Pursuit of advanced fellowships by thoracic surgery residents

Analyzing the pursuit of advanced cardiothoracic surgery training is important for determining the current educational paradigm. To this end, the advanced fellowship training pursued by both integrated 6-year (I-6) and traditional 2- or 3-year thoracic residency trainees was evaluated.

Publicly available trainee lists were collected from I-6 and traditional thoracic surgery residency programs. Demographic information on these trainees was collected via institutional pages and faculty profiles. The following data was collected: year of graduation from cardiothoracic surgery residency, any advanced fellowship training, type of advanced fellowship training, type of practice after completion of training, professorship level, any advanced degrees, and leadership positions.

A total of 671 cardiothoracic surgery trainees (I-6: 71, traditional: 600) who graduated between 2000 to 2021 from 57 training programs were analyzed. Of these 671 trainees, 179 (26.7%) pursued advanced fellowship training (I-6: 27 out of 71 [38%], traditional:152 out of 600 [25.3%]; P = .022). We found no difference in the pursuit of advanced adult fellowships between I-6 or traditional trainees (I-6: 14 out of 71 [19.7%], traditional: 87 out of 600 [14.5%]; P = .245). The majority of trainees who pursued advanced fellowship training have an academic practice (135 out of 179 [75.4%]; P < .0001). The rate of advanced fellowship training has not increased from 2000 to 2021.

The most common advanced fellowships for trainees were congenital, mechanical circulatory support/transplant, and aortic/endovascular surgery. I-6 trainees pursue congenital cardiac surgery and mechanical circulatory support at a higher rate compared with traditional trainees; however, they do not pursue advanced adult fellowships at a higher rate.