Changes in Thoracic Surgery Experience During General Surgery Residency: A Review of the Case Logs From the Accreditation Council for Graduate Medical Education

Ragalie, William S.; Termuhlen, Paula M.; Little, Alex G.

doi:10.1016/j.athoracsur.2016.06.058

Cited by 16 publications

(6 citation statements)

References 17 publications

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“…However, given the projected workforce shortage in cardiothoracic surgery, a significant focus has been placed on recruiting bright medical school and general surgery applicants through mentorship and programs to increase exposure (33,34). This is especially necessary given that operative cardiothoracic surgery experience has declined within general surgery residencies (35). Though continuing to increase the number of training positions would help address the workforce shortage, an emphasis also must be placed on attrition within the field.…”

Section: Thoracic Surgery Training In the Usmentioning

confidence: 99%

A brief overview of thoracic surgery in the United States

Byrd¹,

Williams²,

Backhus³

2022

J Thorac Dis

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The 331 million people of the United States are served by a complex and expensive healthcare system that accounts for nearly 18% of the country's gross domestic product. Over 90% of patients are insured by private or government-funded plans, but despite high coverage and unusually high healthcare spending, vast disparities exist within the United States population based on demographics in terms of diagnosis, treatment, and outcomes of disease. Thoracic surgeons in the United States are trained to treat patients with diseases of the chest in the operative and perioperative settings, and can accomplish this training through multiple highly competitive pathways. Thoracic surgeons perform an average of 135 operations each per year which address diseases of the lungs, trachea, esophagus, chest wall, mediastinum, and diaphragm.Video assisted thoracoscopic surgeries are the most commonly performed procedures, which are primarily completed to treat lung cancer. Lung cancer is the deadliest and second most prevalent malignancy in the United States, with over 200,000 new cases expected this year. In addition to encouragement of smoking cessation and more attention to air pollutants, increased access to lung cancer screening has significantly expedited diagnosis and reduced mortality from lung cancer in the last several years. Thoracic surgeons in the United States are tasked with treating common yet highly morbid diseases of the chest in a patient population that is diverse in terms of race, socioeconomic status, and healthcare insurance coverage. As the population ages and a shortage of thoracic surgeons looms, the importance of early diagnosis, skillful surgical management, and attention to the disparities that exist in our system cannot be overstated.

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Section: Thoracic Surgery Training In the Usmentioning

confidence: 99%

A brief overview of thoracic surgery in the United States

Byrd¹,

Williams²,

Backhus³

2022

J Thorac Dis

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“…Prior studies have demonstrated this same trend in general surgery education and for the field of surgery more broadly. 6,19,20,[23][24][25][26] The increasing predominance of minimally invasive surgery in all surgical fields has changed the landscape of how surgery is performed and taught. Younger generations of surgeons will become increasingly proficient in minimally invasive surgery as they perform more of those procedures during training.…”

Section: Discussionmentioning

confidence: 99%

“…There was no significant difference in thoracic vascular surgery experience between Era 1 (.14 ± .12) and Era 4 (.24 ± .04) (P = . 19). Similarly, no trend was seen across time via Mann-Kendall (P = 1).…”

Section: Vascularmentioning

confidence: 99%

Trends in Comprehensive Thoracic Case Experience Among General Surgery Residents in the Modern Integrated Cardiothoracic Residency Era: Review of Twenty Years of Resident Case Logs

Blitzer

Benintende

Nemeth

et al. 2023

The American Surgeon™

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Background Thoracic surgery training among general surgery residents in the United States is regulated by the Accreditation Council for Graduate Medical Education (ACGME) to ensure exposure to subspecialty fields during residency. Thoracic surgery training has changed over time with the placement of work hour restrictions, the emphasis on minimally invasive surgery, and increased subspecialization of training like integrated six-year cardiothoracic surgery programs. We aim to investigate how these changes over the past twenty years have affected thoracic surgery training among general surgery residents. Methods ACGME general surgery resident case logs from 1999 to 2019 were reviewed. Data included exposure to the thorax via thoracic, cardiac, vascular, pediatric, trauma, and alimentary tract procedures. Cases from the above categories were consolidated to determine the comprehensive experience. Descriptive statistics were performed over four 5-year Eras (Era 1:1999-2004, Era 2: 2004-2009, Era 3: 2009-2014, Era 4: 2014-2019). Results Between Era 1 and Era 4, there was an increase in thoracic surgery experience (37.6 ± 1.03 vs 39.3 ± .64; P = .006). The mean total thoracic experience for thoracoscopic, open, and cardiac procedures was 12.89 ± 3.76, 20.09 ± 2.33, and 4.98 ± 1.28, respectively. There was a difference between Era 1 and Era 4 in thoracoscopic (8.78 ± .961 vs 17.18 ± .75; P < .001) and open thoracic experience (22 ± .97 vs 17.06 ± .88; P < .001), and a decrease in thoracic trauma procedures (3.7 ± .06 vs 3.2 ± .32; P = .03). Discussion Over twenty years there has been a similar, to slight increase in thoracic surgery exposure among general surgery residents. The changes seen in thoracic surgery training reflect the overall movement of surgery towards minimally invasive surgery.

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“…This could be due to a lack of resident interest or perceived insufficient technical skills due to decreasing exposure. 8 In this context, it is essential to find alternatives to increase or maintain general surgery resident physicians’ exposure to cardiothoracic surgery aside from the early exposure in medical school.…”

mentioning

confidence: 99%

Cardiac surgical simulation program during general surgery residency increases resident physician exposure to cardiac surgery and technical expertise

et al. 2022

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Changes in Thoracic Surgery Experience During General Surgery Residency: A Review of the Case Logs From the Accreditation Council for Graduate Medical Education

Abstract: Whereas total thoracic volumes on the whole have not changed significantly, resident participation as a first assistant and in key thoracic cases has decreased over the last 11 years, while participation in VATS and minor cases has increased.

Cited by 16 publications

References 17 publications

A brief overview of thoracic surgery in the United States

A brief overview of thoracic surgery in the United States

Trends in Comprehensive Thoracic Case Experience Among General Surgery Residents in the Modern Integrated Cardiothoracic Residency Era: Review of Twenty Years of Resident Case Logs

Cardiac surgical simulation program during general surgery residency increases resident physician exposure to cardiac surgery and technical expertise

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