The evolution of cardiothoracic surgery training: from apprenticeship to AI-assisted simulation

A highly structured, technologically advanced educational paradigm has replaced the unstructured apprenticeship approach in the training of cardiothoracic surgeons. Early surgical education, which was historically based on the "see one, do one, teach one" principle, mostly depended on one-on-one mentoring and varying operative exposure, with the shortcomings of conventional training becoming more obvious as cardiothoracic surgery developed into a unique, high-stakes specialty requiring extraordinary technical accuracy and judgment. This evolution led to the implemention of standardized curricula, competency-based assessments, and simulation-based learning to ensure consistent skill acquisition and patient safety. In an increasingly digitized and globalized world, personalized learning pathways, objective skill evaluation, and remote training access are all made possible by recent developments in virtual reality (VR), artificial intelligence (AI), and real-time data analytics, further changing surgical education and thereby shaping the future of surgical proficiency.