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Ann Thorac Surg 2005;80:382
© 2005 The Society of Thoracic Surgeons
Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, HA-9, Suite 135, Dallas, TX 75390
(Email: gwheat{at}parknet.pmh.org).
I read with interest the editorial by Kron and Mathisen [1] reviewing the many challenges facing cardiothoracic surgeons today and describing how those issues relate to residency training. Their valuable insights both as program directors of leading residency training programs and as educators at the national level give their remarks a degree of importance that all residents (including those involved in residency education) should carefully consider. I would like to respond to a few of their comments from the perspective of someone who has recently completed residency training in cardiothoracic surgery and is starting a career in this exciting field.
Of utmost concern among all residents is finding a job upon completion of training. Many variables factor into the complex equation of obtaining suitable employment, such as job availability or market forces, educational background, quality and breadth of technical skills, involvement with research activities, and extracurricular honors. Graduating residents have almost no influence on the market forces effecting job availability. Therefore, assistance with finding a rewarding job can be addressed at the individual resident or training program level.
Residents must be individually challenged to become even more competitive job candidates than before by directing their energies into the factors that can have the most impact. With the recent implementation of duty hour restrictions, residents have the opportunity to become increasingly involved with research projects that can lead to more peer-reviewed publications and developing specialized areas of knowledge. In addition, there is ample opportunity for residents to distinguish themselves by working with their program director to implement new educational resources into their own program’s residency curriculum. At the national level, the Thoracic Surgery Residents Association is always searching for motivated residents to assist with resident training issues.
At the same time, training programs and residents must be continually looking ahead to identify future needs of the specialty. One area of future growth appears to be catheter-based interventions. Currently, few, if any, cardiothoracic surgery training programs offer formalized training in abdominal or thoracic stent deployment, carotid stenting, or peripheral vascular interventions. Cardiothoracic surgeons need to embrace these emerging endovascular technologies in order to maintain viability of our specialty. As a result, I believe that residency training programs will soon be forced to include an endovascular training component in their curricula. The American Board of Thoracic Surgery could accelerate this process in the near future by first suggesting, and then requiring, a certain number of endovascular procedures to be included as part of the certification process. Acquiring new endovascular skills during residency, and becoming better prepared to compete with other specialties may even increase resident satisfaction with their current residency. In the meantime, residents should express interest to their program director about these new technologies and even independently seek additional training from qualified cardiothoracic or vascular surgeons, interventional radiologists, or cardiologists.
In conclusion, opportunity comes from change. Residents and training programs must use this opportunity to redefine resident education and meet the demands of the changing marketplace. The future of our specialty depends on it.
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