1
|
Flemming M, Huo B, Keefe B, Wang S, Hodgson D, Horné D, Moeller A, de Waard D. Medical Student Career Perceptions of Cardiac Surgery and Cardiology. Can J Cardiol 2023; 39:1991-1994. [PMID: 37802149 DOI: 10.1016/j.cjca.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/19/2023] [Accepted: 09/10/2023] [Indexed: 10/08/2023] Open
Affiliation(s)
- Maggie Flemming
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Bright Huo
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Benjamin Keefe
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sean Wang
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David Hodgson
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David Horné
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrew Moeller
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Dominique de Waard
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Abdulrahman OA, Baaqeel RG, Alotaibi NF, Althebeti RR, Bahakeem RF, Tukruni OA, Babgi MF, Serafi AS. Knowledge and Perception of Cardiac Surgery Among Medical Students in the Western Region of Saudi Arabia. Cureus 2023; 15:e38605. [PMID: 37284372 PMCID: PMC10239667 DOI: 10.7759/cureus.38605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction Medical undergraduates' educational programs and clinical experiences are important factors in determining their preferred future career path. Unfortunately, the cardiac surgery specialty is experiencing a decline in medical graduates due to many influencing factors as a lack of involvement with the cardiac surgery specialty and a lack of training centers. A detailed evaluation of the student's knowledge and perceptions about cardiac surgery is required to assess the career options in a specialty like cardiac surgery. This study aims to evaluate medical students' knowledge and perceptions of the cardiac surgical specialty. Methodology This is a cross-sectional study that was approved by the institutional research board of Umm Al-Qura University. Adapting a previously published questionnaire data to fit our scope and aims. Necessary adjustments were made adhering to the cardiac surgery experts' instructions. Data was collected through an electronic survey by Google Forms and distributed through social media apps. Results A total of 637 students participated in the study. The majority (75.2%) admitted to having little knowledge of the specialty of cardiac surgery, and 62.8% reported no interest in it. In addition, 88.9% had never done a cardiac surgery rotation before. One of the top concerns of becoming a cardiac surgeon (45.2%) was the amount of time spent studying and working. Conclusion The findings of our study highlight the value of using innovative and targeted learning methods for medical students to enhance their knowledge and pique their interest in cardiac surgery since it was evident that there was a misperception regarding the scope of cases dealt with by cardiac surgery as opposed to other surgical subspecialists.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Abdulhalim S Serafi
- Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah, SAU
| |
Collapse
|
4
|
Cubas WS. Building and training a low-cost and portable vascular anastomosis simulator: Initial experience of a surgical resident. CIRUGIA CARDIOVASCULAR 2021. [DOI: 10.1016/j.circv.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
5
|
Cáceres-Farfán L, Moreno-Loaiza M, Cubas WS. Ankle-brachial index: more than a diagnostic test? ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2021; 2:254-262. [PMID: 37727667 PMCID: PMC10506545 DOI: 10.47487/apcyccv.v2i4.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/20/2021] [Indexed: 09/21/2023]
Abstract
The ankle-brachial index (ABI) is the relationship between the systolic blood pressure taken at the ankle level and the brachial artery. A pathological ABI (<0.90 or >1.40) indicates the presence of peripheral artery disease (PAD). Many studies indicate the great utility of this test in the diagnosis of PAD due to its ease of use, reproducibility, low cost, and high cost-effectiveness. This evaluation can be directly correlated with cardiovascular morbidity and mortality; however, it has recently been confirmed that a low ABI can be a predictor of major cardiovascular events, as it is related to diabetes mellitus, chronic coronary disease, stroke, and more. The objective of this work was to review the current evidence on the importance of ABI in the diagnosis of PAD and its main role as a predictor of cardiovascular morbidity and mortality.
Collapse
Affiliation(s)
- Ludwig Cáceres-Farfán
- Service of Vascular and Endovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Edgardo Rebagliati Martins National Hospital, Lima, Peru. Service of Vascular and Endovascular Surgery Department of Thoracic and Cardiovascular Surgery Edgardo Rebagliati Martins National Hospital Lima Peru
| | - Milagros Moreno-Loaiza
- Service of Vascular and Endovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Edgardo Rebagliati Martins National Hospital, Lima, Peru. Service of Vascular and Endovascular Surgery Department of Thoracic and Cardiovascular Surgery Edgardo Rebagliati Martins National Hospital Lima Peru
| | - W Samir Cubas
- Service of Vascular and Endovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Edgardo Rebagliati Martins National Hospital, Lima, Peru. Service of Vascular and Endovascular Surgery Department of Thoracic and Cardiovascular Surgery Edgardo Rebagliati Martins National Hospital Lima Peru
| |
Collapse
|
6
|
Doreille A, Vilaine E, Belenfant X, Tabbi W, Massy Z, Corruble E, Basse O, Luque Y, Rondeau E, Benhamou D, François H. Can empathy be taught? A cross-sectional survey assessing training to deliver the diagnosis of end stage renal disease. PLoS One 2021; 16:e0249956. [PMID: 34495963 PMCID: PMC8425537 DOI: 10.1371/journal.pone.0249956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/26/2021] [Indexed: 12/30/2022] Open
Abstract
Background Receiving the diagnosis of kidney failure has a major impact on patients. Yet, the way in which this diagnosis should be delivered is not formally taught within our medical curriculum. To fill this gap we set up a training course of kidney failure diagnosis delivery for nephrology trainees since 2016. This study assessed the effectiveness of this educational intervention. Methods The primary outcome was change in the empathy score immediately after the training session and several months afterward, based on the Jefferson Scale of Physician Empathy (JSPE). Self-reported change in clinical practice was also evaluated. As control groups, we assessed empathy levels in untrained nephrology trainees (n = 26) and senior nephrologists (n = 71). Later on (>6 months) we evaluated participants’ perception of changes in their clinical practice due to the training. Results Six training sessions permitted to train 46 trainees. Most respondents (76%) considered the training to have a durable effect on their clinical practice. Average empathy scores were not significantly different in pre-trained trainees (average JSPE: 103.7 ± 11.4), untrained trainees (102.8 ± 16.4; P = 0.81) and senior nephrologists (107.2 ± 13.6; P = 0.15). Participants’ empathy score significantly improved after the training session (112.8 ± 13.9; P = 0.003). This improvement was sustained several months afterwards (average JSPE 110.5 ± 10.8; P = 0.04). Conclusion A single 4-hour training session can have long lasting impact on empathy and clinical practice of participants. Willingness to listen, empathy and kindness are thought to be innate and instinctive skills, but they can be acquired and should be taught.
Collapse
Affiliation(s)
- Alice Doreille
- Department of Nephrology and Transplantation, Hôpital Tenon, AP-HP, Paris, France
| | - Eve Vilaine
- Department of Nephrology, CHU Ambroise Paré, AP-HP, Paris, France
| | - Xavier Belenfant
- Department of Nephrology, CHI André Grégoire, Montreuil, France
- Réseau de Néphrologie d’Ile de France (Rénif), Paris, France
| | - Wided Tabbi
- Department of Nephrology, CHI André Grégoire, Montreuil, France
| | - Ziad Massy
- Department of Nephrology, CHU Ambroise Paré, AP-HP, Paris, France
- Centre for Research in Epidemiology and Population Health (CESP), UMRS 1018, team 5, UVSQ, University Paris Saclay, Villejuif, France
| | | | - Odile Basse
- Association France Rein Ile de France, Paris, France
| | - Yosu Luque
- Department of Nephrology and Transplantation, Hôpital Tenon, AP-HP, Paris, France
- Sorbonne Université, UMR_S1155, Paris, France
| | - Eric Rondeau
- Department of Nephrology and Transplantation, Hôpital Tenon, AP-HP, Paris, France
- Sorbonne Université, UMR_S1155, Paris, France
| | - Dan Benhamou
- Department of Anesthesiology, Hôpital Bicêtre, AP-HP, Kremlin Bicêtre, France
- LabForSIMS Simulation Center, Paris Sud University, Kremlin Bicêtre, France
| | - Helene François
- Department of Nephrology and Transplantation, Hôpital Tenon, AP-HP, Paris, France
- Sorbonne Université, UMR_S1155, Paris, France
- LabForSIMS Simulation Center, Paris Sud University, Kremlin Bicêtre, France
- * E-mail:
| |
Collapse
|
7
|
DuCoin C, Zuercher H, McChesney SL, Korndorffer JR. Peer Assessment in Medical Student Education: A Study of Feasibility, Benefit, and Worth. Am Surg 2021; 88:2361-2367. [PMID: 33870753 DOI: 10.1177/00031348211011096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Direct experience with medical procedures is an important component of medical school training, yet opportunities for medical students have dwindled for various reasons. To offset this, simulated procedures are being integrated into training. However, this comes with additional time commitments required of teaching surgeons regarding assessment of simulation. A solution to this could be peer assessment. We hypothesize that there will be no significant difference between peer assessment when compared to that of a teaching surgeon. METHODS Third-year medical students were shown 3 simulated procedures by teaching surgeon and provided a grading rubric. Student performances were independently graded by peer assessment and by teaching surgeons. All peer assessment grades and surgeon grades were compared. RESULTS Four hundred fifty-nine medical students completed the simulation procedures. Comparisons between the teaching surgeons and peer assessment evaluations demonstrated a 99% interobserver agreement for pass-fail designation and 98% agreement for individual data points (kappa = .78). Survey results demonstrated a significant increase in confidence in performing the tested items and comfort with peer assessment. DISCUSSION This analysis demonstrates that the inclusion of peer assessment within medical school is highly comparable to teaching surgeon assessments.
Collapse
Affiliation(s)
- Christopher DuCoin
- Department of General Surgery, Morsani College of Medicine, 7831University of South Florida, Tampa, FL, USA
| | - Hannah Zuercher
- Undergraduate Medical Education, Morsani College of Medical Education, 7831University of South Florida, Tampa, FL, USA
| | - Shannon L McChesney
- Department of Surgery, 12327Vanderbilt University School of Medicine, Nashville, TN, USA
| | | |
Collapse
|
8
|
Aranda-Michel E, Arnaoutakis G, Kilic A, Bavaria J, Szeto WY, Yousef S, Navid W, Serna-Gallegos D, Sultan I. Thoracic Surgery Foundation Research Awards: Leading the Way to Excellence. Ann Thorac Surg 2021; 113:1015-1020. [PMID: 33882294 DOI: 10.1016/j.athoracsur.2021.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Combining clinical and research excellence has become an increasingly difficult endeavor for thoracic surgeons, with typical success rates for the NHLBI and NCI being 25.1% and 11.3% respectively. The Thoracic Surgery Foundation (TSF), which is an arm of the Society of Thoracic Surgeons, provides research awards and grants aimed at early career faculty to assist in securing federal peer reviewed funding. The aim of this study was to assess the impact of these awards. METHODS Faculty awardees of the TSF research awards from 1995 to 2019 were included in the study. The scholarly work of awardees was assessed using SCOPUS , MEDLINE, and google scholar for publications, citations and h-index. NIH RePorter and federal RePorter was used to search for any grants awarded to these individuals. For publications and citations associated with a TSF grant, a four-year window from the time of the research award was utilized. RESULTS Fifty-two research awards were given to early career faculty during this study period, 8 (15%) were awarded to MD PhDs. Six (12%) of awardees were female. Cardiac faculty were awarded 27 (52%) of awards and general thoracic faculty were awarded 25 (48%); of the cardiac faculty, 4 (17.4%) were congenital cardiac faculty. In the 4-year period following the TSF grant award, the mean number of published articles per awardee was 23 (interquartile range (IQR) 12-36) with a median citation count of 147 (IQR 32-327). The current median h-index was 26 (IQR 15-36) with 2,323 (IQR 1,173-4,568) median citations. Forty-eight percent of all awardees received at least 1 subsequent grant grant, with 40.4% being awarded from the NIH and25% having two or more NIH grants. Comparing academic position at the time of the award to current position, 54% of awardees had an advancement in their professional rank. On analyzing leadership positions, 42% of awardees were division chiefs, 21% were associate clinical directors, and 28% were clinical directors. CONCLUSIONS Being a recipient of the TSF award may position an individual to excel in academic medicine, with a large portion of awardees improving their academic standing with time. The rate of successful NIH grant funding after being a TSF awardee is higher than typical institutional success rates.
Collapse
|
9
|
Kimura T, Kojo K, Shiga M, Chihara I, Ikeda A, Kandori S, Kojima T, Haruta J, Nishiyama H. Impact of Early Exposure to Simulation Program on Undergraduate Medical Students' Interest in Urology. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211020750. [PMID: 34159260 PMCID: PMC8186111 DOI: 10.1177/23821205211020750] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/04/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Urological education is as important as surgical training for undergraduates. However, students in undergraduate medical schools have less exposure to urology as their curriculum focuses more on clinical skills, particularly community-based healthcare for a super-aging society. This study aimed to evaluate whether urology-related hands-on training could increase the interest of undergraduate medical students in urology. METHODS A 1-day elective program in urological surgery at the University of Tsukuba, particularly in robotic, laparoscopic, and endoscopic surgeries, was offered to 85 fourth-year medical students from 2018 to 2020, prior to their clinical clerkship. The average age of the participants was 22 (range: 21-25) years. We used a scoring system that comprised 1-5 Likert-type items to assess training activity, interest in surgery, and interest in urology before and after the course. RESULTS Before attending the program, the average scores of interest in urology were 3.53 in 2018, 3.15 in 2019, and 3.00 in 2020. The scores in surgery increased after the program; however, this was not significantly different from scores prior to the program. However, the average interest scores in urology were significantly increased to 3.91 ± 0.63 (P < .05), 3.88 ± 0.58 (P < .01), and 4.00 ± 0.61 (P < 0.01) in 2018, 2019, and 2020, respectively. Total likely scores of this program in 2018, 2019, and 2020 were 4.59, 4.76, and 4.88, respectively, indicating a motivation to study surgery and urology during clinical clerkship. CONCLUSIONS Urological hands-on training facilitated interest in urology in medical students prior to their clinical clerkship.
Collapse
Affiliation(s)
- Tomokazu Kimura
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
- Center of Planning and Coordination for Medical Education, School of Medicine, University of Tsukuba, Japan
| | - Kosuke Kojo
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| | - Masanobu Shiga
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| | - Ichiro Chihara
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| | - Atsushi Ikeda
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| | - Shuya Kandori
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| | - Takahiro Kojima
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| | - Junji Haruta
- Center of Planning and Coordination for Medical Education, School of Medicine, University of Tsukuba, Japan
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Japan
| |
Collapse
|
10
|
Gender Differences in Cardiothoracic Surgery Interest Among General Surgery Applicants. Ann Thorac Surg 2020; 112:961-967. [PMID: 33127402 DOI: 10.1016/j.athoracsur.2020.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although the overall gender gap in medicine is narrowing, significant gender disparities remain in the cardiothoracic surgery (CTS) field; women represent only 7% of practicing surgeons and 20% of residents. The purpose of this study was to identify gender differences in CTS exposure and interest among fourth year medical students applying to general surgery residency. METHODS An anonymous survey was emailed to general surgery residency applicants at a major academic program for the 2019 and 2020 application cycles. Data were stratified by gender and analyzed using the χ2 and t tests. RESULTS Of the 303 responders to the survey, 44% were women. A total of 58% of women were unlikely to be interested in or were definitely not interested in pursuing a career in CTS compared with 35% of men (P < .05). Men were 2.5 times more likely than women to be interested in CTS (odds ratio, 2.5; 95% confidence interval, 1.5 to 4.1). More men had rotated through CTS (55% vs 44%; P = .04) and shadowed a cardiothoracic surgeon (41% vs 29%; P = .03). More than 30% of women interested in CTS reported mentorship as the most important factor in their decision. Mentorship and CTS rotations were both independently associated with CTS interest after adjusting for gender. CONCLUSIONS Interest in CTS is disappointingly low among women and represents a troublesome disparity that must be addressed. Early exposure to CTS and more mentorship from cardiothoracic surgeons are critical to reverse the current trend. Further studies are necessary to determine factors limiting female exposure to CTS rotations and dissuading female applicants from pursuing careers in CTS.
Collapse
|
11
|
Kilcoyne MF, Do-Nguyen CC, Han JJ, Coyan GN, Sultan I, Roberts MB, Carpenter AJ. Clinical Exposure to Cardiothoracic Surgery for Medical Students and General Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2020; 77:1646-1653. [PMID: 32522562 DOI: 10.1016/j.jsurg.2020.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The introduction of integrated 6-year cardiothoracic surgery (CTS) residency programs has shifted recruitment efforts to encompass not only general surgery (GS) residents, but also medical students. OBJECTIVE The aim of this paper is to assess medical student and GS resident clinical exposure to CTS. DESIGN Data from the Association of American Medical Colleges Visiting Student Application Service and the Accreditation Council for Graduate Medical Education Case Log Reports were collected from 2010 to 2017 and 2010 to 2018, respectively. The data extracted included medical students who applied and received an offer for elective rotations and the cases performed as a GS resident. RESULTS A mean of 95 ± 28.5 medical students applied for CTS rotations annually and the applicants for CTS rotations increased by an average of 11.8% per year. However, significantly less students received an offer compared to other specialties (53.4% CTS vs 74.1% GS, 79.3% plastic surgery, 86.3% urology, 85.7% otolaryngology, 88.6% neurological surgery, and 89.6% orthopedic surgery) (p < 0.001). GS residents performed a mean of 39.3 ± 0.8 CTS procedures during residency: 32.9 ± 1.0 performed as a junior resident and 6.3 ± 0.7 as a chief resident. Out of all CTS procedures, 7.3% were cardiac procedures, with rates increasing from 5.6% to 8.4% during the study period (p = 0.001). CONCLUSIONS Elective rotation opportunities in CTS are high in demand for medical students while GS residents receive limited CTS exposure, especially cardiac cases. Increasing clinical opportunities in both groups will aid in recruiting young talent to the field.
Collapse
Affiliation(s)
- Maxwell F Kilcoyne
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.
| | - Chi Chi Do-Nguyen
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Jason J Han
- Department of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ibrahim Sultan
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Michael B Roberts
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Andrea J Carpenter
- Department of Cardiothoracic Surgery, University of Texas Health San Antonio, San Antonio, Texas
| |
Collapse
|
12
|
Impact of a Surgical Subspecialty Roundtable on Career Perception for Preclerkship Medical Students. J Surg Res 2020; 259:493-499. [PMID: 33070996 DOI: 10.1016/j.jss.2020.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Limited exposure to surgical subspecialties during medical school may be responsible for decreasing medical student interest in surgery. Although most medical schools have surgery interest groups to increase exposure, our aim was to evaluate the impact of a focused surgical subspecialty roundtable on preclerkship students' perceptions of surgical careers. METHODS Faculty members from each surgical subspecialty shared their experiences and led roundtable discussions with five to seven first- and second-year medical students at a time (total n = 59). Pre-event and post-event surveys were administered to assess students' interest in surgery, knowledge of training paths, values related to specialty selection, and perception of surgeons. RESULTS Forty students completed pre-event and post-event surveys. The number of students who were extremely or very interested in surgery increased after this event (65% versus 72.5%, P < 0.001). The greatest number of students indicated an interest in orthopedic surgery, and the fewest indicated an interest in neurosurgery. After the event, thirteen (32.5%) students changed their preferences for the subspecialty in which they were most interested. Students demonstrated improved knowledge of training length and integrated residencies (83.8% versus 96.3%, P = 0.003). The perceived importance of intellectual challenge, research opportunities, and training length decreased, whereas the importance of compensation, work/life balance, long-term patient follow-up, and the job market increased. Students' perceptions of surgeons' work/life balance (10% versus 25%, P < 0.001) and ability to be team players (82.5% versus 85%, P = 0.01) improved significantly after the roundtable. CONCLUSIONS The surgical specialty roundtable increased students' interest in surgery, improved knowledge of training paths, and altered perceptions related to career decision-making.
Collapse
|
13
|
Okusanya O, Bartow A, Aranda-Michel E, Kinnunen A, Schuchert M, Kilic A, Sanchez P, Dhupar R, Luketich J, Sultan I. Resident perception of standardization and credentialing for high-risk bedside procedures in cardiothoracic surgery: Results from an institutional pilot study. J Card Surg 2020; 35:2902-2907. [PMID: 32906194 DOI: 10.1111/jocs.15007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Though clear-guidelines are set by the American Board of Thoracic Surgery (ABTS) for the operative cases that cardiothoracic surgery residents must perform to be board-eligible, no such recommendations exist to assess competency for the wide range of high-risk bedside procedures. Our department created and implemented a multidisciplinary course designed to standardize common high-risk bedside procedures and credential our trainees. The aim of this study was to survey the attitudes of residents towards and query the efficacy of such a course. METHODS The course was designed with the goal of standardizing endotracheal intubation, arterial line insertion (radial and femoral), central venous line insertion, pigtail tube thoracostomy, thoracentesis and nasogastric tube placement. The course consisted of an online module followed by a 4-hour hands-on simulation session. Knowledge-based pre- and post-evaluations were administered as well as a Likert-based survey regarding multiple aspects of the residents' perceptions of the course and the procedures. RESULTS Twenty-three (7 traditional and 16 integrated) cardiothoracic surgical residents participated in the course. Residents reported that 48% of the time, bedside procedures were historically taught by other trainees rather than by faculty. All residents endorsed increased standardization of all procedures after the course. Likewise, residents showed increased confidence in all procedures except for pigtail tube thoracostomy, thoracentesis as well as nasogastric tube placement. 43.5% of the participants demonstrated improvement in the pretest and posttest knowledge-based evaluations. CONCLUSION Cardiothoracic residents have favorable attitudes towards standardization and credentialing for high-risk bedside procedures and utilizing such courses may help standardize procedural techniques.
Collapse
Affiliation(s)
- Olugbenga Okusanya
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alexandrea Bartow
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Edgar Aranda-Michel
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Angela Kinnunen
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Matthew Schuchert
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Arman Kilic
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Pablo Sanchez
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rajeev Dhupar
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James Luketich
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ibrahim Sultan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
14
|
Coyan GN, Sultan I. Reply from authors: Increasing medical student interest in cardiothoracic surgery: Exposure matters. J Thorac Cardiovasc Surg 2020; 161:e318. [PMID: 32682586 DOI: 10.1016/j.jtcvs.2020.06.061] [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: 06/10/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Ibrahim Sultan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| |
Collapse
|
15
|
Coyan GN, Aranda-Michel E, Luketich JD, Kilic A, Okusanya O, Schuchert M, Gleason TG, Carey C, Kinnunen A, Sultan I. Thoracic Surgery In-Training Exam Predicts Written But Not Oral Board Pass Rates: A 15-Year Single-Center Analysis. Semin Thorac Cardiovasc Surg 2020; 33:121-127. [PMID: 32569649 DOI: 10.1053/j.semtcvs.2020.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 11/11/2022]
Abstract
The purpose of the Thoracic Surgery Director's Association In-Training Exam (ITE) is to gauge competency and progression of thoracic surgery residents and to prepare residents for the American Board of Thoracic Surgery (ABTS) examinations. We sought to identify the relationship between traditional resident ITE scores and success at passing the written or oral portion of the ABTS examinations. ITE and ABTS examination records from 2003 to 2019 were examined for all 2-year traditional cardiothoracic surgery residents at a single institution. Paired t tests were carried out between residents on their first- and second-year ITE. Bivariate logistic regression was performed on each of the second ITE component with written or oral board passing rate as the outcome of interest. Sixty residents completed training and took both written and oral boards. First attempt board pass rates were 90% for written and 75% for oral board examination. There was a significant improvement in test scores for each resident between the first the second ITE (P< 0.001 for all scores). Both increasing overall raw (odds ratio 1.26, P = 0.022) and scaled (odds ratio 1.08, P = 0.006) ITE scores were associated with passing the written boards on first attempt. There were no associations identified for oral board passing rates. Traditional residents improved ITE scores from first to second attempt. Increasing ITE scores were associated with improved written but not oral ABTS component pass rates. The ITE serves prepare residents for the ABTS qualifying (written) exam and assists programs with gauging resident readiness for taking this exam.
Collapse
Affiliation(s)
- Garrett N Coyan
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Edgar Aranda-Michel
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James D Luketich
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Arman Kilic
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Olugbenga Okusanya
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Matthew Schuchert
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thomas G Gleason
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Christine Carey
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Angela Kinnunen
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ibrahim Sultan
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| |
Collapse
|
16
|
Coyan GN, Sultan I. Reply from the authors: Commonalities in perspectives in cardiothoracic surgery across the pond. J Thorac Cardiovasc Surg 2019; 159:e132-e133. [PMID: 31630844 DOI: 10.1016/j.jtcvs.2019.08.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Ibrahim Sultan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| |
Collapse
|