Ten Years Into the Integrated Residency Era: A Pilot Study Shows Many Cardiothoracic Surgery Faculty Still Favor the Traditional Pathway

Abstract

The first integrated cardiothoracic surgery residents (I-6) graduated in 2013. Predominantly, there is still the option to pursue a traditional training pathway via general surgery residency followed by 2-3 years of specialized cardiothoracic surgery training. Our aim was to understand the perspectives of academic cardiothoracic faculty on the various training models. An anonymous web-based survey was distributed to all academic cardiothoracic surgeons in the United States. Respondents were asked about their perceptions of the 2 training models (I-6 and traditional). Descriptive statistics and Fisher exact test were used to analyze the data. A total of 15.4% (111/719) of faculty completed responses. When comparing training models, 23.4% of faculty believe the I-6 is a superior structure, 31.5% believe they are about the same, and 45.0% believe the traditional model is better. Also, 51.4% of the faculty said they would still apply into a traditional fellowship, with 27.9% picking an I-6 program and 20.7% picking a 4 + 3 model. A total of 40.5% believe the I-6 is good for the specialty and 55.0% think the I-6 attracts higher achieving applicants, but 26.1% and 19.8% believe it is improving training or increasing the scholarly activity of residents, respectively. When asked about resident experience, 56.4% of I-6 faculty feel there is a bias against their residents on the general surgery service, which some believe leads to poor educational outcomes for I-6 residents. The integrated residency represents a major shift in cardiothoracic surgery training. Faculty opinions vary regarding the quality and effectiveness of this model with many preferring the traditional model.