The ACGME Fellowship in Congenital Cardiac Surgery: The Graduates' Perspective

Area of Science:

• Cardiovascular Surgery
• Surgical Education
• Medical Training

Background:

• Structured fellowship programs have enhanced congenital heart surgery (CHS) training in the US.
• However, significant challenges persist in the transition from fellowship to independent clinical practice.
• A lack of senior mentorship is a critical issue for new CHS graduates.

Purpose of the Study:

• To assess the preparedness and challenges faced by graduates of accredited congenital heart surgery fellowship programs.
• To identify areas for improvement in surgical training and the transition to practice.
• To propose solutions for enhancing the success of congenital heart surgeons.

Main Methods:

• A survey was distributed to all graduates of accredited CHS programs in the United States.
• Response rate was 69% (35 out of 51 graduates).
• Survey data analyzed to evaluate preparedness, mentorship, and transition experiences.

Main Results:

• 91% of practicing graduates (31/34) did not feel ready for solo CHS practice post-fellowship.
• 97% (33/34) deemed mentorship crucial in early practice years, yet nearly 40% reported inadequate mentorship.
• Many graduates remain assistants, lacking independence years after training completion.

Conclusions:

• Current CHS fellowship training requires enhancement to ensure graduates are fully prepared for independent practice.
• A significant gap exists in mentorship and a smooth transition from fellowship to clinical practice.
• A 1-2 year transitional junior faculty period is proposed to improve surgeon readiness and outcomes.