Abstract
We appreciate the comments made by Tchantchaleishvili and Nguyen [1Tchantchaleishvili V. Nguyen T. What got you here won’t keep you there: Differences between cardiac- and thoracic-oriented applicants (letter).Ann Thorac Surg. 2019; 108: 959-960Abstract Full Text Full Text PDF Scopus (3) Google Scholar] regarding our article [2Davis T.A. Yang S.C. Unmatched integrated cardiothoracic surgery program applicants: where do they end up?.Ann Thorac Surg. 2018; 106: 1556-1560Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar], and we agree with the authors regarding our role in keeping general surgery (GS) trainees, especially those unmatched I-6 applicants, who are engaged and interested in pursuing a career within cardiothoracic surgery (CTS). A combined effort between medical school mentors and I-6 program directors in communicating the CTS interest of new GS trainees to their respective institution’s CTS faculty members would allow for early integration and interaction. Another viable option would be to increase the number of I-6 programs or positions available in the integrated training paradigm. If we were to follow this route, however, the authors wonder whether we would observe a higher attrition rate from these integrated programs (ie, maybe the same unmatched integrated program applicants who do not end up in CTS would be the same individuals who would drop out of integrated training if more positions were available and they were matched to the integrated pathway). It is clear that most candidates have a preference for integrated training versus traditional pathways (5+2/3 or 4/3 track); however, what we do not know is the balance point at which we have the right number of integrated positions to attract the largest number of excellent candidates while not leaving positions unfilled or accepting individuals who will later drop out of integrated training [2Davis T.A. Yang S.C. Unmatched integrated cardiothoracic surgery program applicants: where do they end up?.Ann Thorac Surg. 2018; 106: 1556-1560Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar]. There has also been some question regarding the appeal of a true integrated program focused on general thoracic surgery. We believe that there is a subgroup of individuals who would have considered a true integrated program focused on general thoracic surgery, and this could also attract candidates who did not consider I-6 programs given their interest in general thoracic versus cardiac surgery. What Got You Here Won’t Keep You There: Differences Between Cardiac- and Thoracic-Oriented ApplicantsThe Annals of Thoracic SurgeryVol. 108Issue 3PreviewWe read with great interest the manuscript by Davis and Yang [1] exploring where applicants who do not match in an integrated cardiothoracic surgery residency end up. Full-Text PDF
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