A personal experience of 2-year general thoracic surgery training programs in Japan and the United States.

OBJECTIVES: The objective of the study is to review and compare two countries' thoracic surgery training programs.
METHODS: Retrospective review of the first author's prospectively maintained operative case logs in two countries was performed. Each training program was established in a teaching hospital for its country's board requirement. Preoperative diagnosis, operative procedures and postoperative diagnosis were reviewed. The case volume (overall and in each category) was also reviewed. The ratio of each category and overall case volume was compared between the two programs by Chi-square test. p value was considered significant if it is <0.05.
RESULTS: The overall case volumes were 169 cases in the Japanese institution and 456 cases in the United States' institution. The number ratio of each category's procedures and overall procedures was as follows: pleural cases, Japan 19.2 % versus the Unites States 20.6 % (p = 0.782), pulmonary cases, Japan 72.7 % versus the United States 36.8 % (p < 0.0001), mediastinal cases, Japan 8.1 % versus the United States 8.6 % (p = 0.678), diaphragm cases, Japan 0.62 % versus the United States 13.2 % (p = 0.0001), chest wall cases, Japan 1.2 % versus the United States 3.5 % (p = 0.0858), tracheobronchial cases, Japan 1.2 % versus the United States 1.8 % (p = 0.583). Regarding the approach, the ratios of each approach and overall cases are as follows: minimally invasive approach, Japan 78.3 % versus the United States 45.8 % (p < 0.0001), reoperative cases, Japan 0.62 % versus the United States 3.1 % (p = 0.0411).
CONCLUSIONS: Case variety is different between the two countries. Our findings suggest that thoracic surgery training in the United States may be beneficial for Japanese medical graduates.