Introduction of cardiac surgery residency program at an earlier stage in surgical training

Reform of the Japanese postgraduate residency program has dramatically influenced the recruitment system. Because shortage of young cardiac surgeons is anticipated, an effective program for residents who want to become cardiac surgeons must be established at an earlier stage in surgical training.

A 3-year cardiac surgery residency curriculum was developed for senior residents. The surgical training program includes harvesting of the saphenous vein, radial artery and internal thoracic artery, and repair of abdominal aortic aneurysm and specifies the target number of surgical procedures for each training. Academic training is provided in addition to clinical skills training. Nine residents completed the 3-year program between 2004 and 2012. The number of surgical procedures performed, presentations made at scientific meetings, and scientific papers published were investigated and analyzed.

Each resident participated in 438 operations during 3-year program, 25.9 ± 8.3 (5.9 %) as main operator and 182.2 ± 15.8 (42 %) as first assistant. The average number of procedures per resident over the 3 years was 43.0 ± 6.7 for saphenous vein harvest, 14.4 ± 3.9 for radial artery harvest, 27.9 ± 13.0 for internal thoracic artery harvest, 7.1 ± 4.6 for abdominal aortic aneurysm. In addition, over the 3 years, the mean number of presentations at scientific meetings was 13.2 ± 3.2 and the mean number of publication of scientific papers was 1.9 ± 1.4.

The new cardiac surgery training curriculum for residents worked fairly well. A system for assessment of the program by an authoritative body should be established in the future.