“Change in the wind”: report from the 2000 Thoracic Surgery Directors Association Retreat on Thoracic Surgery Graduate Medical Education

Abstract

In October, 1999, the American Board of Thoracic Surgery (ABTS) resolved that “the ABTS change current policy regarding American Board of Surgery (ABS) certification so that at a point in the future, yet to be determined, ABS certification will become optional.” This position was taken by the ABTS after exhaustive study and debate of the relevant issues and of evolving data pertinent to Thoracic Surgery Graduate Medical Education (TSGME), a topic of three major conferences in the last decade 1 and of the addresses of seven thoracic societal presidents, four of them in the last 6 years. Among the most provocative points that were considered by the Board were: (1) The vast expansion of fundamental knowledge and of operative approaches to cardiothoracic diseases currently required to educate the TS resident in a time-frame essentially unchanged since formal education in TS began in 1928; (2) a total duration of medical school and of GME that obligates the thoracic surgeon entering practice to be older, as compared to peers in other professions, and to be constrained by greater indebtedness; (3) a disturbingly diminished pool of applicants to TS residencies, with fewer US medical graduates applying than residency positions to fill; and (4) diminishing funding for TSGME occurring concomitantly with increasing financial burdens on academic thoracic surgery programs. The specific intent of the ABTS was to facilitate change if change were to be the desire of thoracic surgery educators and of the other parties in organized thoracic surgery vested with interest in, and responsibility for, the process and product of TSGME.