Training the thoracic surgeon

Abstract

T HORACIC SURGERY as a specialty has grown rapidly since World War I when chest injuries and disease were recognized as presenting peculiar problems and when, in 1917, a group of self-taught general surgeons with special interest in chest disease organized the American Association for Thoracic Surgery “to encourage and stimulate investigation and study that will increase the knowledge of intrathoracic physiology, pathology and therapy, and to correlate such knowledge and disseminate it.” Early membership of this association exemplified the need for a special organization with interest in thoracic surgery as surgeons, internists, physiologists, phthisiologists, radiologists, anesthetists, and endoscopists were included. It was recognized at the outset that to practice thoracic surgery at its best one needed command of more of the special knowledge of other fields than was common among surgeons. Diagnosis of pulmonary and cardiovascular disease, maintenance of cardiac and respiratory function during and after operations on the chest, and an understanding of thoracic physiology became necessary, and one had to be familiar with the vagaries of the tubercle bacillus and its effects on the body. On the other hand, and perhaps because many of the leaders in thoracic surgery have been general surgeons with a special interest in the chest, thoracic surgery to this date has remained more closely aligned with general surgery than has any of the other recognized surgical specialties in the affiliation of their respective examining boards and the stringent requirement of the thoracic board for general surgical training. This affiliation has been embodied further in the many surgical leaders who practice both general and thoracic surgery. A symposium at the meeting of the American Association for Thoracic Surgery in May