It Is the Journey, Not the Destination

Slides:

Advertisements

Similar presentations

Pulmonary Resection of Metastatic Sarcoma: Prognostic Factors Associated With Improved Outcomes Samuel Kim, MD, Harald C. Ott, MD, Cameron D. Wright, MD,

Advertisements

Factors affecting interest in cardiothoracic surgery: Survey of North American general surgery residents Ara A. Vaporciyan, MD, Carolyn E. Reed, MD,

Results of Coronary Artery Endarterectomy and Coronary Artery Bypass Grafting for Diffuse Coronary Artery Disease Srikrishna Sirivella, MD, Isaac Gielchinsky,

Frederick L. Grover, MD The Annals of Thoracic Surgery

Manuel Caceres, MD, Darryl S. Weiman, MD, JD

Thoracic Surgical Resident Education: A Costly Endeavor

Navigating the New “Flat World” of Cardiothoracic Surgery

Giovanni Mariscalco, MD, PhD, Francesco Musumeci, MD

John J. Squiers, MD, Kevin W. Lobdell, MD, James I. Fann, MD, J

Motivations and Demographics of I-6 and Traditional 5+2 Cardiothoracic Surgery Resident Applicants: Insights From an Academic Training Program Thomas.

Pediatric tracheal surgery

Impact of Medicaid Expansion on Cardiac Surgery Volume and Outcomes

Anastomotic complications after tracheal resection: Prognostic factors and management Cameron D. Wright, MD, Hermes C. Grillo, MD, John C. Wain, MD,

Benign broncho-esophageal fistula in the adult

Increased Exposure Improves Recruitment: Early Results of a Program Designed to Attract Medical Students Into Surgical Careers Kara A. Haggerty, BA,

The Society of Thoracic Surgeons Thoracic Surgery Practice and Access Task Force: 2014 Workforce Report John S. Ikonomidis, MD, PhD The Annals of Thoracic.

James M. Meza, MD, John E. Rectenwald, MD, Rishindra M. Reddy, MD

Factors affecting interest in cardiothoracic surgery: Survey of North American general surgery residents Ara A. Vaporciyan, MD, Carolyn E. Reed, MD,

Thoracic surgery workforce: snapshot at the end of the twentieth century and implications for the new millennium Richard J. Shemin, MD, Stanley W. Dziuban,

Robotic-Assisted Coronary Artery Bypass on a Beating Heart: Initial Experience and Implications for the Future William F. Turner, MD, John H. Sloan,

Sustained Supervised Practice on a Coronary Anastomosis Simulator Increases Medical Student Interest in Surgery, Unsupervised Practice Does Not Xiaoying.

Surgical Resection of a Giant Coronary Aneurysm

A Bright Future: Cardiothoracic Surgery Training in Transition

Public policy and the practicing physician

Intraoperative Temperature Control Using the Thermogard System During Off-pump Coronary Artery Bypass Grafting Gary S. Allen, MD The Annals of Thoracic.

Origins of the Cardiothoracic Surgery Network (CTSNet)

Mariano E. Brizzio, MD, Alex Zapolanski, MD, Richard E

Who Do You Say You Are? The Annals of Thoracic Surgery

Outcome of the Joint Council of Thoracic Surgery Education’s Early Review Course Project Mark S. Allen, MD, John H. Calhoon, MD, David Fullerton, MD,

Surgical economics: MACRA, MIPS, and bundles—Lessons learned in the first 3 years of a coronary artery bypass grafting alternative payment model Daniel.

Survival and function after sleeve lobectomy for lung cancer

Michael Lanuti, MD, Pierre E

Ashok Muniappan, MD, John C. Wain, MD, Cameron D. Wright, MD, Dean M

Graduate Subspecialty and Perceptions of Cardiothoracic Surgery Training: A 60-Year Retrospective Study Mara B. Antonoff, MD, Jessica G.Y. Luc, MD, G.

Terry Shih, MD, Justin B. Dimick, MD, MPH

Lymph Node Assessment and Impact on Survival in Video-Assisted Thoracoscopic Lobectomy or Segmentectomy Haiyu Zhou, MD, Luis F. Tapias, MD, Henning A.

Radiofrequency Ablation for Stage I Non-Small Cell Lung Cancer: Management of Locoregional Recurrence Michael Lanuti, MD, Amita Sharma, MD, Henning Willers,

Impact of Residency Status on Perfusion Times and Outcomes for Coronary Artery Bypass Graft Surgery Constance K. Haan, MD, Sarah Milford-Beland, MS,

Cardiothoracic surgery: A specialty divided or as one

Christina L. Costantino, MD, John L. Niles, MD, Cameron D

Rheumatoid Pleural Effusion in the Absence of Arthritic Disease

Trial of a novel synthetic sealant in preventing air leaks after lung resection John C Wain, MD, Larry R Kaiser, MD, David W Johnstone, MD, Stephen C.

Luis F. Tapias, MD, Christopher R. Morse, MD, Douglas J

Samuel Kim, MD, Harald C. Ott, MD, Cameron D. Wright, MD, John C

National Institutes of Health funding for cardiothoracic surgical research Mark B. Ratcliffe, MD, Cheryl Howard, MPH, Michael Mann, MD, Pedro del Nido,

Limitations of Hospital Volume as a Measure of Quality of Care for Coronary Artery Bypass Graft Surgery Karl F. Welke, MD, Mitchell J. Barnett, PharmD,

Esophageal Leiomyoma: A 40-Year Experience

Inhaled nitric oxide for adult respiratory distress syndrome after pulmonary resection Douglas J Mathisen, MD, Elbert Y Kuo, Chiwon Hahn, MD, Ashby C.

Long-segment colon interposition for acquired esophageal disease

Trends in Patient Characteristics and Outcomes of Coronary Artery Bypass Grafting in the 2000 to 2012 Medicare Population Christian McNeely, MD, Stephen.

Invited Commentary The Annals of Thoracic Surgery

Luis F. Tapias, MD, Douglas J. Mathisen, MD, Cameron D

The American Board of Thoracic Surgery: Update

The Society of Thoracic Surgeons General Thoracic Surgery Database 2017 Update on Outcomes and Quality Christopher W. Seder, MD, Daniel P. Raymond, MD,

On-Pump Versus Off-Pump Surgical Revascularization for Left Main Stem Stenosis: Risk Adjusted Outcomes John C.Y. Lu, Antony D. Grayson, BS, D. Mark Pullan

Improved Long-Term Survival for Diabetic Patients With Surgical Versus Interventional Revascularization Paul Kurlansky, MD, Morley Herbert, PhD, Syma.

“Transitions” for Cardiothoracic Surgeons Now Listed on the Web:

Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting Donald S. Likosky, PhD, Gaetano Paone, MD, MHSA, Min Zhang,

Management of Delayed Gastric Emptying After Esophagectomy With Endoscopic Balloon Dilatation of the Pylorus Michael Lanuti, MD, Pierre DeDelva, MD,

Impact of Cardiothoracic Resident Turnover on Mortality After Cardiac Surgery: A Dynamic Human Factor Jeffrey H. Shuhaiber, MD, Kimberley Goldsmith,

James A. DeWeese, MD Journal of Vascular Surgery

Are There Enough Jobs in Cardiothoracic Surgery

Dumbor L. Ngaage, MD, FRCS (C-Th), Michael E. Cowen, FRCS

Utilization and Outcomes of Unprotected Left Main Coronary Artery Stenting and Coronary Artery Bypass Graft Surgery Chuntao Wu, MD, PhD, Edward L. Hannan,

Lobectomy Versus Limited Resection in T1N0 Lung Cancer

Henning A. Gaissert, MD, Ning Lin, BS, John C

The Impact of New Technology on Cardiothoracic Surgical Practice

Influence of On-Pump Versus Off-Pump Techniques and Completeness of Revascularization on Long-Term Survival After Coronary Artery Bypass Omar M. Lattouf,

Location of the Second Internal Mammary Artery Graft Does Not Influence Outcome of Coronary Artery Bypass Grafting Paul A. Kurlansky, MD, Ernest A. Traad,

Long-Term Results of Sleeve Lobectomy in the Management of Non–Small Cell Lung Carcinoma and Low-Grade Neoplasms Robert E. Merritt, MD, Douglas J. Mathisen,

Presentation transcript:

It Is the Journey, Not the Destination Douglas J. Mathisen, MD The Annals of Thoracic Surgery Volume 93, Issue 5, Pages 1404-1415 (May 2012) DOI: 10.1016/j.athoracsur.2011.11.078 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Massachusetts General Hospital Thoracic Staff: (L-R) Ashok Muniappan, MD, Michael Lanuti, MD, John Wain, MD, Christopher Morse, MD, Dean Donahue, MD, James Allan, MD, Cameron Wright, MD, and Henning Gaissert, MD. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The Society of Thoracic Surgeons Staff. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (Left) Ashby Moncure, MD; (Middle) Hermes C. Grillo, MD; (Right), Earle W. Wilkins, MD. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Total applications (circles) and applications from United States graduates (squares) for available positions (triangles) from 1993 to 2010. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Reasons to choose cardiothoracic surgery. (Reprinted from J Thorac Cardiovasc Surg, Vol. 137, Vaporciyan AA, Reed CE, Erikson C, Dill MJ, Carpenter AJ, Guleserian KJ, Merrill W, Factors affecting interest in cardiothoracic surgery: Survey of North American general surgery residents, Pages 1054–1062, Copyright 2009, with permission from Elsevier [4]). The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Medicare coronary artery bypass grafting (CABG, squares) payment vs cardiothoracic (CT) residency applications (circles) from 1986 to 2010. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Mean age trend for thoracic surgeons. (*American College of Surgeons Health Policy Research Institute.) Note: The source of the past years' data is Thoracic Surgery Workforce: Survey at the End of the 20th Century and Implications for the New Millennium, 2001. 2002 STS/AATS Practice Survey. (Reprinted with permission from Elsevier.) The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 8 Projected year of retirement for cardiothoracic surgeons: 73% of cardiothoracic surgeons will retire by 2019. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 9 Declining number of active thoracic surgeons 1990–2010. Source: American Medical Association Physician Characteristics and Distribution. Includes physicians self-designating as cardiovascular surgery, cardiothoracic surgery, and thoracic surgery. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 10 The 2010 Thoracic Surgery Residents Association Workforce Study (General Surgery In-Service Exam). (Reprinted from Ann Thorac Surg, Vol. 92(6), Sarkaria IS, Carr SR, MacIver RH, et al. Results of the 2010 Thoracic Surgery Residents Association Workforce Survey: a view from the trenches, pages 2062–71, Copyright 2011, with permission from Elsevier [6].) The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 11 Survey of general surgery residents. The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 12 Resident perspective on Accreditation Council on Graduate Medical Education (ACGME) regulation of supervision and duty hours. (Reprinted from Drolet BC, Spalluto LB, Fischer SA, Residents' perspectives on ACGME Regulation of Supervision and Duty Hours—A national survey. N Engl J Med, Dec 2010;e34:1–5, with permission [8].) The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 13 Effect of work-hour restriction on operative experience in cardiothoracic surgical training. (Reprinted from J Thorac Cardiovasc Surg, Vol 137(3), Connors RC, Doty JR, Bull DA, May, HT, Fullerton DA, Robbins RC, Effect of work-hour restriction on operative experience in cardiothoracic surgical residency training, pages 710–713, Copyright 2009, with permission from Elsevier [9].) The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 14 Internal mammary artery (IMA) use in isolated coronary artery bypass grafting (CABG). The Society of Thoracic Surgeons (STS) (diamonds), Michigan (squares), and low IMA users (triangles). Courtesy of Richard Prager. (Reprinted from Ann Thorac Surg, Vol 90(4), Johnson SH, Theurer PF, Bell GF, Maresca L, Leyden T, et al, A statewide quality collaborative for process improvement: Internal mammary artery utilization, Pages 1158–1164, Copyright 2010, with permission from Elsevier [10].) The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Douglas J. Mathisen, MD The Annals of Thoracic Surgery 2012 93, 1404-1415DOI: (10.1016/j.athoracsur.2011.11.078) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions