602 DOI: 10.1016/j.jtcvs.2016.01.004] [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: 01/03/2016] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Affiliation(s)
- David D Odell
- Division of Thoracic Surgery, Department of Surgery, Surgical Outcomes and Quality Improvement Center, Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
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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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