Asad A Shah1, Muhammad Aftab2, Vakhtang Tchantchaleishvili3, Damien J LaPar4, Elizabeth H Stephens5, Dustin M Walters6, Walter F DeNino7, David D Odell8, Michael Robich2, Marisa Cevasco9, Amanda L Eilers10, Erin A Gillaspie11, Andrew Goldstone12, Tarek Malas13, Robert D Rice14, Ryan C Shelstad15, Nicholas D Andersen16. 1. Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: asad.shah@duke.edu. 2. Department of Surgery, Cleveland Clinic, Cleveland, Ohio. 3. Department of Surgery, University of Rochester, Rochester, New York. 4. Department of Surgery, University of Virginia, Charlottesville, Virginia. 5. Department of Surgery, Columbia University, New York, New York. 6. Department of Surgery, University of Washington, Seattle, Washington. 7. Department of Surgery, Medical University of South Carolina, Charleston, South Carolina. 8. Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. 9. Department of Surgery, Harvard University, Boston, Massachusetts. 10. Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas. 11. Department of Surgery, Mayo Clinic, Rochester, Minnesota. 12. Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. 13. Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada. 14. Department of Surgery, University of Texas, Houston, Texas. 15. Department of Surgery, University of Colorado, Aurora, Colorado. 16. Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
Abstract
BACKGROUND: The present study aimed to describe and compare the operative experience of cardiothoracic surgical residents for basic and advanced cardiac surgical procedures. METHODS: Data were obtained from the 2015 Thoracic Surgery Directors Association Survey administered to all thoracic surgical residents taking the yearly In-Service Training Examination (n = 356). Residents were asked whether they routinely served as the operative surgeon on various cardiac operations and operative tasks. Results were stratified by postgraduate year (PGY), residency type, and primary career interest. RESULTS: The survey response rate was 100%. Considering all training pathways, only 2 of 13 cardiac operations surveyed were routinely performed by graduating chief residents as the operative surgeon: coronary artery bypass grafting (CABG; 92%) and aortic valve replacement (AVR; 88%). Off-pump CABG, minimally invasive mitral valve operation, and transcatheter aortic interventions were infrequently (<30% of the time) performed by graduating residents as the operative surgeon. These results were similar when residents with a career interest in general thoracic surgery were excluded from the analysis. For the operative progression of integrated 6-year (I-6) residents, most began to routinely cannulate for cardiopulmonary bypass, perform proximal coronary anastomoses, and harvest the mammary artery during PGY3. The majority (>50%) of I-6 residents performed CABG as the operative surgeon by PGY4. CONCLUSIONS: There is pronounced heterogeneity in the cardiac operative experience of cardiothoracic surgical residents in the United States, with only CABG and AVR routinely performed by graduating residents as the operative surgeon. This heterogeneity may lead to insufficient training in certain procedures for many graduates.
BACKGROUND: The present study aimed to describe and compare the operative experience of cardiothoracic surgical residents for basic and advanced cardiac surgical procedures. METHODS: Data were obtained from the 2015 Thoracic Surgery Directors Association Survey administered to all thoracic surgical residents taking the yearly In-Service Training Examination (n = 356). Residents were asked whether they routinely served as the operative surgeon on various cardiac operations and operative tasks. Results were stratified by postgraduate year (PGY), residency type, and primary career interest. RESULTS: The survey response rate was 100%. Considering all training pathways, only 2 of 13 cardiac operations surveyed were routinely performed by graduating chief residents as the operative surgeon: coronary artery bypass grafting (CABG; 92%) and aortic valve replacement (AVR; 88%). Off-pump CABG, minimally invasive mitral valve operation, and transcatheter aortic interventions were infrequently (<30% of the time) performed by graduating residents as the operative surgeon. These results were similar when residents with a career interest in general thoracic surgery were excluded from the analysis. For the operative progression of integrated 6-year (I-6) residents, most began to routinely cannulate for cardiopulmonary bypass, perform proximal coronary anastomoses, and harvest the mammary artery during PGY3. The majority (>50%) of I-6 residents performed CABG as the operative surgeon by PGY4. CONCLUSIONS: There is pronounced heterogeneity in the cardiac operative experience of cardiothoracic surgical residents in the United States, with only CABG and AVR routinely performed by graduating residents as the operative surgeon. This heterogeneity may lead to insufficient training in certain procedures for many graduates.
Authors: William M Novick; Frank Molloy; Karen Bowtell; Brian Forsberg; Martina Pavanić; Igor Polivenok; Sri Rao; Yamile Muñoz; Marcelo Cardarelli Journal: Front Pediatr Date: 2019-09-20 Impact factor: 3.418
Authors: Alexander A Brescia; Clauden Louis; Jessica G Y Luc; Garrett N Coyan; Jason J Han; David Blitzer; Fatima G Wilder; Curtis S Bergquist; Jordan P Bloom; Rishindra M Reddy; Gurjit Sandhu; J Hunter Mehaffey Journal: JTCVS Open Date: 2022-05-13