Mara B Antonoff1, Jessica G Y Luc2, G Alexander Patterson3, Bryan F Meyers3, Ralph J Damiano3, Marc R Moon3. 1. Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: mbantonoff@mdanderson.org. 2. Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. 3. Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, Missouri.
Abstract
BACKGROUND: Recent initiatives in cardiothoracic (CT) surgery education have been aimed at early tracking, emphasizing specialization during the final years of residency. This study was performed to examine the impact of subspecialization on graduate assessment of quality of training and to identify educational gaps. METHODS: Surveys were sent to 119 surgeons who completed thoracic surgery residency at Washington University in St. Louis, Missouri between 1958 and 2017. Surveys evaluated transition-to-practice preparedness in patient care, technical skills, and qualifying and certifying examinations. A total of 78 surveys were returned complete, and 14 were returned "deceased" or "address unknown." Clinical practices included combined CT surgery (n = 22; 28%) and subspecialty cardiac (n = 28; 36%) or thoracic surgery (n = 28; 36%). Responses were quantified on five-point Likert scales. Statistical analyses compared excellent (five points) with less than excellent (one to four points). RESULTS: Graduates who practiced combined CT surgery were more likely to report excellent preparation for qualifying examinations (cardiac, 60.7% vs thoracic, 35.7% vs CT, 86.4%; p = 0.001) and certifying examinations (cardiac, 71.4% vs thoracic, 53.6% v. CT, 86.4%; p = 0.042). Compared with thoracic surgery and combined CT surgery graduates, graduates who practiced cardiac surgery were more likely to indicate excellent preparation for performing adult cardiac surgery (cardiac, 85.2% vs thoracic, 34.8% vs CT, 81.8%; p < 0.001), although they felt least prepared to perform general thoracic surgery (cardiac, 85.7% vs thoracic, 100.0% vs CT, 100.0%; p = 0.023). CONCLUSIONS: Graduates with combined CT surgery practices self-reported greater examination preparation and technical training compared with graduates who subspecialized in cardiac or thoracic surgery. Subspecialization led to perceived deficiencies among graduates in nonspecialty areas. This should be considered when developing new CT residency training paradigms.
BACKGROUND: Recent initiatives in cardiothoracic (CT) surgery education have been aimed at early tracking, emphasizing specialization during the final years of residency. This study was performed to examine the impact of subspecialization on graduate assessment of quality of training and to identify educational gaps. METHODS: Surveys were sent to 119 surgeons who completed thoracic surgery residency at Washington University in St. Louis, Missouri between 1958 and 2017. Surveys evaluated transition-to-practice preparedness in patient care, technical skills, and qualifying and certifying examinations. A total of 78 surveys were returned complete, and 14 were returned "deceased" or "address unknown." Clinical practices included combined CT surgery (n = 22; 28%) and subspecialty cardiac (n = 28; 36%) or thoracic surgery (n = 28; 36%). Responses were quantified on five-point Likert scales. Statistical analyses compared excellent (five points) with less than excellent (one to four points). RESULTS: Graduates who practiced combined CT surgery were more likely to report excellent preparation for qualifying examinations (cardiac, 60.7% vs thoracic, 35.7% vs CT, 86.4%; p = 0.001) and certifying examinations (cardiac, 71.4% vs thoracic, 53.6% v. CT, 86.4%; p = 0.042). Compared with thoracic surgery and combined CT surgery graduates, graduates who practiced cardiac surgery were more likely to indicate excellent preparation for performing adult cardiac surgery (cardiac, 85.2% vs thoracic, 34.8% vs CT, 81.8%; p < 0.001), although they felt least prepared to perform general thoracic surgery (cardiac, 85.7% vs thoracic, 100.0% vs CT, 100.0%; p = 0.023). CONCLUSIONS: Graduates with combined CT surgery practices self-reported greater examination preparation and technical training compared with graduates who subspecialized in cardiac or thoracic surgery. Subspecialization led to perceived deficiencies among graduates in nonspecialty areas. This should be considered when developing new CT residency training paradigms.
Authors: Rui J Cerqueira; Samuel Heuts; Can Gollmann-Tepeköylü; Simo O Syrjälä; Marlies Keijzers; Alicja Zientara; Omar A Jarral; Kirolos A Jacob; Josephina Haunschild; Priyadharshanan Ariyaratnam; Andras P Durko; Patrick Muller; Patrick O Myers; Justo Rafael Sadaba; Miia L Lehtinen Journal: Interact Cardiovasc Thorac Surg Date: 2021-01-22
Authors: Amy G Fiedler; Dominic Emerson; Erin A Gillaspie; Joshua L Hermsen; Melissa M Levack; Daniel P McCarthy; Smita Sihag; Stephanie G Worrell; Mara B Antonoff Journal: JTCVS Open Date: 2020-07-25