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Fraser CD, Mikulski MF, Venardos NM, Mery CM, Well A. The journey of becoming a congenital heart surgeon: Too long, too costly, too unpredictable. J Thorac Cardiovasc Surg 2024; 167:312-321.e4. [PMID: 37385526 DOI: 10.1016/j.jtcvs.2023.05.046] [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] [Received: 02/28/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE The pathway to become a congenital heart surgeon (CHS) is challenging and unpredictable. Previous voluntary manpower surveys have shed partial light on this problem but have not included all trainees. We believe that this arduous journey merits more attention. METHODS To examine the real-life challenges of recent participants in Accreditation Council for Graduate Medical Education-accredited CHS training programs, we conducted phone interviews with all graduates of approved programs from 2021 to 2022. This institutional review board approved survey focused on issues including preparation, length of training, debt burden, and employment. RESULTS All 22 (100%) graduates during the study period were interviewed. Age at fellowship completion was a median 37 years (range, 33-45 years). Pathways to fellowship included traditional general surgery with adult cardiac (43%), abbreviated general surgery ("4 + 3," 19%) and integrated-6 (38%). Time spent on any pediatric related rotation before CHS fellowship was a median 4 months (range, 1-10 months). During CHS fellowship, graduates reported medians of 100 (range, 75-170) total cases and 8 (range, 0-25) neonatal cases as the primary surgeon. Debt burden at completion was a median of $179,000 (range, $0-$550,000). Maximal financial compensation during training before and during CHS fellowship were medians of $65,000 (range, $50,000-$100,000) and $80,000 (range, $65,000-$165,000), respectively. Six (27.3%) are currently in roles in which they cannot practice independently (5 [22.7%] faculty instructors, 1 [4.5%] CHS clinical fellowship). Median salary in first job is $450,000 (range, $80,000-$700,000). CONCLUSIONS Graduates of CHS fellowships are old, and training is highly variable. Aptitude screening and pediatric-focused preparation are minimal. Debt burden is onerous. Further attention to refining training paradigms and compensation are justified.
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Affiliation(s)
- Charles D Fraser
- Division of Pediatric and Congenital Cardiothoracic Surgery, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Tex; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, Austin, Tex.
| | - Matthew F Mikulski
- Division of Pediatric and Congenital Cardiothoracic Surgery, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Tex; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, Austin, Tex
| | - Neil M Venardos
- Division of Pediatric and Congenital Cardiothoracic Surgery, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Tex; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, Austin, Tex
| | - Carlos M Mery
- Division of Pediatric and Congenital Cardiothoracic Surgery, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Tex; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, Austin, Tex
| | - Andrew Well
- Division of Pediatric and Congenital Cardiothoracic Surgery, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Tex; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, Austin, Tex
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Blitzer D, Benintende AJ, Nemeth S, Kurlansky P, Antkowiak M, Fischkoff K, Argenziano M, Takayama H. Trends in Comprehensive Thoracic Case Experience Among General Surgery Residents in the Modern Integrated Cardiothoracic Residency Era: Review of Twenty Years of Resident Case Logs. Am Surg 2023; 89:5512-5519. [PMID: 36797046 DOI: 10.1177/00031348231157417] [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: 02/18/2023]
Abstract
BACKGROUND Thoracic surgery training among general surgery residents in the United States is regulated by the Accreditation Council for Graduate Medical Education (ACGME) to ensure exposure to subspecialty fields during residency. Thoracic surgery training has changed over time with the placement of work hour restrictions, the emphasis on minimally invasive surgery, and increased subspecialization of training like integrated six-year cardiothoracic surgery programs. We aim to investigate how these changes over the past twenty years have affected thoracic surgery training among general surgery residents. METHODS ACGME general surgery resident case logs from 1999 to 2019 were reviewed. Data included exposure to the thorax via thoracic, cardiac, vascular, pediatric, trauma, and alimentary tract procedures. Cases from the above categories were consolidated to determine the comprehensive experience. Descriptive statistics were performed over four 5-year Eras (Era 1:1999-2004, Era 2: 2004-2009, Era 3: 2009-2014, Era 4: 2014-2019). RESULTS Between Era 1 and Era 4, there was an increase in thoracic surgery experience (37.6 ± 1.03 vs 39.3 ± .64; P = .006). The mean total thoracic experience for thoracoscopic, open, and cardiac procedures was 12.89 ± 3.76, 20.09 ± 2.33, and 4.98 ± 1.28, respectively. There was a difference between Era 1 and Era 4 in thoracoscopic (8.78 ± .961 vs 17.18 ± .75; P < .001) and open thoracic experience (22 ± .97 vs 17.06 ± .88; P < .001), and a decrease in thoracic trauma procedures (3.7 ± .06 vs 3.2 ± .32; P = .03). DISCUSSION Over twenty years there has been a similar, to slight increase in thoracic surgery exposure among general surgery residents. The changes seen in thoracic surgery training reflect the overall movement of surgery towards minimally invasive surgery.
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Affiliation(s)
- David Blitzer
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Andrew J Benintende
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Samantha Nemeth
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Paul Kurlansky
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Mark Antkowiak
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katherine Fischkoff
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Michael Argenziano
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Hiroo Takayama
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
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Bougioukas L, Heiser A, Berg A, Polomsky M, Rokkas C, Hirashima F. Integrated cardiothoracic surgery match: Trends among applicants compared with other surgical subspecialties. J Thorac Cardiovasc Surg 2023; 166:904-914. [PMID: 35461707 DOI: 10.1016/j.jtcvs.2021.11.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate trends, qualifications, race/ethnicity, and gender of applicants to integrated cardiothoracic (CT I-6) residency programs and compare them with other competitive surgical subspecialties. METHODS Data were collected from the National Residency Matching Program, Electronic Residency Application Service, and Association of American Medical Colleges for thoracic surgery, orthopedic surgery, neurological surgery, otolaryngology (ENT), plastic surgery, and vascular surgery for 2010 t0 2020. Applicant gender, race/ethnicity, Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination scores, research productivity, and graduation from a top-40 medical school were analyzed. RESULTS From 2010 to 2020, CT I-6 experienced growth in postgraduate year 1 positions (280.0%), total applicants (62.2%), and US senior applicants (59.2%). No growth in CT I-6 positions (38) or programs (29) occurred from 2016 to 2020. CT I-6 had the lowest match rates among total applicants (31.7%) and US seniors (41.0%) in 2020. CT I-6 had fewer female applicants compared with ENT (P < .001) and plastic surgery (P < .001), but more than orthopedic surgery (P < .001). Although most CT I-6 US applicants self-identified as White (75.0%), there were more Asian applicants compared with applicants for orthopedic surgery (P < .001), ENT (P < .001), plastic surgery (P < .001), and neurological surgery (P < .01). Matched applicants averaged the highest Step 2-Clinical Knowledge scores (255.1), AOA membership (48.5%), and graduation rates from top-40 medical schools (54.5%). CONCLUSIONS Despite tremendous growth in positions, CT I-6 has consistently been the most difficult surgical subspecialty to match. CT I-6 has recently attracted an increasingly diverse applicant pool. For the 2019 to 2020 National Residency Matching Program Match Cycle, successful applicants had the highest Step 2-Clinical Knowledge scores, AOA membership rates, and graduation rates from a top-40 medical school among all surgical subspecialties examined.
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Affiliation(s)
- Lauren Bougioukas
- Division of Cardiothoracic Surgery, Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, Vt
| | - Alyssa Heiser
- Division of Cardiothoracic Surgery, Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, Vt
| | - Adrian Berg
- Division of Cardiothoracic Surgery, Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, Vt
| | - Marek Polomsky
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Vermont Medical Center, Burlington, Vt
| | - Chris Rokkas
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Vermont Medical Center, Burlington, Vt
| | - Fuyuki Hirashima
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Vermont Medical Center, Burlington, Vt.
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Aranda-Michel E, Trager L, Gerhard EF, Magura C, Han J, Merritt-Genore H, Lin J, David E, Tong B, Reddy R, Moon M, Sultan I. The Thoracic Surgery Medical Student Association: Understanding the needs of medical students pursuing cardiothoracic surgery in the United States. J Thorac Cardiovasc Surg 2023; 166:171-178. [PMID: 35410691 DOI: 10.1016/j.jtcvs.2021.11.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/10/2021] [Accepted: 11/09/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Founded in 2020, the Thoracic Surgery Medical Student Association is the first national organization dedicated to supporting medical students interested in pursuing cardiothoracic surgery. Our inaugural survey aimed to describe their basic characteristics and needs. METHODS An Institutional Review Board-approved, nonincentivized, anonymous electronic survey was distributed to any medical students enrolled in Liaison Committee on Medical Education-accredited medical schools through social media such as Twitter, national organizations (Association of Women Surgeons, Thoracic Surgery Resident Association), and medical school cardiothoracic surgery interest groups. Their basic characteristics, attitudes, and preferences regarding cardiothoracic surgery were recorded. RESULTS Of the 167 students from 117 unique schools who completed the survey, 53% identified as White and 57% identified as female. Stages of training were well distributed: 16% first-year medical students, 33% second-year medical students, 16% third-year medical students, 21% fourth-year medical students, and 14% dual degree/research students. Most participants (57%) did not have (32%) or were not aware of having (25%) a thoracic surgery training program at their home institution. The majority (72%) of students reported not having a cardiothoracic surgery interest group at their home institution. The most desired areas of cardiothoracic were networking (31%) and mentorship (28%). CONCLUSIONS There is a significant need to directly engage medical students who are interested in cardiothoracic surgery considering limited exposure at home institutions through a lack of cardiothoracic surgery interest groups and cardiothoracic residency programs. The Thoracic Surgery Medical Student Association is poised to address these areas with directed networking by connecting cardiothoracic surgery faculty and residents from other institutions with medical students interested in pursuing cardiothoracic surgery.
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Affiliation(s)
- Edgar Aranda-Michel
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | | | | | | | - Jason Han
- University of Pennsylvania, Philadelphia, Pa
| | | | - Jules Lin
- University of Michigan, Ann Arbor, Mich
| | | | | | | | | | - Ibrahim Sultan
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
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Silvestre J, Cevasco M. Comparing Match Outcomes in a Surgical Subspecialty: Independent Versus Integrated Training Pathways. JOURNAL OF SURGICAL EDUCATION 2023; 80:468-475. [PMID: 36464614 DOI: 10.1016/j.jsurg.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE In recent years, the Thoracic Surgery Match (TSM) has become increasingly competitive. The purpose of this study was to compare recent trends in application and match rates in the TSM by training pathway. DESIGN This was a retrospective cohort study of all applicants to Integrated and Independent pathways for Thoracic Surgery training (2008-2021). Chi square tests were used to elucidate temporal trends and make comparisons by training pathway. SETTING Accreditation Council for Graduate Medical Education (ACGME)-accredited Thoracic Surgery training programs in the United States. PARTICIPANTS 1500 Independent and 1242 Integrated pathway applicants for Thoracic Surgery training. RESULTS From 2008 to 2021, the annual match rate decreased from 91% to 71% in the Independent pathway (p < 0.001). This was driven by a decrease in the number of training positions (130-101, 22% decrease) and increase in number of applicants (96-140, 46% increase). In the Integrated pathway, the annual match rate increased from 33% to 35% (p < 0.001) as did the number of training positions (3 to 46, 1430% increase) and applicants (9-129, 1333% increase). During each year, match rates in the Independent pathway exceeded those in the Integrated pathway (p < 0.001). U.S. Allopathic graduates had higher match rates than non-U.S. Allopathic graduates for both Integrated and Independent training pathways. The percentage of applicants in the Independent pathway matching at one of their top 3 choices decreased from 73% to 40% (p < 0.001). The percentage of Independent thoracic surgery training positions that went unmatched decreased from 28% to 2% (p < 0.001). This percentage was stable at an average of 1% in the Integrated pathway (p > 0.05). CONCLUSIONS The TSM has become increasingly competitive for Independent pathway applicants and remains ultracompetitive for Integrated pathway applicants. More research is needed to understand disparities in match rates by Thoracic Surgery training pathway.
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Cardiothoracic Surgery: Present and Future. Surg Clin North Am 2022. [DOI: 10.1016/j.suc.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rabenstein AP, Khomutova A, Shroyer ALW, Scriven R, McLarty A, Tannous H, Balaguer JM. Cardiac surgical simulation program during general surgery residency increases resident physician exposure to cardiac surgery and technical expertise. JTCVS OPEN 2022; 9:179-184. [PMID: 36003448 PMCID: PMC9390549 DOI: 10.1016/j.xjon.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Andrew P. Rabenstein
- Department of Thoracic and Cardiovascular Surgery, Allegheny General Hospital, AHN Cardiovascular Institute, Pittsburgh, Pa
| | - Alisa Khomutova
- Department of Surgery, General Surgery Residency Program, Stony Brook University Hospital, Stony Brook, NY
| | - A. Laurie W. Shroyer
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
| | - Richard Scriven
- Department of Surgery, General Surgery Residency Program, Stony Brook University Hospital, Stony Brook, NY
| | - Allison McLarty
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
| | - Henry Tannous
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
| | - Jorge M. Balaguer
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
- Address for reprints: Jorge M. Balaguer, MD, Division of Cardiothoracic Surgery, Department of Surgery, Health Sciences Center T19-080, Stony Brook, NY 11794-8191.
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Deboever N, Bayley EM, Vaporciyan AA, Antonoff MB. Traits of the current traditional pathway cardiothoracic surgery training pool: Results of a cross-sectional study. J Thorac Cardiovasc Surg 2021; 165:1743-1750. [PMID: 34920868 DOI: 10.1016/j.jtcvs.2021.08.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE As new paradigms for cardiothoracic surgery training emerged in recent years, the traditional 2- or 3-year pathway has persisted as an option for trainees completing general surgery residencies. Although the applicant pool for 6-year integrated cardiothoracic surgery training programs has been superficially explored, little data exist characterizing those applicants to the traditional cardiothoracic surgery training pathway and the influence of 6-year integrated expansion on the traditional applicant pool. METHODS We reviewed materials from candidates applying to a single 2-year cardiothoracic surgery training program between 2015 and 2020. Descriptive and comparative analyses of multiple characteristics were performed over the years of the study. RESULTS During the years 2015 through 2020, we received 571 applications, accounting for 72% of the total National Residency Matching Program applicant pool. We saw no significant trends in numbers of peer-reviewed publications or presentations. There was a minimal year-to-year increase in number of first-authored posters, 2.04 in 2015 to 2.13 in 2020 (P = .008). Online publications, book chapters, and other publications were stable throughout the study period. Applicants consistently provided an average of 3.6 letters of recommendation, 1.9 from cardiothoracic surgery faculty. Mean in-service score percentiles were stable at the 54th percentile, whereas US Medical Licensing Examination scores increased. CONCLUSIONS Despite expansion of the 6-year integrated pathway to cardiothoracic surgery, we have seen no substantial year-to-year changes in attributes of traditional applicants. Our findings suggest that the cardiothoracic surgery applicant pool continues to be composed of a stable group of highly productive trainees. Future initiatives in candidate selection should emphasize interview strategies to highlight aspects of grit, emotional intelligence, and team dynamics.
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Affiliation(s)
- Nathaniel Deboever
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Erin M Bayley
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Ara A Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.
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Newsome K, Selvakumar S, McKenny M, Elkbuli A. Shifting the Surgical Residency Match to a 100% Virtual Interview Format During the COVID-19 Pandemic, How has It Affected Placement Into Surgical Training Programs? Am Surg 2021:31348211047498. [PMID: 34732065 DOI: 10.1177/00031348211047498] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The AAMC transitioned to virtual interview formats for the 2020-2021 residency match. This study aims to examine the impact of the 100% virtual interview format for the 2020-2021 residency match on both application and match changes for multiple surgical specialties, including neurosurgery (NS), orthopedic surgery (OS), plastic surgery (PS), general surgery (GS), thoracic surgery (TS), and vascular surgery (VS). METHODS Cross-sectional study comparing application and match changes between the in-person 2019-2020 and virtual 2020-2021 residency match cycles for different surgical specialties. RESULTS There was an overall increase in the number of applicants for 5 of the surgery specialties but not VS, and an overall increase in the number of applications per residency program across all specialties. The average number of applications per applicant also increased, except in TS. There were no major match changes except in TS, which saw an increase in number of spots filled by MDs to nearly 100% from 84.2% in the previous cycle. CONCLUSION The switch to the 100% virtual 2020-2021 residency match interview format was associated with an overall increase in the number of applications per program and number of applications per applicant across multiple surgical specialties. There was a decrease in the number of applicants to VS and an increase in the number of applications per applicant. The switch to a virtual interview format in 2020-2021 was also associated with an increase in TS spots filled by MDs to almost 98%, increasing the already concerning TS match disparity for DO and IMG applicants.
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Affiliation(s)
- Kevin Newsome
- Department of Surgery, Division of Trauma and Surgical Critical Care, 14506Kendall Regional Medical Center, Miami, FL, USA
| | - Sruthi Selvakumar
- Department of Surgery, Division of Trauma and Surgical Critical Care, 14506Kendall Regional Medical Center, Miami, FL, USA
| | - Mark McKenny
- Department of Surgery, Division of Trauma and Surgical Critical Care, 14506Kendall Regional Medical Center, Miami, FL, USA.,Department of Surgery, University of South Florida, Tampa, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, 14506Kendall Regional Medical Center, Miami, FL, USA
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Zurcher JR, Grubb KJ. Commentary: All roads lead to Rome: General surgery still a noble path to cardiothoracic surgery. J Thorac Cardiovasc Surg 2021; 165:1751-1752. [PMID: 34602254 DOI: 10.1016/j.jtcvs.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - Kendra J Grubb
- Division of Cardiothoracic Surgery, Emory University, Atlanta, Ga.
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Constants and Currents in the Education and Training of General Thoracic Surgeons. Thorac Surg Clin 2021; 31:303-308. [PMID: 34304838 DOI: 10.1016/j.thorsurg.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Teaching multiple, evolving surgical approaches to thoracic surgical residents at a time of decreasing surgeon volume, increasing scrutiny of quality, greater demands on surgical efficiency, and reduced resident work hours requires a new mindset and new methods of education. The challenge presented to general thoracic surgeon educators and residents is explained, and encouragement is drawn from the examples of previous educational crises and their solutions.
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