Establishing an academic niche in cardiothoracic surgery: The earlier the better

Abstract

Academic cardiothoracic surgery has undergone a significant transformation over the last several decades. Although clinical demands and administrative responsibilities have increased to care for an ailing and elder patient population, the surgeon workforce continues to decline. Research funding has also progressively become more difficult to secure, whereas the research techniques have become more complex and expensive to perform. These constraints have limited the available bandwidth for surgeons to contribute to new discovery and innovation.Despite these challenges, cardiothoracic surgeons can and should still occupy a unique position at the forefront of clinical and scientific discovery. The academic cardiothoracic surgeon of the future will indeed look very different from those of our predecessors and mentors. A critical part of this transition and transformation will be acquiring the experience and training necessary to conduct innovative discovery within our field, given the modern research environment. This process requires a significant time commitment above and beyond the surgeon's clinical practice. Because of the nature of multidisciplinary teams and broad knowledge base required for scientific discovery, a well-protected opportunity to invest in research opportunities in the very early stages of surgeon development is necessary to achieve academic success. We believe developing a research niche as early as possible is a key stepping stone to building a successful career in academic cardiothoracic surgery today. EARLY MENTORED RESEARCH ENVIRONMENT IS CRITICALMost cardiothoracic surgery residents (76% according to a recent survey) plan to conduct research as a part of their career pathway in cardiothoracic surgery. 1 Importantly, that same study demonstrated that previous participation in clinical research during residency, as well as a desire for an academic practice environment, were significant predictors of a career involving research production. Surveys from academic surgical programs have shown that those graduates who requested research time during their residency training are significantly more likely to hold academic positions after completion of residency. 2 Despite this enthusiasm among residents, the skills and experiences required to transition from simply participating in a research project to becoming a primary investigator require an environment built around developing clinician-scientists with mentors who are experienced in this process. The mentored research environment for early cardiothoracic surgery trainees should involve a program that takes responsibility for guiding residents through the progression of developing an idea into a completed research project, including appropriate deliverables (manuscripts, grants, patents, and presentations as applicable). Dedicated mentored research programs have been shown in other specialties to improve both production quantity and quality in trainee research. 3 Encouraging collaboration among trainees involved in research also leads to importan...

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