Securing the future: Financial ties of thoracic surgery program directors to industry

Thoracic surgery program directors (PDs) are key mentors for the next generation of cardiothoracic surgeons and surgeon-scientists. This study evaluates the industry payments to PDs compared to other practicing thoracic surgeons, with the aim of assessing potential conflicts of interest and their influence.

PDs were identified using the Electronic Residency Application System (ERAS) and their National Provider Identifiers (NPIs). Industry payments from 2015 to 2021 were extracted from the OpenPayments (cms.gov) database. We analyzed the number and types of payments, including consulting fees, speaking engagements, and research-related contributions. Payments were compared by PD characteristics, such as gender, specialty, and academic metrics, using the χ² test and Kruskal-Wallis test.

All 77 identified PDs (66 males and 11 females) received industry payments, totaling $14,094,422 across 8028 transactions. The median payment was $16,716, with the maximum reaching $2,661,001. Male PDs and PDs in cardiac specialties received significantly higher payments. Research funding for PDs was awarded predominantly to males (100%). Significant disparities were observed in industry payments to PDs compared to non-PDs, especially in food and beverage and educational activities. PDs initially received more than double the research payments compared to non-PDs in the early years. This disparity was reduced significantly by 2021, reflecting a move toward more equitable research funding.

The substantial payment to PDs reflects their significant role in thoracic surgery but raises concerns regarding potential influence on trainees. These findings underscore the need for increased transparency and measures to address disparities in industry support, particularly concerning gender and specialty.