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George J, Lotto A. Perception of congenital cardiac surgery as a career choice among cardiothoracic surgery trainees in the United Kingdom. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2024; 38:ivae008. [PMID: 38684184 PMCID: PMC11078891 DOI: 10.1093/icvts/ivae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/20/2023] [Accepted: 04/27/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES Our goal was to evaluate interest among trainees in pursuing congenital cardiac surgery (CCS) as a sub-specialty career and probe for reasons in decline in interest. METHODS An anonymized, voluntary survey of cardiothoracic surgical trainees across the United Kingdom and Ireland was conducted from October 2020 to December 2020. The questionnaire included demographics, congenital experience and career intentions. RESULTS A total of 43 respondents from all training regions responded with a response rate of 36%. A total of 28% reported having no access to a congenital cardiac unit in their training region, reflecting that 4 out of the 14 regions do not have a congenital unit. Although only 18% of trainees have undertaken a placement, a large proportion (74%) have considered a career in CCS, predominantly (50%) before entering training or in the first half of the training programme (38%). Reasons for not pursuing included discouragement by colleagues (42%) and concerns regarding the training pathway, citing, among other reasons, length of training, limited exposure to operations and uncertainty about career progression. Respondents suggested improvements to the training programme, including increasing exposure and early mentoring and steps to dispel unduly negative perceptions about the specialty. CONCLUSIONS A large proportion of cardiothoracic trainees have a negative perception of CCS in terms of career and training. Interest wanes substantially after entry into the United Kingdom cardiothoracic training programme for several reasons. As well as short-term measures to improve exposure to CCS and structure of training, there has to be long-term planning to improve perception about this sub-specialty at all levels.
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Affiliation(s)
- Joseph George
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - Attilio Lotto
- Department of Cardiothoracic Surgery, Alder Hey Children’s Hospital, Liverpool, United Kingdom
- Liverpool John Moores University, Liverpool, United Kingdom
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Poljo A, Sortino R, Daume D, Probst P, Billeter AT, Müller-Stich BP, Klasen JM. Educational challenges and opportunities for the future generation of surgeons: a scoping review. Langenbecks Arch Surg 2024; 409:82. [PMID: 38433154 DOI: 10.1007/s00423-024-03270-7] [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] [Received: 12/29/2023] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Surgery offers exciting opportunities but comes with demanding challenges that require attention from both surgical program administrators and aspiring surgeons. The hashtag #NoTrainingTodayNoSurgeonsTomorrow on 𝕏 (previously Twitter) underscores the importance of ongoing training. Our scoping review identifies educational challenges and opportunities for the next generation of surgeons, analyzing existing studies and filling gaps in the literature. METHODS Following the PRISMA guidelines, MEDLINE/PubMed was searched in February 2022, using the MeSH terms "surgeons/education," for articles in English or German on general, abdominal, thoracic, vascular, and hand surgery and traumatology targeting medical students, surgical residents, future surgeons, and fellows. RESULTS The initial search yielded 1448 results. After a step-by-step evaluation process, 32 publications remained for complete review. Three main topics emerged: surgical innovations and training (n = 7), surgical culture and environment (n = 19), and mentoring (n = 6). The articles focusing on surgical innovations and training mainly described the incorporation of structured surgical training methods and program initiatives. Articles on surgical culture examined residents' burnout, well-being, and gender issues. Challenges faced by women, including implicit bias and sexual harassment, were highlighted. Regarding mentoring, mentees' needs, training challenges, and the qualities expected of both mentors and mentees were addressed. CONCLUSION At a time of COVID-19-driven surgical innovations, the educational and working environment of the new generation of surgeons is changing. Robotic technology and other innovations require future surgeons to acquire additional technological and digital expertise. With regard to the cultural aspects of training, surgery needs to adapt curricula to meet the demands of the new generation of surgeons, but even more it has to transform its culture.
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Affiliation(s)
- Adisa Poljo
- Department of Visceral Surgery, Clarunis - University Digestive Healthcare Center Basel, University Hospital Basel and St. Clara Hospital, Basel, Switzerland
| | - Rosita Sortino
- Department of Visceral Surgery, Clarunis - University Digestive Healthcare Center Basel, University Hospital Basel and St. Clara Hospital, Basel, Switzerland
| | - Diana Daume
- Department of Surgery, Lucerne Cantonal Hospital, Spitalstrasse, 6000, Lucerne, Switzerland
| | - Pascal Probst
- Department of Surgery, Cantonal Hospital Thurgau, 8501, Frauenfeld, Switzerland
| | - Adrian T Billeter
- Department of Visceral Surgery, Clarunis - University Digestive Healthcare Center Basel, University Hospital Basel and St. Clara Hospital, Basel, Switzerland
| | - Beat P Müller-Stich
- Department of Visceral Surgery, Clarunis - University Digestive Healthcare Center Basel, University Hospital Basel and St. Clara Hospital, Basel, Switzerland
| | - Jennifer M Klasen
- Department of Visceral Surgery, Clarunis - University Digestive Healthcare Center Basel, University Hospital Basel and St. Clara Hospital, Basel, Switzerland.
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Feeley AA, Feeley IH, Sheehan E, Carroll C, Queally J. Impact of Mentoring for Underrepresented Groups in Undergraduate Medical Education: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2024; 81:353-366. [PMID: 38160117 DOI: 10.1016/j.jsurg.2023.11.015] [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: 07/03/2023] [Revised: 10/11/2023] [Accepted: 11/11/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Despite efforts to mitigate challenges to advance underrepresented groups (URG) groups' representation in medical education, diversity remains underwhelming. In response to this several mentoring programs to increase diversification within medical education have been implemented. However, the impact of these programs on URG representation across disciplines is unknown. The aim of this review is to evaluate the impact of structured mentoring programs on URGs in undergraduate medical education. DESIGN Systematic review. METHODS A comprehensive search strategy was performed of electronic databases including PubMed, Ovid Medline, and EMBASE between January and September 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Both qualitative and quantitative outcomes including characteristics of the mentoring structure explored within each study were collected, and differences in study outcomes analyzed. RESULTS In total 17 studies were included for analysis. Mentoring within URGs resulted in an increase in research opportunities, exam performance, medical specialty applications, and residency matching. Structured feedback yielded positive experiences by both mentors and mentees participating in programs, with both emotional and cultural competence issues explored across studies included for analysis. CONCLUSIONS Mentoring for medical students underrepresented in medicine across mentoring relationships including peer, senior, formal, and informal structures yield positive outcomes within research, academic modules, and career pathways. Future applications of mentoring programs should consider the use of tandem mentoring from both senior and peer mentors to optimize benefits URG students derive from each mentoring relationship.
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Affiliation(s)
- Aoife A Feeley
- Connolly Hospital Blanchardstown, Dublin, Ireland; Royal College Surgeons Ireland, Dublin, Ireland.
| | - Iain H Feeley
- Midlands Regional Hospital Tullamore, Offaly, Ireland
| | - Eoin Sheehan
- Midlands Regional Hospital Tullamore, Offaly, Ireland
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Olive JK, Yost CC, Robinson JA, Brescia AA, Han JJ, Haney JC, Forbess JM, Varghese TK, Backhus LM, Cooke DT, Cornwell LD, Preventza OA. Demographics of Current and Aspiring Integrated Six-year Cardiothoracic Surgery Trainees. Ann Thorac Surg 2023; 115:771-777. [PMID: 35934069 DOI: 10.1016/j.athoracsur.2022.06.051] [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: 12/15/2021] [Revised: 04/16/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The integrated 6-year thoracic surgery (I-6) residency model was developed in part to promote early interest in cardiothoracic surgery in diverse trainees. To determine gaps in and opportunities for recruitment of women and minority groups in the pipeline for I-6 residency, we quantified rates of progression at each training level and trends over time. METHODS We obtained 2015 to 2019 medical student, I-6 applicant, and I-6 resident gender and race/ethnicity demographic data from the American Association of Medical Colleges and Electronic Residency Application Service public databases and Accreditation Council for Graduate Medical Education Data Resource Books. We performed χ2, Fisher exact, and Cochran-Armitage tests for trend to compare 2015 and 2019. RESULTS Our cross-sectional analysis found increased representation of women and all non-White races/ethnicities, except Native American, at each training level from 2015 to 2019 (P < .001 for all). The greatest trends in increases were seen in the proportions of women (28% vs 22%, P = .46) and Asian/Pacific Islander (25% vs 15%, P = .08) applicants. There was also an increase in the proportions of women (28% vs 24%, P = .024) and White (61% vs 58%, P = .007) I-6 residents, with a trend for Asian/Pacific Islanders (20% vs 17%, P = .08). The proportions of Hispanic (5%) and Black/African American (2%) I-6 residents in 2019 remained low. CONCLUSIONS I-6 residency matriculation is not representative of medical student demographics and spotlights a need to foster early interest in cardiothoracic surgery among all groups underrepresented in medicine while ensuring that we mitigate bias in residency recruitment.
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Affiliation(s)
- Jacqueline K Olive
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
| | - Colin C Yost
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Justin A Robinson
- Division of Cardiac Surgery, Department of Surgery, University of Maryland, Baltimore, Maryland
| | | | - Jason J Han
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John C Haney
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
| | - Joseph M Forbess
- Division of Cardiac Surgery, Department of Surgery, University of Maryland, Baltimore, Maryland
| | - Thomas K Varghese
- Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah
| | - Leah M Backhus
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - David T Cooke
- Division of General Thoracic Surgery, Department of Surgery, University of California, Davis Health, Sacramento, California
| | - Lorraine D Cornwell
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Ourania A 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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Chen L, Barrios P, Karamlou T. Visiting Medical Student Clerkships: Call to Action for Program Directors, Faculty, and the Thoracic Surgery Medical Student Association. Semin Thorac Cardiovasc Surg 2023; 35:90-91. [PMID: 35134529 DOI: 10.1053/j.semtcvs.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/21/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Lin Chen
- Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Paola Barrios
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tara Karamlou
- Division of Pediatric Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
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Han JJ, Cevasco M. An Idea Whose Time Has Come. Ann Thorac Surg 2022; 114:600. [PMID: 34166635 DOI: 10.1016/j.athoracsur.2021.05.070] [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: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Jason J Han
- Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 6 Silverstein Pavilion, 3400 Spruce St, Philadelphia, PA 19104.
| | - Marisa Cevasco
- Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 6 Silverstein Pavilion, 3400 Spruce St, Philadelphia, PA 19104
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Affiliation(s)
- Lin Chen
- Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106
| | - Samantha Xu
- Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106
| | - Alejandro C Bribriesco
- Section of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
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Diversity in National Society Leadership and Podium Speakers in Cardiothoracic Surgery. Ann Thorac Surg 2022; 114:561-566. [PMID: 35182515 DOI: 10.1016/j.athoracsur.2022.01.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/05/2022] [Accepted: 01/26/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Women and people of colour are often under-represented in medicine. The objective of this study was to examine the inclusivity and diversity of the recent history of the Canadian Association of Thoracic Surgeons (CATS), in terms of both its executive committees and invited participation at its annual meeting. METHODS CATS internal records and previous programs of CATS annual meetings were reviewed from 1997-2020. Leadership positions, invited speakers and award recipients were categorized by sex and race. RESULTS Of 199 CATS members in 2020, 93 were white men (47%), 64 were men of colour (32%), 24 were white women (12%) and 18 were women of colour (9%). The majority of CATS Presidents (86%), committee chairs (57%), named lecturers (88%), other invited speakers (67%) and major award winners (90%) were white men. Women and people of colour were under-represented. The resident research award was the most diverse: Of 23 awards, 10 have been to men of colour (44%), six to white men (26%), four to women of colour (15%) and two to white women (8%). CONCLUSIONS There is a need for more representation and inclusion of both women and people of colour at multiple levels in CATS. This includes opportunities for improvement in the make-up of its executive, the speakers at its annual conference and the recipients of its awards. CATS has established an Equity, Diversity and Inclusion Task Force to address this critical issue.
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Chen L, Karamlou T, Bribriesco AC. Diversity and Inclusion in the Virtual Era. Ann Thorac Surg 2021; 114:599-600. [PMID: 34139188 DOI: 10.1016/j.athoracsur.2021.05.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/18/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Lin Chen
- Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106.
| | - Tara Karamlou
- Division of Pediatric Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Alejandro C Bribriesco
- Section of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
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From Individualism to Esprit de Corps. Ann Thorac Surg 2021; 113:2114. [PMID: 33974893 DOI: 10.1016/j.athoracsur.2021.04.075] [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: 04/12/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 11/21/2022]
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