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Gulati S, Marshall MB. Hobbies, Distractions, Obsessions, and Addictions. Thorac Surg Clin 2024; 34:233-238. [PMID: 38944450 DOI: 10.1016/j.thorsurg.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
A career in cardiothoracic surgery takes a psychological and emotional toll, which is likely increased by recent changes in our health care environment. The benefits of leisure pursuits are severalfold, one of which includes supporting physician wellness. However, we are at risk of relying on unhealthy mechanisms to provide relief. The incidence of addiction and substance abuse is high, particularly among women surgeons. There are a variety of opportunities to help ourselves and support our colleagues. We need to promote healthy activities outside of our profession for the long-term well-being of cardiothoracic surgeons and our specialty.
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Affiliation(s)
- Shubham Gulati
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA; Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - M Blair Marshall
- Division of Thoracic Surgery, Sarasota Memorial Hospital, Sarasota, FL, USA
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2
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Huo B, Dow T, Wallace AM, French DG. Grit and Thoracic Surgery Interest Among Medical Students. JOURNAL OF SURGICAL EDUCATION 2024; 81:1044-1049. [PMID: 38806309 DOI: 10.1016/j.jsurg.2024.05.008] [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: 11/19/2023] [Revised: 04/11/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE This study evaluated the relationship between medical student Grit and thoracic surgery career interest. DESIGN An online questionnaire was designed to measure self-reported ratings of Grit among medical student using the Short-Grit scale, as well as thoracic surgery career interest. SETTING Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. PARTICIPANTS From 2019 to 2021, 192/367 (52.3%) participants in their first or second year of medical school. The cohort was comprised of 109 (56.8%) females while 115 (59.9%) were <24 years of age. RESULTS Mean Grit was high (M = 4.159 +/- 0.450) among medical students. There were 80 (41.2%) students interested in thoracic surgery. There was a significant difference in Grit between students with a career interest in thoracic surgery (4.256 +/- 0.442) and those uninterested in thoracic surgery (4.089 +/- 0.444); t(190) = 2.572, p = 0.011; Cohen's D = 0.442. Career interest in thoracic surgery was not influenced by career factor interest. CONCLUSIONS Grittier students have a career interest in thoracic surgery. Recruitment teams in thoracic surgery residency programs with high rates of burnout and poor psychological wellbeing among trainees may take interest in these findings.
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Affiliation(s)
- Bright Huo
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario.
| | - Todd Dow
- Division of Plastic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
| | - Alison M Wallace
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia; Department of Pathology, Dalhousie University, Halifax, Nova Scotia
| | - Daniel G French
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
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Venkateswaran S, Wang D, Potter AL, Jeffrey Yang CF. Safety and Optimizing Ergonomics for Cardiothoracic Surgeons. Thorac Surg Clin 2024; 34:197-205. [PMID: 38944446 DOI: 10.1016/j.thorsurg.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Cardiothoracic surgery, demanding in nature, often results in surgeons suffering from musculoskeletal injuries, causing chronic pain and leading to premature retirement. A significant majority report experiencing pain, exacerbated by minimally invasive techniques such as video-assisted thoracoscopic surgery. Despite this, many surgeons delay seeking medical assistance. To mitigate these risks, preventative strategies such as strength exercises, stretching during operations, and taking brief breaks are crucial. However, the surgical community faces a shortage of institutional support and comprehensive ergonomic education. Advancements in technology, including artificial intelligence and virtual reality, could offer future solutions.
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Affiliation(s)
- Shivaek Venkateswaran
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Danny Wang
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Alexandra L Potter
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Chi-Fu Jeffrey Yang
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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Jindani R, Olivera J, Rodriguez-Quintero JH, Friedmann P, Vimolratana M, Chudgar N, Antonoff MB, Stiles B. The Representation of Women Moderators at The Society of Thoracic Surgeons Annual Meeting. Ann Thorac Surg 2024:S0003-4975(24)00584-8. [PMID: 39067634 DOI: 10.1016/j.athoracsur.2024.07.015] [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: 02/24/2024] [Revised: 06/19/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Recently, there has been an increase in the representation of women within the cardiothoracic surgery workforce, with discussions about gender equity garnering interest. We sought to identify whether this increase is accompanied by commensurate selection for representation at national meetings. METHODS Online archives of The Society of Thoracic Surgeons (STS) Annual Meetings were reviewed from 2015 to 2024. Data regarding the moderator's gender were abstracted. The gender distribution of moderators across the various session categories was surveyed, and subgroup analyses were performed. RESULTS During the years of study, the STS Annual Meeting Taskforce selected 983 moderators to participate in the conference, including 218 women. The representation of women moderators demonstrated a favorable, upward trend. In 2015, 12.1% of moderators were women, with a consistent rate from 2015 to 2018. There was a noticeable rise in invited women moderators in 2019, with 25.4% of moderators being women. This proportion increased to 36.9% women in 2024. General Thoracic sessions have consistently included a greater percentage of women moderators compared with other sessions. Other topic areas, such as Education and Quality Improvement and Critical Care, transitioned to greater representation of women in recent years. CONCLUSIONS There has been an increase over time in women moderators selected for participation in the STS Annual Meeting, with progress in gender diversity seen in most session types. Although the overall proportion of women within cardiothoracic surgery remains low, the STS has increasingly worked toward encouraging inclusivity. Efforts to further support well-rounded representation are of important benefit.
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Affiliation(s)
- Rajika Jindani
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, New York
| | - Justin Olivera
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, New York
| | | | - Patricia Friedmann
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, New York
| | - Marc Vimolratana
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, New York
| | - Neel Chudgar
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, New York
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Brendon Stiles
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, New York.
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Mehta LS, Churchwell K, Coleman D, Davidson J, Furie K, Ijioma NN, Katz JN, Moutier C, Rove JY, Summers R, Vela A, Shanafelt T. Fostering Psychological Safety and Supporting Mental Health Among Cardiovascular Health Care Workers: A Science Advisory From the American Heart Association. Circulation 2024; 150:e51-e61. [PMID: 38813685 DOI: 10.1161/cir.0000000000001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
The psychological safety of health care workers is an important but often overlooked aspect of the rising rates of burnout and workforce shortages. In addition, mental health conditions are prevalent among health care workers, but the associated stigma is a significant barrier to accessing adequate care. More efforts are therefore needed to foster health care work environments that are safe and supportive of self-care. The purpose of this brief document is to promote a culture of psychological safety in health care organizations. We review ways in which organizations can create a psychologically safe workplace, the benefits of a psychologically safe workplace, and strategies to promote mental health and reduce suicide risk.
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Larson EL, Sangalang J, Chinedozi I, Yang S, Lawton JS. Preparing for a Cardiothoracic Surgery Career: Opportunities for Undergraduate and Medical Students. Ann Thorac Surg 2024; 117:883-886. [PMID: 38342397 DOI: 10.1016/j.athoracsur.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/19/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Affiliation(s)
- Emily L Larson
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Janelle Sangalang
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ifeanyi Chinedozi
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stephen Yang
- Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jennifer S Lawton
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Brocklebank PW, Achurch MM, Sbrocchi AJ, Rauls G, Kilic A. Quality and Impact of Manuscripts Using The Society of Thoracic Surgeons National Databases. Ann Thorac Surg 2024; 117:237-246. [PMID: 37150271 DOI: 10.1016/j.athoracsur.2023.04.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND The Society of Thoracic Surgeons (STS) National Databases contain the largest and most comprehensive cardiac, thoracic, and congenital surgery data available. In this analysis characteristics of manuscripts that used the STS National Databases were examined to evaluate the quality and impact of these publications. METHODS Manuscripts published from 2010 to 2020 that used the STS National Databases (Adult Cardiac, General Thoracic, and Congenital Heart Surgery) were examined. The number of times cited per published manuscript, journal of publication, and journal CiteScore were assessed. Author characteristics, including institutional association and h-index, were evaluated for first and last authors. RESULTS Of 539 published manuscripts, 179 (33.2%) used the Adult Cardiac Surgery, 128 (23.7%) the Congenital Heart Surgery, 85 (15.8%) the General Thoracic Surgery, and 136 (25.2%) used unspecified STS National Databases. Collectively the analyzed manuscripts were cited 18,943 times, with a mean of 35.1 (range, 0-528) citations per manuscript. Manuscripts were published in 97 journals with a mean year-adjusted CiteScore of 5.6 (range, 0.1-60.2). Authors associated with 361 institutions contributed to published manuscripts. The mean h-index of first authors was 24.6 (range, 0-100) and of last authors was 44.1 (range, 0-164). From 2010 to 2020 first authors wrote a mean of 1.6 (range, 1-31) and last authors wrote a mean of 1.9 (range, 1-29) STS National Databases publications. CONCLUSIONS The STS National Databases are some of the most robust data collection sources available to cardiothoracic surgeons. These data have enabled valuable research in respected journals from authors of varying experience levels.
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Affiliation(s)
- Paul W Brocklebank
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Mary Margaret Achurch
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Alexander J Sbrocchi
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Gabrielle Rauls
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Arman Kilic
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina.
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Zeigler SM, Starnes SL, Sade RM. Should a questionably competent resident be allowed to continue in the program? J Thorac Cardiovasc Surg 2024; 167:283-288. [PMID: 36357222 DOI: 10.1016/j.jtcvs.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Sanford M Zeigler
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Sandra L Starnes
- Section of Cardiothoracic Surgery, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Robert M Sade
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC.
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Villa Hernandez F, Tolunay UT, Demblowski LA, Wang H, Carr SR, Hoang CD, Choo-Wosoba H, Steinberg SM, Zeiger MA, Schrump DS. Current status of National Institutes of Health funding for thoracic surgeons in the United States: Beacon of hope or candle in the wind? J Thorac Cardiovasc Surg 2024; 167:271-280.e4. [PMID: 36456359 PMCID: PMC10704923 DOI: 10.1016/j.jtcvs.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Increasing forces threaten the viability of thoracic surgeon-initiated research, a core component of our academic mission. National Institutes of Health funding is a benchmark of research productivity and innovation. This study examined the current status of National Institutes of Health funding for thoracic surgeons. METHODS Thoracic surgeon principal investigators on National Institutes of Health-funded grants during June 2010, June 2015, and June 2020 were identified using National Institutes of Health iSearchGrants (version 2.4). American Association of Medical Colleges data were used to identify all surgeons in the United States. Types and total costs of National Institutes of Health-funded grants were compared relative to other surgical specialties. RESULTS A total of 61 of 4681 (1.3%), 63 of 4484 (1.4%), and 60 of 4497 (1.3%) thoracic surgeons were principal investigators on 79, 76, and 87 National Institutes of Health-funded grants in 2010, 2015, and 2020, respectively; these rates were higher than those for most other surgical specialties (P ≤ .0001). Total National Institutes of Health costs for Thoracic Surgeon-initiated grants increased 57% from 2010 to 2020, outpacing the 33% increase in total National Institutes of Health budget. Numbers and types of grants varied among cardiovascular, transplant, and oncology subgroups. Although the majority of grants and costs were cardiovascular related, increased National Institutes of Health expenditures primarily were due to funding for transplant and oncology grants. Per-capita costs were highest for transplant-related grants during both years. Percentages of R01-to-total costs were constant at 55%. Rates and levels of funding for female versus male thoracic surgeons were comparable. Awards to 5 surgeons accounted for 33% of National Institutes of Health costs for thoracic surgeon principal investigators in 2020; a similar phenomenon was observed for 2010 and 2015. CONCLUSIONS Long-term structural changes must be implemented to more effectively nurture the next generation of thoracic surgeon scientists.
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Affiliation(s)
- Frank Villa Hernandez
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Md; Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Umay Tuana Tolunay
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Lindsay A Demblowski
- Office of Surgeon Scientists Programs, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Haitao Wang
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Shamus R Carr
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Chuong D Hoang
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Hyoyoung Choo-Wosoba
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Seth M Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - Martha A Zeiger
- Office of Surgeon Scientists Programs, Center for Cancer Research, National Cancer Institute, Bethesda, Md
| | - David S Schrump
- Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Md.
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Parini S, Azzolina D, Lucidi D, Verdi D, Ceccarelli I, Manganiello S, Francescato A, Parise M, Peluttiero I, Sicolo E, Pompili C, Spolverato G. Women in thoracic, cardiac and vascular surgery claim for a change in the working situation: an Italian national survey. J Thorac Dis 2023; 15:6623-6633. [PMID: 38249859 PMCID: PMC10797384 DOI: 10.21037/jtd-23-1123] [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: 07/20/2023] [Accepted: 11/03/2023] [Indexed: 01/23/2024]
Abstract
Background Women's participation in the surgical workforce has increased. The aim of the study is to acquire objective data regarding practice, training, satisfaction, and discrimination of women surgeons working in cardiothoracic and vascular surgery in Italy. Methods An 83-item questionnaire was distributed through social media and sent to e-mails of women surgeons from November through December 2020. A sub-analysis on women working in cardiac, thoracic, and vascular surgery was performed. Results Overall, 222 respondents were included (48 cardiac, 62 thoracic, and 112 vascular surgeons). Thirty-six percent partially abandoned surgical activities in favor of other professional activities, not including the operating room. On average, our respondents took part in 33% of all surgical cases performed in their units; however, of 12 high complexity surgeries per month, less than one is performed by them. Only 7 female participants who answered the questionnaire were in leadership positions. Many respondents struggle with lack of mentorship and missing opportunities in operating room. A high percentage of women experienced discrimination due to their gender in their professional life, and 59% claimed to have been subject to sexual harassment. Conclusions In Italy, women thoracic, cardiac, and vascular surgeons face lack of mentorship, opportunities in the operating room, and gender-related issues including some episodes of sexual harassment. Diversity, equity, and inclusion should become strategic priorities in all institutions. Among our respondents, surgical exposure is limited, which may deter a surgical career and play a crucial role in surgeons' dissatisfaction, that also include poor work-life-balance, and a large amount of administrative work. Surgical societies may address these issues by providing structured mentorship programs and networking opportunities. Societies' contributions might substantially impact supporting and retaining women at different stages of their careers.
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Affiliation(s)
- Sara Parini
- Division of Thoracic Surgery, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy
| | - Danila Azzolina
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Daniela Lucidi
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
| | - Daunia Verdi
- Department of Surgery, Mirano Hospital, Mirano, Italy
| | - Ilaria Ceccarelli
- Division of Thoracic Surgery, Department of Surgical Medical and Molecular Pathology and Critical Area, University Hospital of Pisa, Pisa, Italy
| | - Sabrina Manganiello
- Division of Cardiac Surgery, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy
| | - Annalisa Francescato
- Division of Cardiac Surgery, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy
| | - Michela Parise
- Division of Vascular Surgery, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Ilaria Peluttiero
- Division of Vascular Surgery, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Elisa Sicolo
- Division of Thoracic Surgery, Department of Surgical Medical and Molecular Pathology and Critical Area, University Hospital of Pisa, Pisa, Italy
| | - Cecilia Pompili
- Department of Thoracic Surgery, University of Leeds, Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James’s, Leeds, UK
| | - Gaya Spolverato
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padua, Italy
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Oh NA, Blitzer D, Chen L, Guariento A, Fuller S, Subramanyan RK, St Louis JD, Karamlou T. The Impact of Congenital Cardiac Surgery Fellowship on Training and Practice. Ann Thorac Surg 2023; 116:1320-1327. [PMID: 37419170 DOI: 10.1016/j.athoracsur.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 05/21/2023] [Accepted: 06/12/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND In 2007, congenital cardiac surgery became a recognized fellowship by the American Council of Graduate Medical Education (ACGME). Beginning in 2023, the fellowship transitioned from a 1-year to a 2-year program. Our objective is to provide current benchmarks by surveying current training programs and assessing characteristics contributing to career success. METHODS This was a survey-based study in which tailored questionnaires were distributed to program directors (PDs) and graduates of the ACGME accredited training programs. Data collection included responses to multiple-choice and open-ended questions relevant to didactics, operative training, training center characteristics, mentorship, and employment characteristics. Results were analyzed using summary statistics and subgroup and multivariable analyses. RESULTS The survey yielded responses from 13 of 15 PDs (86%) and 41 of 101 graduates (41%) from ACGME accredited programs. Perceptions among PDs and graduates were somewhat discordant, with PDs more optimistic than graduates. Of PDs, 77% (n = 10) believed current training adequately prepares fellows and is successful in securing employment for graduates. The responses from graduates demonstrated 30% (n = 12) were dissatisfied with operative experience and 24% (n = 10) with overall training. Being supported during the first 5 years of practice was significantly associated with retention in congenital cardiac surgery and greater practicing case volumes. CONCLUSIONS Dichotomous views exist between graduates and PDs regarding success in training. Mentorship during the early career was associated with increased case volumes, career satisfaction, and retention in the congenital cardiac surgery field. Educational bodies should incorporate these elements during training and after graduation.
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Affiliation(s)
- Nicholas A Oh
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - David Blitzer
- Department of Cardiothoracic Surgery, Columbia University, New York, New York
| | - Lin Chen
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Alvise Guariento
- Department of Cardiac Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephanie Fuller
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ram Kumar Subramanyan
- Division of Cardiac Surgery, Children's Hospital of Los Angeles, Los Angeles, California
| | - James D St Louis
- Section of Pediatric and Congenital Heart Surgery, Children's Hospital of Georgia, Augusta, Georgia
| | - Tara Karamlou
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
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Tolis G, Piechura LM, Mohan N, Pomerantsev EV, Hirji SA, Bloom JP. Operative Teaching of Coronary Bypass and Need for Repeat Catheterization: Does it Matter Who is Sewing? JOURNAL OF SURGICAL EDUCATION 2023; 80:826-832. [PMID: 37080797 DOI: 10.1016/j.jsurg.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/22/2023] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE There are no studies to date comparing the patency of coronary bypass grafts constructed by attending surgeons versus trainees and the potential consequences of any such disparities. We explored this issue by comparing the patency of individual anastomoses performed by residents versus the attending surgeon. DESIGN We reviewed 765 continuous cases performed by a single surgeon which involved at least 1 coronary bypass anastomosis, totaling 2,173 distal anastomoses. At a median follow-up time of 36 months (interquartile range 20.5-47.3), 83 (10.9%) patients had undergone 110 cardiac catheterization procedures after their original operation for various indications. This angiographic information provided the data for our comparison cohorts. SETTING Cardiac surgery practice within an academic setting PARTICIPANTS: Adult patient undergoing coronary bypass grafting RESULTS: Of the 83 patients that underwent repeat catheterization, 23 (27.7%) were resident cases, 25 (30.1%) were attending cases and 35 (42.2%) were mixed. There were 4/83 (4.8%) patients with angiographic evidence of internal mammary artery graft compromise of which 3/4 (75%) had been constructed by the attending surgeon. Angiographic evidence of saphenous vein graft compromise was appreciated in 16/83 (19.3%) patients of which 9/16 (56.3%) of the grafts were constructed by the attending surgeon. CONCLUSIONS Liberal involvement of surgical trainees as primary operators in coronary revascularization cases led to equivalent rates of postoperative ischemic complications between the attending and resident groups. The outcome equivalence was also maintained when evaluated at the individual anastomosis patency level between the 2 groups. We conclude that academic programs should continue providing trainees significant experience as primary operating surgeons without fear of clinical outcome compromise.
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Affiliation(s)
- George Tolis
- Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Laura M Piechura
- Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Navyatha Mohan
- Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Eugene V Pomerantsev
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Sameer A Hirji
- Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jordan P Bloom
- Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
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Chikwe J. Unequal Treatment: An Introduction to The Annals Reprint Collection. Ann Thorac Surg 2023; 115:e87-e88. [PMID: 36966008 DOI: 10.1016/j.athoracsur.2023.02.034] [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: 02/17/2023] [Indexed: 03/27/2023]
Affiliation(s)
- Joanna Chikwe
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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Hamilton BCS, Nguyen D, Grondin SC, Sadaba JR, Myers PO, Young CM, Calhoon JH, Moon MR, Colson YL, Keshavjee S, Nguyen TC. Global Makeup of Cardiothoracic Surgeons as Represented by Our Major Societies and Associations. Ann Thorac Surg 2023; 115:1052-1060. [PMID: 35934066 DOI: 10.1016/j.athoracsur.2022.07.032] [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: 01/29/2022] [Revised: 07/02/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prior efforts to capture the cardiothoracic surgery community rely on survey data with potentially biased or low response rates. Our goal is to better understand our community by assessing the membership directories from The Society of Thoracic Surgeons (STS), American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), and Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS). METHODS Membership data were obtained from membership directories. Data for STS and EACTS were supplemented by the associations from their internal databases. The inclusion criterion was active membership; trainees and wholly incomplete profiles were excluded. RESULTS A total of 12 053 membership profiles were included (STS, 6365; EACTS, 3661; AATS, 1495; ASCVTS, 532). Membership is 7% female overall (EACTS, 9%; STS, 6%; AATS, 5%; ASCVTS, 3%), with a median age of 57 years (STS, 60 years; EACTS, 52 years). All societies had a broad scope of practice including members who practiced both adult cardiac and thoracic (20% overall), but most members practiced adult cardiac (31% overall; ASCVTS, 48%; AATS, 36%; EACTS, 30%; STS, 28%) and were in the late stage of their careers. CONCLUSIONS We present the makeup of our 4 major societies. We are global with a diversity of careers but concerning factors that require immediate attention. The future of our specialty depends on our ability to evolve, to promote the specialty, to attract trainees, and to include and promote female surgeons. It is crucial that we wake up to these issues, change the narrative, and create action on both individual and leadership levels.
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Affiliation(s)
- Barbara C S Hamilton
- Division of Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California.
| | - Dang Nguyen
- Department of Biomedical Engineering, University of South Florida, Tampa, Florida
| | - Sean C Grondin
- Department of Surgery, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - J Rafael Sadaba
- Department of Cardiac Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Patrick O Myers
- Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Carolyn M Young
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - John H Calhoon
- Department of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Texas
| | - Marc R Moon
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri; Division of Cardiothoracic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas; Texas Heart Institute, Houston, Texas
| | - Yolonda L Colson
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Shaf Keshavjee
- Division of Thoracic Surgery, Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada
| | - Tom C Nguyen
- Division of Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California
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15
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Disparities in Access to Thoracic Surgeons among Patients Receiving Lung Lobectomy in the United States. Curr Oncol 2023; 30:2801-2811. [PMID: 36975426 PMCID: PMC10047038 DOI: 10.3390/curroncol30030213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Objective: Lung lobectomy is the standard of care for early-stage lung cancer. Studies have suggested improved outcomes associated with lobectomy performed by specialized thoracic surgery providers. We hypothesized that disparities would exist regarding access to thoracic surgeons among patients receiving lung lobectomy for cancer. Methods: The Premier Hospital Database was used to identify adult inpatients receiving lung lobectomy from 2009 to 2019. Patients were categorized as receiving their lobectomy from a thoracic surgeon, cardiovascular surgeon, or general surgeon. Sample-weighted multivariable analysis was performed to identify factors associated with provider type. Results: When adjusted for sampling, 121,711 patients were analyzed, including 71,709 (58.9%) who received lobectomy by a thoracic surgeon, 36,630 (30.1%) by a cardiovascular surgeon, and 13,373 (11.0%) by a general surgeon. Multivariable analysis showed that thoracic surgeon provider type was less likely with Black patients, Medicaid insurance, smaller hospital size, in the western region, and in rural areas. In addition, non-thoracic surgery specialty was less likely to perform minimally-invasive (MIS) lobectomy (cardiovascular OR 0.80, p < 0.001, general surgery OR 0.85, p = 0.003). Conclusions: In this nationally representative analysis, smaller, rural, non-teaching hospitals, and certain regions of the United States are less likely to receive lobectomy from a thoracic surgeon. Thoracic surgeon specialization is also independently associated with utilization of minimally invasive lobectomy. Combined, there are significant disparities in access to guideline-directed surgical care of patients receiving lung lobectomy.
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16
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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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17
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Idhrees M, Narayan P, George M, Radhakrishna P, Abraham SJ, Velayudhan B. The motivators and barriers to a career in cardiothoracic surgery: a cross-sectional study among surgical residents in India. Indian J Thorac Cardiovasc Surg 2022; 38:613-623. [PMID: 36258817 PMCID: PMC9569278 DOI: 10.1007/s12055-022-01406-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction A consistent decline in the number of applicants to cardiothoracic and vascular surgery (CTVS) training programs has been observed across the country over the last few years. This disenchantment with the speciality will lead to a shortage of trained CTVS surgeons at a time when incidence of cardiovascular diseases is continuously rising in India. Aims/Objectives The aim of the study was to reflect on the reasons that averted applicants from pursuing a career in CTVS and measures that would make CTVS a more attractive option to future applicants. Methods An online nationwide prospective cross-sectional survey was conducted. The participants were from a pool of general surgery residents/residents who had just completed the training. A 5-point Likert scale was utilized to rate and evaluate the factors influencing CTVS as the primary choice, factors influencing any super-speciality, and factors that would aid in decision-making and encourage an interest in CTVS. Results A total of 618 responses were obtained, 25.6% (N = 158) of the responses were from female residents. Only 10.7% (N = 66) of the respondents wanted to pursue CTVS as their primary choice. While interest in CTVS among the 1st year residents was 26%, it was further observed to decline to 18.72% after completion of training. The main disincentives for pursuing CTVS were the need for a hospital with required infrastructure and the dependence on a multi-disciplinary team. The perception of the participants that the cardiologist will take over CTVS procedures was another misguided but important factor. Those residents interested in pursuing CTVS identified the dynamic nature of the speciality as well as the thrills of being a cardiac surgeon as important motivators. Participants felt that adding catheter-based technology to the CTVS curriculum, mandatory CTVS rotation during surgical training, and closer interaction with CTVS residents will generate more interest in CTVS. Conclusion Although surgical residents report early interest in CTVS, a lack of adequate exposure to the speciality leads to a decline in interest in CTVS. An overhaul of the surgical training that mandates rotating to CTVS, increased interactions with medical students and surgical trainees by CTVS faculty, and incorporation of catheter-based training in the CTVS syllabus is urgently required to increase the number of applicants to CTVS. Supplementary Information The online version contains supplementary material available at 10.1007/s12055-022-01406-2.
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Affiliation(s)
- Mohammed Idhrees
- Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes of Medical Science (SIMS Hospital), 600026 Vadapalani, Chennai, India
| | - Pradeep Narayan
- Department of Cardiac Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Narayana Health, 124, EM Bypass, Mukundapur, Kolkata India
| | - Melvin George
- Department of Clinical Pharmacology, SRM Medical College Hospital & Research Centre, Kattankulathur, Chengalpet, India
| | - Patta Radhakrishna
- Department of Gastrointestinal Surgery, SRM Institutes of Medical Science (SIMS Hospital), Chennai Vadapalani, India
| | | | - Bashi Velayudhan
- Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes of Medical Science (SIMS Hospital), 600026 Vadapalani, Chennai, India
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18
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Luc JGY, Pizano A, Udwadia F, Gupta S, Dairywala M, Joyce C, Robinson E, Rush G, Dunning J, Myers PO, Antonoff MB, Nguyen TC. Early effect of the COVID-19 pandemic on the North American cardiothoracic surgery job market. J Thorac Dis 2022; 14:3304-3313. [PMID: 36245601 PMCID: PMC9562543 DOI: 10.21037/jtd-22-320] [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: 03/04/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022]
Abstract
Background The present study aims to report the early effect of the coronavirus disease 2019 (COVID-19) pandemic on the cardiothoracic surgery job market in North America. Methods The Cardiothoracic Surgery Network (CTSNet) job market database was queried, and patterns from January to May for 2019 versus January to May 2020 were compared for trends in job postings and job seekers. Results Our study is comprised of 395 cardiothoracic surgery job postings, of which 98% were positions located in North America and 63% were academic. The negative impact of the pandemic on the cardiothoracic surgery job market was greatest in the cardiothoracic/cardiovascular combined subspecialty, followed by congenital and adult cardiac surgery, whereas general thoracic surgery experienced an increase in proportion of jobs available. Despite an increase in views per job posted in 2020 vs. 2019 (532 vs. 290), employer views of job seeker curriculum vitae declined over the same time period in 2020 (January, 380 views/month to May, 3 views/month) compared to 2019 (January, 100 views/month to May, 54 views/month). Conclusions An analysis of job postings from CTSNet suggests a decline in job availability in the North American cardiothoracic surgical job market following declaration of the pandemic with acknowledgement that there is month to month variability and a supply-demand mismatch. The COVID-19 pandemic has had an unprecedented impact on our field, and the ultimate consequences remain unknown.
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Affiliation(s)
- Jessica G. Y. Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alejandro Pizano
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, TX, USA
| | - Farhad Udwadia
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Saurabh Gupta
- Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mohammed Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, TX, USA
| | | | | | - Grahame Rush
- The Cardiothoracic Surgery Network, Chicago, IL, USA
| | - Joel Dunning
- Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Patrick O. Myers
- Department of Cardiac Surgery, CHUV-Center Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mara B. Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tom C. Nguyen
- Division of Cardiothoracic Surgery, Department of Surgery, University of California San Francisco, CA, USA
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19
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Aranda-Michel E, Trager LE, Han JJ, Aggarwal R, Cevasco M, Kelly RF, Sultan I. Considerations for a Holistic Model in Evaluating Medical Students for Cardiothoracic Surgical Residency. Semin Thorac Cardiovasc Surg 2022; 35:705-710. [PMID: 35714822 DOI: 10.1053/j.semtcvs.2022.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022]
Abstract
Program directors are tasked with selecting whom they think will be the best fit for residency and the next leaders of the field. While numerical metrics have played a vital role in this process, recent changes to student evaluation are reducing the availability of these metrics. This poses unique challenges for both applicants and program directors. Here we discuss how this will likely shift the focus on other parts of the application and the consequences (good and bad) of doing so.
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Affiliation(s)
- Edgar Aranda-Michel
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lena E Trager
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jason J Han
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Rishav Aggarwal
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Marisa Cevasco
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rosemary F Kelly
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Ibrahim Sultan
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
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20
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Dearani JA. Resilience. Hope. Unity. STS Presidential Address 2021. Ann Thorac Surg 2022; 114:5-17. [DOI: 10.1016/j.athoracsur.2022.01.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 11/01/2022]
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21
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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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22
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Gao SW, Forcillo J, Watkins AC, Antonoff MB, Luc JG, Chung JC, Ritchie L, Eikelboom R, Shashidharan S, Maruyama M, Whitlock RP, Ouzounian M, Belley-Côté EP. 60 Years After the First Woman Cardiac Surgeon: We Still Need More Women in Cardiac Surgery. CJC Open 2021; 3:S89-S94. [PMID: 34993438 PMCID: PMC8712594 DOI: 10.1016/j.cjco.2021.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/13/2021] [Indexed: 11/29/2022] Open
Abstract
In 1960, Dr Nina Starr Braunwald became the first woman to perform open heart surgery. Sixty years later, despite the fact that women outnumbered men in American medical school in 2017, men still dominate the field of cardiac surgery. Women surgeons remain underrepresented in cardiac surgery; 11% of practicing cardiac surgeons in Canada were women in 2015, and 6% of practicing adult cardiac surgeons in the US were women in 2019. Although women remain a minority in other surgical specialties also, cardiothoracic surgery remains one of the most unevenly–gender distributed specialties. Why are there so few women cardiac surgeons, and why does it matter? Evidence is emerging regarding the benefits of diversity for a variety of industries, including healthcare. In order to attract and retain the best talent, we must make the cardiac surgery environment more diverse, equitable, and inclusive. Some causes of perpetuation of the gender gap have been documented in the literature—these include uneven compensation and career advancement opportunities, outdated views on family dynamics, and disproportionate scrutiny of women surgeons, causing additional workplace frictions for women. Diversity is an organizational strength, and gender-diverse institutions are more likely to outperform their non-gender-diverse counterparts. Modifiable issues perpetuate the gender gap, and mentorship is key in helping attract, develop, and retain the best and brightest within cardiac surgery. Facilitating mentorship opportunities is key to reducing barriers and bridging the gap.
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Affiliation(s)
- Sophie Weiwei Gao
- Department of Surgery, Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jessica Forcillo
- Department of Cardiac Surgery, Division of Cardiac Surgery, Université de Montréal, Montreal, Quebec, Canada
| | - Amelia Claire Watkins
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California, USA
| | - Mara B. Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jessica G.Y. Luc
- Department of Surgery, Division of Cardiac Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C.Y. Chung
- Department of Surgery, Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Laura Ritchie
- Department of Surgery, Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Rachel Eikelboom
- Department of Surgery, Division of Cardiac Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Subhadra Shashidharan
- Department of Surgery, Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA
| | - Michiko Maruyama
- Department of Family Medicine, University of Calgary, University of Calgary, Calgary, Alberta, Canada
| | - Richard P. Whitlock
- Department of Surgery, Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Maral Ouzounian
- Department of Surgery, Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Emilie P. Belley-Côté
- Department of Medicine, Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
- Corresponding author: Dr Emilie P. Belley-Côté, McMaster University, David Braley Cardiac, Vascular, and Stroke Research Institute, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada. Tel.: +1-905-527-4322, x40741.
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Dairywala MI, Gupta S, Salna M, Nguyen TC. Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic Surgery. Semin Thorac Cardiovasc Surg 2021; 34:1220-1229. [PMID: 34597795 DOI: 10.1053/j.semtcvs.2021.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/09/2023]
Abstract
With the high prevalence of musculoskeletal pain in surgeons and interventionalists, it is critical to analyze the impact of ergonomics on cardiothoracic surgeon health. Here, we review the existing literature and propose recommendations to improve physical preparedness for surgery both in and outside the operating room. For decades, cardiothoracic surgeons have suffered from musculoskeletal pain, most commonly in the neck, and back due to a lack of proper ergonomics during surgery. A lack of dedicated ergonomics curriculum during training may leave surgeons at a high predisposition for work-related musculoskeletal disorders. We searched PubMed, Google Scholar, and other sources for studies relevant to surgical ergonomics and prevalence of musculoskeletal disease among surgeons and interventionalists. Whenever possible, data from quantitative studies, and meta-analyses are presented. We also contacted experts and propose an exercise routine to improve physical preparedness for demands of surgery. To date, many studies have reported astonishingly high rates of work-related pain in surgeons with rates as high as 87% in minimally-invasive surgeons. Several optimizations regarding correct table height, monitor positioning, and loupe angles have been discussed. Lastly, implementation of ergonomics training at some programs have been effective at reducing the rates of musculoskeletal pain among surgeons. Surgical work-related stress injuries are more common than we think. Many factors including smaller incisions and technological advancements have led to this plight. Ultimately, work-related injuries are underreported and understudied and the field of surgical ergonomics remains open for investigative study.
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Affiliation(s)
- Mohammed I Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, Texas
| | - Saurabh Gupta
- Division of Cardiac Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael Salna
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Tom C Nguyen
- Division of Adult Cardiothoracic Surgery, Department of Surgery, UCSF Health, San Francisco, California.
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24
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Preparing for the Future: Funding for Graduate Medical Education in Cardiothoracic Surgery. Ann Thorac Surg 2021; 112:1736-1740. [PMID: 34547298 DOI: 10.1016/j.athoracsur.2021.09.002] [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: 05/17/2021] [Revised: 07/29/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022]
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25
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Loo MK, Cohen RG, Baker CJ, Starnes VA, Bowdish ME. Lack of Awareness of Reimbursement and Compensation Models amongst Cardiothoracic Surgery Trainees. Ann Thorac Surg 2021; 113:2085-2091. [PMID: 34454900 DOI: 10.1016/j.athoracsur.2021.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/06/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The objective of this study was to identify trainee knowledge gaps in reimbursement and compensation, determine the perceived importance of understanding these topics, and to explore if the Thoracic Surgery Curriculum needs additional educational material. METHODS The Thoracic Surgical Residents Association (TSRA) Executive committee selected the research proposal and distributed an anonymous electronic survey to 531 ACGME cardiothoracic surgery trainees. Standard descriptive statistics and regression analyses were performed. RESULTS 114 responses were collected (response rate 21.5%). Most trainees understand little or not at all about how attending surgeons are reimbursed (n=74, 69%). Most trainees reported knowing little or nothing about pay-for-performance compensation (n=73, 67%), bundled care (n=82, 75%) or value-based reimbursement (n=84, 77%). Only approximately 20% of trainees were accurate in estimating surgeon reimbursement for three common cardiothoracic surgery procedures to within 20% of the true reimbursement value, while approximately 30% were accurate to within 50% of the true reimbursement value. No respondent characteristics were found to be associated with a more or less accurate reimbursement response. Additionally, 81% of trainees responded that by the conclusion of training, understanding surgeon reimbursement is very important or extremely important (n=87) and 90% of trainees either somewhat agree or strongly agree with including these topics in the Thoracic Surgical Curriculum (n=95). CONCLUSIONS Despite acknowledging the importance of understanding physician compensation and reimbursement, cardiothoracic surgery trainees do not understand how the current models work. This study exemplifies the need for a succinct curriculum in this domain for trainees nationwide.
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Affiliation(s)
- Megan K Loo
- Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Robbin G Cohen
- Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Craig J Baker
- Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Vaughn A Starnes
- Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Michael E Bowdish
- Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California; Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, California.
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Olive JK, Mansoor S, Simpson K, Cornwell LD, Jimenez E, Ghanta RK, Groth SS, Burt BM, Rosengart TK, Coselli JS, Preventza O. Demographic Landscape of Cardiothoracic Surgeons and Residents at United States Training Programs. Ann Thorac Surg 2021; 114:108-114. [PMID: 34454903 DOI: 10.1016/j.athoracsur.2021.07.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/29/2021] [Accepted: 07/20/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Recruiting and promoting women and racial/ethnic minorities could help enhance diversity and inclusion in the academic cardiothoracic (CT) surgery workforce. However, the demographics of trainees and faculty at US training programs have not yet been studied. METHODS Traditional, integrated (I-6), and fast-track (4+3) programs listed in the Accreditation Council for Graduate Medical Education (ACGME) public database were analyzed. Demographics of trainees and surgeons, including gender, race/ethnicity, subspecialty, and academic appointment (if applicable), were obtained from ACGME Data Resource Books, institutional websites, and public profiles. Chi-square and Cochran-Armitage trend tests were performed. RESULTS In July 2020, 78 institutions had at least one CT surgery training program; 40 (51%) had only a traditional program, 20 (26%) traditional and I-6, 6 (8%) all three types of program, and 4 (5%) only I-6. The proportion of female trainees increased significantly from 2011 to 2019 (19% vs 24%, p<0.001), with female I-6 trainees outnumbering female traditional trainees since 2018. Significant increases by race/ethnicity were observed overall and by program type, notably for Asians and Hispanics in I-6 programs and Blacks in traditional programs. Finally, of the 1,175 CT surgeons identified, 633 (54%) were adult cardiac surgeons, 360 (37%) assistant professors, 116 (10%) women, and 33 (3%) Black. CONCLUSIONS The demographic landscape of CT surgery trainees and faculty across multiple training pathways reflects increasing representation by gender and race/ethnicity. However, we must continue to work toward equitable representation in the workforce to benefit the diverse patients we treat.
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Affiliation(s)
| | | | - Katherine Simpson
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Lorraine D Cornwell
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Ernesto Jimenez
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Ravi K Ghanta
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Shawn S Groth
- Division of General Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Bryan M Burt
- Division of General Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Todd K Rosengart
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Joseph S Coselli
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - Ourania Preventza
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas.
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Trudell AM, Frankel WC, Luc JGY, Blackmon SH, Kane L, Varghese TK, Antonoff MB. Enhancing Support for Women in Cardiothoracic Surgery through Allyship and Targeted Initiatives. Ann Thorac Surg 2021; 113:1676-1683. [PMID: 34332996 DOI: 10.1016/j.athoracsur.2021.06.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/25/2021] [Accepted: 06/17/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Issues of diversity, equity, and inclusion in cardiothoracic surgery have garnered increased attention. While barriers persist for women in our field, they may be ameliorated through enhanced support from allies. We aimed to determine best practices for allyship to better support female cardiothoracic surgeons. METHODS A survey was electronically distributed to members of the Women in Thoracic Surgery, addressing presence of female colleagues, sense of allyship among colleagues/leadership, and supportive versus detrimental characteristics of colleagues. Qualitative responses were grouped and coded to identify key themes. RESULTS Of 309 Women in Thoracic Surgery members, 87(28%) responded. Over half of respondents felt supported by their male colleagues in the areas of clinical practice, research, teaching, and personal life. While 64% of respondents considered at least one woman in their division an ally, only 48% considered at least one man in their division an ally, and 53% considered their division chief or department chair an ally. A theme of mentorship, support, and sponsorship was reported as the most important quality of allies, regardless of gender. A theme of disrespect, discrimination, stereotyping, and unconscious bias was reported as the most detrimental characteristic of male colleagues, while a theme of competitiveness and undermining was reported as the most detrimental of female colleagues. Initiatives to enhance support for female cardiothoracic surgeons were identified, with increased access to mentorship and sponsorship consistently identified as an important endeavor. CONCLUSIONS Increasing access to mentors, promoting positive behavior, and minimizing detrimental behavior may enhance support for female cardiothoracic surgeons.
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Affiliation(s)
- Avery M Trudell
- McGovern Medical School at the University of Texas Health Science Center, Houston, Texas
| | | | - Jessica G Y Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver
| | - Shanda H Blackmon
- Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester
| | - Lauren Kane
- Department of Surgery, Children's Hospital of New Orleans, New Orleans
| | - Thomas K Varghese
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, Houston.
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Surgeons and Industry Support- How to Find the Balance? Ann Thorac Surg 2021; 112:2045-2046. [PMID: 34214550 DOI: 10.1016/j.athoracsur.2021.06.009] [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: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/23/2022]
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29
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To Re-resect or Not Re-resect, That Is The Question. Ann Thorac Surg 2021; 113:1391-1392. [PMID: 34102179 DOI: 10.1016/j.athoracsur.2021.05.030] [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: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 11/21/2022]
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30
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Lawton JS. A historic event: The first female officer of the American Association for Thoracic Surgery. J Thorac Cardiovasc Surg 2021; 161:730-732. [PMID: 32741627 PMCID: PMC7335416 DOI: 10.1016/j.jtcvs.2020.06.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Abstract
At the 100th meeting of the AATS, the first woman ever was nominated to be an officer. Dr Yolonda Colson was nominated as Vice President and will be the first female President of the AATS. We celebrate her amazing and inspiring accomplishments.
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Affiliation(s)
- Jennifer S. Lawton
- Address for reprints: Jennifer S. Lawton, MD, Johns Hopkins Hospital, 1800 Orleans St Zayed 7107, Baltimore, MD 21287
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31
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Bui J, Bennett WC, Long J, Strassle PD, Haithcock B. Recent Trends in Cardiothoracic Surgery Training: Data from the National Resident Matching Program. JOURNAL OF SURGICAL EDUCATION 2021; 78:672-678. [PMID: 32928698 DOI: 10.1016/j.jsurg.2020.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In 2008, integrated thoracic residency programs (IP) for cardiothoracic (CT) training were created in response to a decline in CT trainees. However, few studies have reported on trends in the CT training pathway since the inception of IPs. This manuscript examines the current trends related to the overall number of surgical trainees entering CT surgery training following the introduction of IPs into the National Resident Match Program (NRMP). DESIGN Main and specialty match data were gathered from NRMP annual reports between 2008 and 2018. Descriptive statistics were used to analyze program size, applications, and filled and unfilled positions for IPs and traditional CT residency programs. Pearson's correlation coefficient was used to determine associations between program variables. SETTING NRMP main and specialty match in 2008 to 2018. PARTICIPANTS Participants of the NRMP main and specialty match in 2008 to 2018. RESULTS IPs increased from 2 programs offering 3 positions in 2008 to 28 programs offering 36 positions in 2018. However, during the same time period, the number of available traditional CT residency positions have decreased by 29% (130 to 92). As the number of IPs increased, there was a significant decrease in the number of traditional CT residency positions (ρ = -0.95, p < 0.001). Although, the overall number of CT residency programs (traditional and IP) remained largely unchanged, the proportion of filled CT residency positions increased from 67.7% in 2008 up to 97.7% in 2018. CONCLUSION The IP training format has shown success in increasing the number of trainees entering into CT training programs. Consideration should be given to increasing the number of IP positions or increase interest in CT among general surgery residents to increase the number of CT surgery trainees with the goal of increasing the size of the future CT workforce.
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Affiliation(s)
- Jenny Bui
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - William C Bennett
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Jason Long
- Department of Surgery, Division of Cardiothoracic Surgery, Chapel Hill, North Carolina
| | | | - Benjamin Haithcock
- Department of Surgery, Division of Cardiothoracic Surgery, Chapel Hill, North Carolina.
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Kilcoyne MF, Han JJ, Dewan KC, Wallen TJ, Nguyen TC. Training the trainee in structural heart disease: A need for change. J Thorac Cardiovasc Surg 2021; 163:2166-2170. [PMID: 33685736 DOI: 10.1016/j.jtcvs.2021.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 01/23/2023]
Affiliation(s)
| | - Jason J Han
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Krish C Dewan
- Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Tyler J Wallen
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, The University of Florida, Gainesville, Fla
| | - Tom C Nguyen
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, Tex
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33
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Ceppa DP, Ikonomidis JS, Timsina LR, Boden N, Kane LC, Donington JS. STS 2019 Workforce Report: Ad Hoc Analysis of Women in Cardiothoracic Surgery. Ann Thorac Surg 2021; 111:383-385. [DOI: 10.1016/j.athoracsur.2020.07.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022]
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Van Hemelrijck M. Make Cardiac Surgery Great again: The Perks of Being a Resident. Thorac Cardiovasc Surg Rep 2021; 10:e6-e8. [PMID: 33489713 PMCID: PMC7815334 DOI: 10.1055/s-0040-1721471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 10/07/2020] [Indexed: 11/14/2022] Open
Abstract
Training in cardiac surgery is a cumbersome topic. Over the last years, major cardiac surgical operations have been found to decrease due to the increasing number in transcatheter interventions. Becoming a cardiac surgeon has become partly a hard task. Since the beginning of 2020, the new coronavirus epidemic has been shaking peoples' lives all over the world, hindering every normal hospital activity including residency programs.
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Moon MR. Equal means equal: Cardiothoracic surgery in its second century. J Thorac Cardiovasc Surg 2020; 161:1381-1389. [PMID: 33487415 DOI: 10.1016/j.jtcvs.2020.12.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/27/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE As the specialty of cardiothoracic surgery turns the corner into its second century of existence, there has been an uptick in the number of women and underrepresented minorities entering the field, but we have a long way to go before race and gender equity prevails. METHODS In this report, specific barriers to diversity without exclusion and mechanisms to breakdown these barriers will be explored. RESULTS Barriers to inclusion include a long-standing deficiency in exposure, encouragement, mentorship, and sponsorship to actively attract underrepresented groups to the specialty. Diversity will not occur passively. It will take a concerted effort best employed through a top-down approach at the local and national level, and it has to seem normal. CONCLUSIONS Cardiothoracic surgery is an outstanding field for anyone and everyone who seeks a challenging, rewarding career, regardless of their gender, race, or ethnic background. It is the responsibility of leadership to dispel the tradition that certain individuals are not welcome.
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Affiliation(s)
- Marc R Moon
- Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Mo.
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36
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Ouzounian M, Chung JCY, Rao V. Commentary: Changing times, changing faces. J Thorac Cardiovasc Surg 2020; 163:187-188. [PMID: 33277029 DOI: 10.1016/j.jtcvs.2020.11.013] [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: 11/02/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Maral Ouzounian
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Jennifer C-Y Chung
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Vivek Rao
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
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37
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Ikonomidis JS. Underestimation of CT Surgery "Burnout": Reply. Ann Thorac Surg 2020; 111:1405. [PMID: 32890489 DOI: 10.1016/j.athoracsur.2020.06.089] [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: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- John S Ikonomidis
- Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, 3034 Burnett-Womack Bldg, 160 Dental Circle, Chapel Hill, NC 27599.
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38
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Stephens EH, Dearani JA, Guleserian KJ. Courage, Fortitude, and Effective Leadership of Surgical Teams During COVID-19. World J Pediatr Congenit Heart Surg 2020; 11:675-679. [PMID: 32648522 PMCID: PMC7355204 DOI: 10.1177/2150135120938330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 02/06/2023]
Abstract
The world as we once knew it has been drastically altered secondary to coronavirus disease 2019 (COVID-19). The impact of these changes, particularly for those practicing in the medical profession, extends beyond the physical to the psychological, emotional, and spiritual. We discuss the factors that contribute to these stresses, way to manage them, and how we as leaders of our teams can inspire resilience and help our colleagues endure these most difficult times.
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Affiliation(s)
| | - Joseph A. Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kristine J. Guleserian
- Department of Congenital Heart Surgery, Medical City Children’s
Hospital, Dallas, TX, USA
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39
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Blitzer D, Coyan GN. Resident Response to the 2019 Thoracic Surgery Practice and Access Task Force. Ann Thorac Surg 2020; 111:1405. [PMID: 32835751 PMCID: PMC7442578 DOI: 10.1016/j.athoracsur.2020.06.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- David Blitzer
- Department of Surgery, Columbia University Irving Medical Center, 177 Fort Washington Ave, 7SK, New York, NY 10034.
| | - Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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40
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Chang SH, Smith DE. Commentary: Recognition is the first step. J Thorac Cardiovasc Surg 2020; 162:643-644. [PMID: 32763033 DOI: 10.1016/j.jtcvs.2020.07.024] [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: 07/06/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Stephanie H Chang
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY.
| | - Deane E Smith
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY
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