The Training of Congenital Heart Surgeons

Abstract

Congenital heart surgery is a specialty characterized by low error tolerance, a high level of cognitive and technical performance, and coordinated efforts of multiple individuals operating within a sophisticated organizational structure. Training in adult and pediatric cardiac surgery is undergoing major changes. In 2007, nearly one-third of American Board of Thoracic Surgery-certified training positions went unfilled. The reasons that are usually cited include a shrinking patient pool (mostly due to percutaneous coronary interventions), the perception of a poorer quality of life for cardiothoracic surgeons (compared to other specialties), declining reimbursements and salaries, a shrinking job market, increased legal challenges, and increased scrutiny by professional societies, payors, and government [9]. Congenital and pediatric heart surgery has been somewhat protected from these changes, although our ‘‘recruits’’ have traditionally come from the general ranks of cardiothoracic surgery trainees. In a recent survey, nearly one-quarter of cardiothoracic surgery training program graduates reported that they would not choose a career in cardiothoracic surgery again, and more than half would not strongly recommend cardiothoracic surgery to potential trainees [5]. The (Long) Road to Becoming a Congenital Heart Surgeon