Cardiac Surgery Exposure in General Surgery Residency—A Survey of General Surgery Residency Program Directors

• Published in: Journal of surgical education 2023-05, Vol.80 (5), p.633-638
• Main Authors: Rabenstein, Andrew P., Santore, Lee Ann, Starnes, Sandra L., Van Haren, Robert M., Balaguer, Jorge M., Abdel-Misih, Sherif
• Format: Article
• Language: English
• Subjects: Cardiac surgery; Cardiac surgery training; Cardiac Surgical Procedures; General Surgery - education; Internship and Residency; Mentorship; Resident exposure; Specialties, Surgical - education; Surveys and Questionnaires; Thoracic Surgery - education; United States
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2023.01.007

•Resident exposure to cardiac surgery varies significantly across institutions.•Residents choose cardiac surgery more in programs with cardiac training pathways.•Residents have concerns about race, gender, and family life in cardiac surgery. Little is known regarding how much exposure general surgery residents have to cardiac surgery, despite cardiothoracic (CT) surgery being an offered postresidency fellowship and career. Exposure to a subspecialty is important in shaping residents’ interests and career decisions. A survey was sent to all general surgery program directors via the Association of Program Directors in Surgery examining cardiac surgery exposure during training. The survey examined the presence of operative rotations in cardiac surgery and cardiac critical care, portions of cases residents were permitted to perform, cardiac surgery mentorship and education, and perceived biases in applying to cardiac surgery. Differences between programs with and without cardiothoracic training programs were analyzed. In total, 44% (102/230) of program directors responded to the survey. Residents were involved in operative cardiac and cardiac ICU rotations in 61 programs (69.8%) and 39 programs (38.2%), respectively. Twenty programs (19.6%) had a dedicated cardiothoracic surgery training program and these programs had significantly more graduates who aspired to be cardiac surgeons (M = 2.75, SD = 2.47) compared to hospitals with no CT programs (M = 1.43, SD = 1.41; p = 0.031). 35.3% of program directors reported resident concern over family life. There is a notable heterogeneity in general surgery resident exposure to cardiac surgery, cardiac ICU, and cardiac surgery mentorship. Increased exposure, mentorship and mitigating resident concern over the impact of social factors on cardiac surgical careers should be key areas of focus to ensure continued encouragement of future trainees and surgeons.